Form990
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 07-01-2013 , 2013, and ending 06-30-2014
BCheck if applicable:
CName of organization
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
6901 NORTH 72ND STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
OMAHA, NE68154
D Employer identification number

47-0376615
E Telephone number

G Gross receipts $ 252,265,154
F Name and address of principal officer:
CLIFF A ROBERTSON
12809 WEST DODGE ROAD
OMAHA,NE68154
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CHIHEALTH.COM
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 MediumBullet  
K Form of organization:
 
L Year of formation: 1904
M State of legal domicile: NE
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 8
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 1,829
6 Total number of volunteers (estimate if necessary) ............. 6 321
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 274,236
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -22,211
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 457,479 428,392
9 Program service revenue (Part VIII, line 2g) ......... 227,510,598 225,396,884
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 32,928,054 21,564,198
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 6,878,834 2,966,802
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 267,774,965 250,356,276
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 19,451,389 18,170,699
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) 111,872,954 79,563,596
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).... 100,778,105 132,470,011
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 232,102,448 230,204,306
19 Revenue less expenses. Subtract line 18 from line 12....... 35,672,517 20,151,970
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 603,353,569 673,155,371
21 Total liabilities (Part X, line 26)............. 130,841,202 145,509,945
22 Net assets or fund balances. Subtract line 21 from line 20..... 472,512,367 527,645,426
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 MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION.
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 $ 63,664,571 including grants of $ 5,280,280 ) (Revenue $ 64,965,494 )
ALEGENT HEALTH IMMANUEL MEDICAL CENTER MENTAL HEALTH PHYSICIANS ARE UNIQUE IN THEIR CARE-GIVING APPROACH TO EMOTIONAL AND BEHAVIORAL PROBLEMS OF CHILDREN, ADOLESCENTS, ADULTS AND SENIORS. PHYSICIANS PROVIDE THE MOST APPROPRIATE CARE AT THE LEVEL OF SERVICE THAT EACH PATIENT NEEDS. OUTPATIENT AND INPATIENT BEHAVIORAL SERVICE PROGRAMS ARE PROVIDED. RECENTLY, IMMANUEL MEDICAL CENTER BUILT THE RESIDENTIAL TREATMENT CENTER. THIS NEW STATE OF THE ART FACILITY FEATURES 20 PRIVATE ROOMS FOR BOYS AND GIRLS BETWEEN THE AGES OF SIX AND EIGHTEEN YEARS OF AGE.
4b (Code:   ) (Expenses $ 50,669,414 including grants of $ 4,202,474 ) (Revenue $ 51,704,795 )
ALEGENT HEALTH-IMMANUEL MEDICAL CENTER REHABILITATION CENTER PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT PROGRAMS FOR INDIVIDUALS OF ALL AGES. THE REHABILITATION CENTER IS THE REGION'S MOST COMPREHENSIVE CENTER FOR PHYSICAL MEDICINE AND REHABILITATION, OFFERING PATIENTS SOME OF THE MOST ADVANCED REHABILITATIVE TECHNOLOGY. IMMANUEL REHABILITATION CENTER HAS RECEIVED THE HIGHEST LEVEL OF ACCREDITATION AWARDED BY THE JOINT COMMISSION AND BY THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF). AT EVERY LEVEL OF CARE, A TEAM OF LICENSED AND CERTIFIED REHABILITATION PROFESSIONALS ARE AVAILABLE. EACH ONE OF THE REHABILITATION PROGRAMS ARE DESIGNED TO MAXIMIZE INDEPENDENCE AND QUALITY OF LIFE.
4c (Code:   ) (Expenses $ 48,608,046 including grants of $ 4,031,506 ) (Revenue $ 49,601,304 )
ALEGENT HEALTH-IMMANUEL MEDICAL CENTER CANCER SUPPORT AND DIAGNOSTIC TEAM IS COMPRISED OF A GROUP OF HEALTHCARE PROFESSIONALS WHO WORK TOGETHER IN A VARIETY OF WAYS TO HELP THE PATIENT AND FAMILY COPE WITH CANCER. EACH ONE OF THE PHYSICIANS ARE EQUIPPED TO DIAGNOSE AND AGGRESSIVELY TREAT CANCER AND GET PATIENTS BACK TO THERE LIFE AS SOON AS POSSIBLE. INDIVIDUAL TEAM MEMBERS INCLUDE CANCER SUPPORT SERVICE SPECIALISTS, MEDICAL SOCIAL WORKERS, CANCER REHABILITATION SPECIALIST, PASTORAL SERVICES, DIETITIANS, ONCOLOGY NURSE NAVIGATORS, HOSPICE & HOME CARE SERVICES, INPATIENT NURSING SERVICES, RADIATION ONCOLOGY, AND VOLUNTEER SERVICES.
(Code:   ) (Expenses $ 57,607,877 including grants of $ 4,656,439 ) (Revenue $ 59,066,722 )
ALEGENT HEALTH-IMMANUEL MEDICAL CENTER PROVIDES ADDITIONAL SERVICES INCLUDING BUT NOT LIMITED TO: WEIGHT MANAGEMENT, A 24 HOUR EMERGENCY DEPARTMENT, INPATIENT HOSPITAL FACILITIES, PROCEDURE CENTER, ORTHOPEDIC SERVICES, DIGESTIVE HEALTH CENTER, FAMILY LIFE CENTER, RADIOLOGY, UROLOGY, DIAGNOSTIC SERVICES AND PHYSICAL THERAPY. PATIENTS ARE AT THE CENTER OF EVERYTHING DONE AT ALEGENT HEALTH-IMMANUEL MEDICAL CENTER.
4d Other program services (Describe in Schedule O.)
(Expenses $ 57,607,877 including grants of $ 4,656,439 ) (Revenue $ 59,066,722 )
4e Total program service expensesMediumBullet220,549,908
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 I..........
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 I........................
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 II...
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 ....................
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 IV..............
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
Yes
 
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 VIII.......
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
Yes
 
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
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII .................
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.........
14b
 
No
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 IV
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...
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............ Click to see attachment
18
Yes
 
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 attachment
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
Yes
 
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................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
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........
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...................
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....................
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.........
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 ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV.....................
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...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
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........
33
 
No
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...
35b
 
No
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.............
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 VI
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
116
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
1,829
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
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
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
11
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
8
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
Yes
 
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
Yes
 
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
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
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:
MediumBulletJEANETTE WOJTALEWICZ12809 WEST DODGE ROADOMAHANE68154 (402) 343-4671
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) CLIFF ROBERTSON........................................................................
Board Member/CEO CHI Health
 1.00
.......................59.00 		X   X       0 761,591 100,446
(2) MICHAEL DEFREECE........................................................................
SECRETARY/TREASURER
 1.00
.......................11.00 		X   X       0 0 0
(3) RICHARD HACHTEN II........................................................................
Board Member/ACH President & CEO
 10.00
.......................39.00 		X   X       0 4,316,298 67,124
(4) RICHARD HERINK........................................................................
BOARD CHAIR
 1.00
.......................11.00 		X   X       0 0 0
(5) RICHARD J VIERK........................................................................
VICE CHAIR
 1.00
.......................11.00 		X   X       0 0 0
(6) BARRY SANDSTROM........................................................................
Board Member
 1.00
.......................12.00 		X           0 0 0
(7) DR MARYANNE STEVENS RSM........................................................................
Board Member
 1.00
.......................11.00 		X           0 0 0
(8) FR JAMES CLIFTON SJ........................................................................
Board Member
 1.00
.......................11.00 		X           0 0 0
(9) GREGORY HEIDRICK........................................................................
Board Member
 1.00
.......................12.00 		X           0 0 0
(10) H KEITH SCHMODE........................................................................
Board Member
 1.00
.......................11.00 		X           0 0 0
(11) LARRY BUTLER........................................................................
Board Member
 1.00
.......................11.00 		X           0 0 0
(12) MARTIN M MANCUSO MD........................................................................
Board Member
 1.00
.......................67.00 		X           0 416,092 25,222
(13) MICHAEL ROWAN FACHE........................................................................
Board member/CHI EVP & COO
 1.00
.......................69.00 		X           0 2,769,716 258,055
(14) PAUL EDGETT III........................................................................
Board Member/CHI SVP
 1.00
.......................54.00 		X           0 1,126,594 94,198
(15) ROBERT LANIK........................................................................
Board Member/CHI NE President/CEO
 1.00
.......................66.00 		X           0 1,314,093 48,200
(16) SISTER NADINE HEIMANN........................................................................
Board Member
 1.00
.......................11.00 		X           0 0 0
(17) JEANETTE WOJTALEWICZ........................................................................
CFO, CHI HEALTH
 5.00
.......................55.00 		    X       0 499,985 59,878
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) JOAN NEUHAUS........................................................................
CHI HEALTH SVP COO
 15.00
.......................45.00 		    X       0 881,905 35,871
(19) KENNETH LAWONN........................................................................
ACH SVP STRATEGY & TECH
 15.00
.......................45.00 		    X       0 722,060 44,976
(20) NANCY WALLACE........................................................................
SVP HR CHI HEALTH
 15.00
.......................60.00 		    X       0 441,427 37,539
(21) RICHARD ROLSTON MD........................................................................
ACC CEO
 4.00
.......................58.00 		    X       0 870,699 86,126
(22) RICK MILLER MD........................................................................
ACH SVP/CHIEF QUALITY OFFICER
 15.00
.......................45.00 		    X       0 615,417 36,323
(23) SCOTT WOOTEN........................................................................
ACH SVP/CFO
 14.00
.......................50.00 		    X       0 826,804 10,063
(24) AMY HATCHER........................................................................
VP DIVISIONAL FINANCE
 5.00
.......................55.00 		      X     0 361,979 29,782
(25) ANN SCHUMACHER........................................................................
PRESIDENT
 56.00
.......................4.00 		      X     0 481,946 51,280
(26) ELIZABETH LLEWELLYN........................................................................
VP MISSION INTEGRATION
 19.00
.......................42.00 		      X     0 295,802 28,154
(27) JANE CARMODY........................................................................
CHIEF NURSING OFFICER
 15.00
.......................46.00 		      X     0 482,759 29,502
(28) JASON YUNGTUM........................................................................
VP/REG GENERAL COUNSEL
 15.00
.......................52.00 		      X     0 322,322 30,216
(29) JOSEPH HOAGBIN MD........................................................................
CHIEF MEDICAL OFFICER
 28.00
.......................32.00 		      X     0 386,883 33,403
(30) KEVIN BONNEY........................................................................
VP CHIEF DEVELOPMENT OFFICER
 5.00
.......................55.00 		      X     0 212,088 278,707
(31) PATRICIA MASEK........................................................................
VP MEDICAL AFFAIRS
 19.00
.......................38.00 		      X     0 257,116 54,690
(32) SHEREE KEELY........................................................................
VP BEHAVIORAL
 20.00
.......................40.00 		      X     0 247,613 29,077
(33) STEVE HOUSTON........................................................................
SVP STRATEGY AND TECHNOLOGY
 18.00
.......................40.00 		      X     0 155,070 297,967
(34) TIM SCHNACK........................................................................
VP OPERATIONAL FINANCE
 9.00
.......................51.00 		      X     0 447,318 45,657
(35) AISHWARYA PATIL........................................................................
PHYSICIAN
 60.00
.......................0 		        X   238,268 0 18,904
(36) AMANDA KEEL........................................................................
PHYSICIAN
 60.00
.......................0 		        X   339,055 0 23,485
(37) CHRISTOPHER CRISCUOLO MD........................................................................
PHYSICIAN
 60.00
.......................0 		        X   348,051 0 0
(38) TYRUS SOARES MD........................................................................
PHYSICIAN
 60.00
.......................0 		        X   310,725 0 28,119
(39) WESLEY SMEAL MD........................................................................
PHYSICIAN
 60.00
.......................0 		        X   247,479 0 18,822
(40) ANTHONY HATCHER........................................................................
SECRETARY/TREASURER
 0.00
.......................60.00 		          X 0 443,555 34,367
(41) FRANK EMSICK........................................................................
FORMER FACILITIES OPS EXEC
 5.00
.......................14.00 		          X 0 190,241 20,446
(42) LARRY BROWN MD........................................................................
FORMER ACC CEO
 0.00
.......................60.00 		          X 0 382,005 47,203
(43) PAUL STRAWHECKER........................................................................
FORMER CHIEF DEVEL OFFICER
 4.00
.......................56.00 		          X 0 278,165 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,483,578 20,507,543 2,003,802
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet59
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
Yes
 
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
COMPHEALTH ASSOCIATESPO BOX 972625DALLASTX75397 MEDICAL SERVICES 876,959
CASSLING DIAGNOSTIC IMAGING INC13808 F STREETOMAHANE68137 DIAGNOSTIC IMAGING SERVICES 802,705
MCCARTHY BUILDING COMPANIES INC936 N 24TH STREETOMAHANE68102 CONSTRUCTION SERVICES 681,385
AMERITEX SERVICES1321 SOUTH 20TH STREETOMAHANE68108 LAUNDRY SERVICES 434,788
MMC MECHANICAL CONTRACTORS INC9751 S 142ND STREETOMAHANE68138 MAINTENACE SERVICES 356,770
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet14
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b 107,400
c Fundraising events....1c 42,169
d Related organizations...1d 272,173
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		6,650
g Noncash contributions included in lines
1a-1f:$ 		46,739
h Total. Add lines 1a-1f.......MediumBullet 428,392
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICES 900099 216,340,413 216,340,413    
b MEANINGFUL USE REVENUE 900099 1,448,290 1,448,290    
c HOSPITAL PHARMACY 446110 1,520,319 1,520,319    
d FOOD AND NUTRITION 722100 556,700 556,700    
e MEDICAL SERVICES 621300 763,284 760,841 2,443  
f All other program service revenue . 4,767,878 4,711,752 56,126 0
g Total. Add lines 2a–2f........MediumBullet 225,396,884
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 9,909,373   -24,839 9,934,212
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 1,894,045  
b Less: rental expenses 1,561,924  
c Rental income or (loss) 332,121 0
d Net rental income or (loss).......MediumBullet 332,121     332,121
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 11,606,926 47,899
b Less: cost or other basis and sales expenses    
c Gain or (loss) 11,606,926 47,899
d Net gain or (loss)..........MediumBullet 11,654,825     11,654,825
8a Gross income from fundraising events (not including
$ 42,169
of contributions reported on line 1c). See Part IV, line 18 ..
a 85,348
b Less: direct expenses ...b 125,516
c Net income or (loss) from fundraising events..MediumBullet -40,168   -40,168
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 13,370
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 13,370     13,370
10a Gross sales of inventory, less
returns and allowances .
a 358,652
b Less: cost of goods sold ..b 221,438
c Net income or (loss) from sales of inventory..MediumBullet 137,214     137,214
Miscellaneous Revenue Business Code
11a CHILD CARE 624410 1,026,119   240,506 785,613
b WELLNESS SERVICES 900099 207,071     207,071
c     0      
d All other revenue .... 1,291,075 0 0 1,291,075
e Total. Add lines 11a–11d ...... MediumBullet 2,524,265
12 Total revenue. See Instructions......MediumBullet 250,356,276 225,338,315 274,236 24,315,333
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 72,467 72,467
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 18,098,232 18,098,232
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 1,276,104 1,212,299 63,805  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 60,714,745 57,679,008 3,035,737  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,050,499 997,974 52,525  
9 Other employee benefits ....... 11,971,689 11,373,105 598,584  
10 Payroll taxes ........... 4,550,559 4,323,031 227,528  
11 Fees for services (non-employees):        
a Management ...... 1,849,588 1,757,109 92,479  
b Legal ......... 3,470   3,470  
c Accounting ........... 0      
d Lobbying ........... 5,497 5,497    
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 1,542,097 1,464,992 77,105  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 20,051,244 18,950,336 1,100,908 0
12 Advertising and promotion .... 13,872 13,178 694  
13 Office expenses ....... 5,159,501 4,901,526 257,975  
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 5,320,596 5,054,266 266,330  
17 Travel ............ 171,675 163,091 8,584  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 5,994 5,694 300  
20 Interest ........... 5,759,505 5,759,505    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 11,608,461 11,028,038 580,423  
23 Insurance .............. 852,057 809,454 42,603  
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 UNRELATED BUSINESS TAXES 2,925 2,925    
b BAD DEBTS 15,084,878 15,084,878    
c MEDICAL SUPPLIES 22,531,471 21,404,897 1,126,574  
d INTERCOMPANY ALLOCATIONS 38,808,924 36,868,478 1,940,446  
e All other expenses 3,698,256 3,519,928 178,328 0
25 Total functional expenses. Add lines 1 through 24e 230,204,306 220,549,908 9,654,398 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). 0      
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 ............. 2,877,297 1 211,401
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 26,054,466 4 28,967,237
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 .............   7  
8 Inventories for sale or use .............. 2,634,344 8 3,080,023
9 Prepaid expenses and deferred charges .......... 230,776 9 114,025
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 146,540,409
b Less: accumulated depreciation ..... 10b 18,901,223 138,320,708 10c 127,639,186
11 Investments—publicly traded securities .......... 418,189,987 11  
12 Investments—other securities. See Part IV, line 11 ..... 0 12 422,406,426
13 Investments—program-related. See Part IV, line 11 ..... 10,534,594 13 9,665,458
14 Intangible assets ............... 3,704,442 14  
15 Other assets. See Part IV, line 11 ........... 806,955 15 81,071,615
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 603,353,569 16 673,155,371
Liabilities 17 Accounts payable and accrued expenses ......... 4,189,494 17 15,849,606
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 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 ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 126,651,708 25 129,660,339
26 Total liabilities. Add lines 17 through 25......... 130,841,202 26 145,509,945
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 .............. 472,419,042 27 527,552,101
28 Temporarily restricted net assets ........... 93,325 28 93,325
29 Permanently restricted net assets ...........   29  
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 ........... 472,512,367 33 527,645,426
34 Total liabilities and net assets/fund balances ........ 603,353,569 34 673,155,371
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
250,356,276
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
230,204,306
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
20,151,970
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
472,512,367
5
Net unrealized gains (losses) on investments ...............
5
35,906,143
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
-925,053
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
527,645,426
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
 
No
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
 
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID: 13000248
Software Version: 2013v3.1
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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number

47-0376615
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
 
15
15
 
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: 13000248
Software Version: 2013v3.1
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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number

47-0376615
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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
  		Employer identification number

47-0376615
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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
  		Employer identification number

47-0376615
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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
  		Employer identification number

47-0376615
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: 13000248
Software Version: 2013v3.1
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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number

47-0376615
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).Click to see attachment
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) ......   0
b Total lobbying expenditures to influence a legislative body (direct lobbying) ....... 5,497 169,386
c Total lobbying expenditures (add lines 1a and 1b) ................... 5,497 169,386
d Other exempt purpose expenditures ........................ 220,544,411 958,094,759
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 220,549,908 958,264,145
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000 1,000,000
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) ................. 250,000 250,000
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................   0
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................ 0 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 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		6,000,000
c Total lobbying expenditures 106,741 193,039 211,323 169,386 680,489
d Grassroots nontaxable amount 250,000 250,000 250,000 250,000 1,000,000
e Grassroots ceiling amount
(150% of line 2d, column (e))		 1,500,000
f Grassroots lobbying expenditures   0 0 0 0
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? .........................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
 
c
Media advertisements? ....................................
 
 
 
d
Mailings to members, legislators, or the public? .........................
 
 
 
e
Publications, or published or broadcast statements? .......................
 
 
 
f
Grants to other organizations for lobbying purposes? .......................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
 
 
i
Other activities? ..........................
 
 
 
j
Total. Add lines 1c through 1i ...............................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
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? .......
 
 
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 (Form 990 or 990EZ) 2013

Additional Data


Software ID: 13000248
Software Version: 2013v3.1

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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number

47-0376615
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 .... 3,074,442 3,486,427 3,218,021 2,938,870 2,665,977
b Contributions ........ 278,063 371,183 176,396 5,001 126,695
c Net investment earnings, gains, and losses 687,126 208,849 143,624 464,742 298,938
d Grants or scholarships ..... 298,447 326,703 4,500 6,642 9,996
e Other expenditures for facilities
and programs ........ 		0 665,314 47,114 183,950 142,744
f Administrative expenses ....          
g End of year balance ...... 3,741,184 3,074,442 3,486,427 3,218,021 2,938,870
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 Bullet  
c
Temporarily restricted endowment SchDMd Bullet100.000 %
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)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
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 .................   17,222,007 17,222,007
b Buildings ................   87,141,750 7,384,120 79,757,630
c Leasehold improvements ............   258,419 89,342 169,077
d Equipment ................   32,584,375 10,318,260 22,266,115
e Other .................   9,333,858 1,109,501 8,224,357
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 127,639,186
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 0  
(2)Closely-held equity interests 0  
(3)Other
(A) CHI OIP - FIXED INCOME 		205,565,925 F

(B) CHI OIP - EQUITY SECURITIES 		216,840,498 F

(C) CHI OIP - MONEY MARKET 		3 F






Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 422,406,426
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
(1) INTERCOMPANY RECEIVABLES 81,071,615








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 81,071,615
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
LONG TERM DEBT TO RELATED ENTITIES 119,379,614
OTHER CURRENT LIABILITIES 1,443,710
ENVIRONMENTAL REMEDIATION LIABILITY 494,537
OTHER INTERCOMPANY LIABILITY 8,342,478





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 129,660,339
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  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
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
Schedule D, Part V, Line 4, Intended uses of endowment funds ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF ALEGENT HEALTH-IMMANUEL MEDICAL CENTER.
Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote ALEGENT HEALTH-IMMANUEL MEDICAL CENTER'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2014 READS AS FOLLOWS: "CHI IS A TAX-EXEMPT COLORADO CORPORATION AND HAS BEEN GRANTED AN EXEMPTION FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CHI OWNS CERTAIN TAXABLE SUBSIDIARIES AND ENGAGES IN CERTAIN ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE AND THEREFORE SUBJECT TO INCOME TAX. MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS."
Schedule D (Form 990) 2013

Additional Data


Software ID: 13000248
Software Version: 2013v3.1




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
right arrowInformation about Schedule G (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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number

47-0376615
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

A NIGHT TO CELEBRATE
(event type) 		(b) Event #2

 
(event type) 		(c) Other events

 
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 127,517     127,517
2 Less: Contributions . . 42,169     42,169
3 Gross income (line 1
minus line 2) . . . 		85,348 0 0 85,348
VerticalDirectExpenses 4 Cash prizes . . .       0
5 Noncash prizes . . 46,739     46,739
6 Rent/facility costs . . 2,500     2,500
7 Food and beverages . 32,120     32,120
8 Entertainment . . .       0
9 Other direct expenses . 44,157     44,157
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 125,516
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow -40,168
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
%
%
%
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2013
Additional Data


Software ID: 13000248
Software Version: 2013v3.1
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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number

47-0376615
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
 
No
%
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
 
No
%
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
 
No
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
 
 
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) .. 		  5,639 7,027,791   7,027,791 3.270 %
b Medicaid (from Worksheet 3,
column a) .... 		  3,068 38,346,285 16,560,101 21,786,184 10.130 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		    1,463,953 1,098,459 365,494 0.170 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		0 8,707 46,838,029 17,658,560 29,179,469 13.570 %
Other Benefits
 29 8,830 599,710 36,705 563,005 0.260 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		9 1,799 966,286 216,742 749,544 0.350 %
g Subsidized health services
(from Worksheet 6) .. 		1   213,715 124,423 89,292 0.040 %
h Research (from Worksheet 7) 1   32,862   32,862 0.020 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		7 3,391 129,656   129,656 0.060 %
j Total. Other Benefits .. 47 14,020 1,942,229 377,870 1,564,359 0.730 %
k Total. Add lines 7d and 7j . 47 22,727 48,780,258 18,036,430 30,743,828 14.300 %
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         0 0 %
2 Economic development         0 0 %
3 Community support 1   75   75 0 %
4 Environmental improvements         0 0 %
5 Leadership development and training for community members         0 0 %
6 Coalition building 1   7,830   7,830 0 %
7 Community health improvement advocacy 1 9 28   28 0 %
8 Workforce development 3 83 2,327   2,327 0 %
9 Other         0 0 %
10 Total 6 92 10,260 0 10,260 0 %
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
4,552,616
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
0
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
39,543,601
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
42,607,839
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-3,064,238
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 %
1
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?1
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 ALEGENT HEALTH IMMANUEL MEDICAL CENTER
6901 NORTH 72ND STREET
OMAHA,NE68122
WWW.ALEGENTCREIGHTON.COM
NE 260002 		X 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)
ALEGENT HEALTH IMMANUEL MEDICAL CENTER
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 12
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   No
If "Yes," indicate the FPG family income limit for eligibility for free care:   %
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11   No
If "Yes," indicate the FPG family income limit for eligibility for discounted care:   %
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
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
Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: ACH SERVED AS A KEY MEMBER OF THE STEERING COMMITTEE FOR A TRI-COUNTY CHNA LED BY LOCAL HEALTH DEPARTMENTS; THE FOLLOWING LEADERS PARTICIPATED IN SURVEY CREATION, FOCUS GROUPS AND DISSEMINATING RESULTS. INPUT FROM THE GREATER COMMUNITY WAS ALSO OBTAINED IN THE CHNA PROCESS VIA SURVEY AND KEY INFORMANT INTERVIEWS WITH OVERSAMPLES TO INTENTIONALLY HEAR FROM UNDERSERVED POPULATIONS OF BLACK/AFRICAN AMERICAN RESIDENTS AND HISPANIC RESIDENTS. COMMUNITY REPRESENTATIVES AND THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE AS TO THE HEALTH NEEDS OF THE SERVICE AREA PARTICIPATED IN FIVE FOCUS GROUPS WITH 88 KEY INFORMANTS. ALEGENT CREIGHTON HEALTH- * BETH LLEWELLYN-VICE PRESIDENT MISSION INTEGRATION * MIKKI FROST -DIRECTOR COMMUNITY BENEFIT AND HEALTHIER COMMUNITIES DOUGLAS COUNTY HEALTH DEPARTMENT- * ADI POUR -HEALTH DIRECTOR LIVE WELL OMAHA- * KERRI PETERSON -EXECUTIVE DIRECTOR METHODIST HEALTH SYSTEM- * KEN KLAASMEYER- VICE PRESIDENT * RUTH FREED-FOUNDATION POTTAWATTAMIE HEALTH DEPARTMENT/VNA- * KRIS STAPP-VISITING NURSES ASSOCIATION SARPY/CASS COUNTY HEALTH DEPARTMENT- * DIANE KELLY-DIRECTOR THE NEBRASKA MEDICAL CENTER- * LESLIE UTTECHT - COMMUNITY RELATIONS LIAISON * TADD PULLIN- VICE PRESIDENT MARKETING, PLANNING AND NETWORK OPERATIONS PRC IS A NATIONALLY RECOGNIZED CONSULTING FIRM WITH EXTENSIVE EXPERIENCE CONDUCTING CHNAS SINCE 1994. THIS CHNA IS AN UPDATE TO THE CHNAS CONDUCTED BY PRC IN 2002 AND 2008 THAT WERE USED TO DEVELOP A COMMUNITY REPORT CARD, DIALOGUE AND PRIORITIES THROUGH THE LIVE WELL OMAHA COALITION. ;
Schedule H, Part V Sec B, Line 4, Other Hospital Facilities included in Needs Assessment (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: ALEGENT CREIGHTON HEALTH INVESTED IN THE CHNA AND SERVED AS AN EQUAL PARTNER WITH THE TWO OTHER HEALTH SYSTEMS SERVING THE SAME MSA; THE NEBRASKA MEDICAL CENTER AND METHODIST HEALTH SYSTEM. CHILDREN'S HOSPITAL AND MEDICAL CENTER CONDUCTED A SEPARATE ASSESSMENT FOCUSED ON CHILDREN. ;
Schedule H, Part V Sec B, Line 5d, Availability of Needs Assessment (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: THE CHNA RESULTS WERE SHARED WITH THE COMMUNITY AT AN ANNUAL HEALTH SUMMIT FACILITATED BY LIVE WELL OMAHA - A 35 MEMBER HEALTHY COMMUNITY COLLABORATION, AND CONTINUES TO BE A KEY FINANCIAL SUPPORTER AND MEMBER OF THE BOARD OF THE DIRECTORS OF THE ORGANIZATION. IN ADDITION, THE DATA IS SHARED ON AN EASILY ACCESSIBLE, PUBLIC WEBSITE WWW.DOUGLASCOHEALTH.ORG THAT IS PARTIALLY FUNDED BY ALEGENT CREIGHTON HEALTH AND OTHER AREA HOSPITALS INCLUDING THE NEBRASKA MEDICAL CENTER AND METHODIST HEALTH SYSTEM TO SHARE TRI-COUNTY HEALTH DATA AND BEST PRACTICES. ;
Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: TWO HEALTH NEEDS IDENTIFIED IN THE PRIMARY DATA WILL NOT BE ADDRESSED BY THE HOSPITAL: 1) ORAL HEALTH; AND 2) SEXUALLY TRANSMITTED DISEASES. CURRENTLY, ACH DOES NOT OFFER ANY ORAL HEALTH CARE OR FUTURE PLANS TO PROVIDE DIRECT ORAL HEALTH CARE. OTHER ORGANIZATIONS SUCH AS CREIGHTON SCHOOL OF DENTISTRY AND BUILDING HEALTHY FUTURES ARE TAKING ON THIS ISSUE. SEXUALLY TRANSMITTED DISEASE IS ALSO AN ISSUE THAT IS COVERED BY OTHER KEY ORGANIZATIONS SUCH AS THE DOUGLAS COUNTY HEALTH DEPARTMENT, FEDERALLY QUALIFIED HEALTH CENTERS, THE NEBRASKA AIDS PROJECT, ETC. THE FINAL LIST OF HEALTH PRIORITIES SELECTED BY THE COMMUNITY IS BEING ADDRESSED BY ACH IN EITHER SYSTEM-WIDE OR INDIVIDUAL HOSPITAL IMPLEMENTATION STRATEGIES.;
Schedule H, Part V Sec B, Line 10, Used federal poverty guidelines (FPG) to determine eligibility (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: ALEGENT HEALTH-IMMANUEL MEDICAL CENTER BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORDS THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25%-100% OF CHARGES;
Schedule H, Part V Sec B, Line 11, Eligibility for Discounted Care (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: ALEGENT HEALTH-IMMANUEL MEDICAL CENTER BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORDS THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25%-100% OF CHARGES;
Schedule H, Part V Sec B, Line 12i, Other factors used in determining amounts charged to patients (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: SIZE OF FAMILY IS ALSO USED IN THE CALCULATION.;
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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?1
Name and address Type of Facility (describe)
1 AH IMMANUEL FONTENELLE HOME
6809 NORTH 68TH PLAZA
OMAHA,NE68152 		SKILLED NURSING FACILITY
2
3
4
5
6
7
8
9
10
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
Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: ACH SERVED AS A KEY MEMBER OF THE STEERING COMMITTEE FOR A TRI-COUNTY CHNA LED BY LOCAL HEALTH DEPARTMENTS; THE FOLLOWING LEADERS PARTICIPATED IN SURVEY CREATION, FOCUS GROUPS AND DISSEMINATING RESULTS. INPUT FROM THE GREATER COMMUNITY WAS ALSO OBTAINED IN THE CHNA PROCESS VIA SURVEY AND KEY INFORMANT INTERVIEWS WITH OVERSAMPLES TO INTENTIONALLY HEAR FROM UNDERSERVED POPULATIONS OF BLACK/AFRICAN AMERICAN RESIDENTS AND HISPANIC RESIDENTS. COMMUNITY REPRESENTATIVES AND THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE AS TO THE HEALTH NEEDS OF THE SERVICE AREA PARTICIPATED IN FIVE FOCUS GROUPS WITH 88 KEY INFORMANTS. ALEGENT CREIGHTON HEALTH- * BETH LLEWELLYN-VICE PRESIDENT MISSION INTEGRATION * MIKKI FROST -DIRECTOR COMMUNITY BENEFIT AND HEALTHIER COMMUNITIES DOUGLAS COUNTY HEALTH DEPARTMENT- * ADI POUR -HEALTH DIRECTOR LIVE WELL OMAHA- * KERRI PETERSON -EXECUTIVE DIRECTOR METHODIST HEALTH SYSTEM- * KEN KLAASMEYER- VICE PRESIDENT * RUTH FREED-FOUNDATION POTTAWATTAMIE HEALTH DEPARTMENT/VNA- * KRIS STAPP-VISITING NURSES ASSOCIATION SARPY/CASS COUNTY HEALTH DEPARTMENT- * DIANE KELLY-DIRECTOR THE NEBRASKA MEDICAL CENTER- * LESLIE UTTECHT - COMMUNITY RELATIONS LIAISON * TADD PULLIN- VICE PRESIDENT MARKETING, PLANNING AND NETWORK OPERATIONS PRC IS A NATIONALLY RECOGNIZED CONSULTING FIRM WITH EXTENSIVE EXPERIENCE CONDUCTING CHNAS SINCE 1994. THIS CHNA IS AN UPDATE TO THE CHNAS CONDUCTED BY PRC IN 2002 AND 2008 THAT WERE USED TO DEVELOP A COMMUNITY REPORT CARD, DIALOGUE AND PRIORITIES THROUGH THE LIVE WELL OMAHA COALITION. ;
Schedule H, Part V Sec B, Line 4, Other Hospital Facilities included in Needs Assessment (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: ALEGENT CREIGHTON HEALTH INVESTED IN THE CHNA AND SERVED AS AN EQUAL PARTNER WITH THE TWO OTHER HEALTH SYSTEMS SERVING THE SAME MSA; THE NEBRASKA MEDICAL CENTER AND METHODIST HEALTH SYSTEM. CHILDREN'S HOSPITAL AND MEDICAL CENTER CONDUCTED A SEPARATE ASSESSMENT FOCUSED ON CHILDREN. ;
Schedule H, Part V Sec B, Line 5d, Availability of Needs Assessment (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: THE CHNA RESULTS WERE SHARED WITH THE COMMUNITY AT AN ANNUAL HEALTH SUMMIT FACILITATED BY LIVE WELL OMAHA - A 35 MEMBER HEALTHY COMMUNITY COLLABORATION, AND CONTINUES TO BE A KEY FINANCIAL SUPPORTER AND MEMBER OF THE BOARD OF THE DIRECTORS OF THE ORGANIZATION. IN ADDITION, THE DATA IS SHARED ON AN EASILY ACCESSIBLE, PUBLIC WEBSITE WWW.DOUGLASCOHEALTH.ORG THAT IS PARTIALLY FUNDED BY ALEGENT CREIGHTON HEALTH AND OTHER AREA HOSPITALS INCLUDING THE NEBRASKA MEDICAL CENTER AND METHODIST HEALTH SYSTEM TO SHARE TRI-COUNTY HEALTH DATA AND BEST PRACTICES. ;
Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: TWO HEALTH NEEDS IDENTIFIED IN THE PRIMARY DATA WILL NOT BE ADDRESSED BY THE HOSPITAL: 1) ORAL HEALTH; AND 2) SEXUALLY TRANSMITTED DISEASES. CURRENTLY, ACH DOES NOT OFFER ANY ORAL HEALTH CARE OR FUTURE PLANS TO PROVIDE DIRECT ORAL HEALTH CARE. OTHER ORGANIZATIONS SUCH AS CREIGHTON SCHOOL OF DENTISTRY AND BUILDING HEALTHY FUTURES ARE TAKING ON THIS ISSUE. SEXUALLY TRANSMITTED DISEASE IS ALSO AN ISSUE THAT IS COVERED BY OTHER KEY ORGANIZATIONS SUCH AS THE DOUGLAS COUNTY HEALTH DEPARTMENT, FEDERALLY QUALIFIED HEALTH CENTERS, THE NEBRASKA AIDS PROJECT, ETC. THE FINAL LIST OF HEALTH PRIORITIES SELECTED BY THE COMMUNITY IS BEING ADDRESSED BY ACH IN EITHER SYSTEM-WIDE OR INDIVIDUAL HOSPITAL IMPLEMENTATION STRATEGIES.;
Schedule H, Part V Sec B, Line 10, Used federal poverty guidelines (FPG) to determine eligibility (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: ALEGENT HEALTH-IMMANUEL MEDICAL CENTER BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORDS THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25%-100% OF CHARGES;
Schedule H, Part V Sec B, Line 11, Eligibility for Discounted Care (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: ALEGENT HEALTH-IMMANUEL MEDICAL CENTER BASES ITS FINANCIAL ASSISTANCE ELIGIBILITY ON HUD'S 130% OF VERY LOW INCOME GUIDELINES BASED ON GEOGRAPHY, AND AFFORDS THE UNINSURED AND UNDERINSURED THE ABILITY TO OBTAIN FINANCIAL ASSISTANCE WRITE-OFFS, BASED ON A SLIDING SCALE, RANGING FROM 25%-100% OF CHARGES;
Schedule H, Part V Sec B, Line 12i, Other factors used in determining amounts charged to patients (1) - ALEGENT HEALTH IMMANUEL MEDICAL CENTER: SIZE OF FAMILY IS ALSO USED IN THE CALCULATION.;
Schedule H (Form 990) 2013
Additional Data


Software ID: 13000248
Software Version: 2013v3.1
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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number
47-0376615
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) ALEGENT CREIGHTON HEALTH FOUNDATION
12809 W DODGE ROAD
OMAHA,NE68154 		47-0648586 501(C)(3) 47,037   BOOK   GENERAL SUPPORT
(2) AMERICAN CANCER SOCIETY
3721 23RD STREET
ST CLOUD,MN56301 		41-0724036 501(C)(3) 5,000   BOOK   GENERAL SUPPORT




















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
 
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
(1) FINANCIAL ASSISTANCE/CHARITY CARE 5639   18,092,732 FMV REDUCTION OR WRITE OFF OF PATIENT SERVICES
(2) SCHOLARSHIPS 15 5,500      










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
SCHEDULE I, PART III, SCHOLARSHIPS SISTER INGEBORG BLOMBERG SCHOLARSHIP: SCHOLARSHIPS ARE PROVIDED BY THE IMMANUEL MEDICAL CENTER AUXILIARY TO PROVIDE CONTINUING EDUCATION FOR ALEGENT HEALTH - IMMANUEL MEDICAL CENTER EMPLOYEES FOR THEIR PERSONAL GROWTH AND/OR PROFESSIONAL DEVELOPMENT, ALL PERMANENT, FULL-TIME AND PART-TIME EMPLOYEES IN GOOD STANDING WHO HAVE SIX MONTHS OR MORE OF SERVICE WITH ALEGENT HEALTH - IMMANUEL MEDICAL CENTER MAY APPLY FOR THE SCHOLARSHIPS. PAYMENT FOR TUITION, LAB FEES, BOOKS AND REGISTRATION EXPENSES WILL BE MADE DIRECTLY TO THE INSTITUTION UPON RECEIPT OF A STATEMENT OF COSTS FROM THE INSTITUTION. THE AWARDING OF THE SISTER INGEBORG BLOMBERG SCHOLARSHIP SHALL BE SUBJECT TO THE FOLLOWING CRITERIA: 1 APPLICATION IS MADE PRIOR TO MAKING A COMMITMENT TO THE SCHOOL 2. THE SCHOOL AND COURSE ARE OF RECOGNIZED STANDING 3. THE EMPLOYEE CONTINUES TO MAINTAIN HIS/HER REGULARLY SCHEDULED WORKING HOURS 4. THE EMPLOYEE SHALL SIGN AN AUTHORIZATION ALLOWING THE AUXILIARY TO RECEIVE WRITTEN CERTIFICATION OF PERFORMANCE FROM THE INSTITUTION 5. IT IS EVIDENT THAT THE COURSE, OR COURSES ARE MUTUALLY BENEFICIAL TO THE EMPLOYEE AND TO ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6. THE EMPLOYEE IS EXPECTED TO REMAIN EMPLOYED AT ALEGENT HEALTH - IMMANUEL MEDICAL CENTER FOR AT LEAST ONE YEAR AFTER RECEIVING THE SISTER INGEBORG BLOMBERG SCHOLARSHIP. ALEGENT HEALTH - IMMANUEL MEDICAL CENTER OCCASIONALLY DISTRIBUTES FUNDS TO OTHER 501(C)(3) ORGANIZATIONS. THESE DISTRIBUTIONS ARE MONITORED TO ENSURE THEY ARE BEING USED AS SPECIFIED BY THE ORGANIZATION.
SCHEDULE I, PART II, FINANCIAL ASSISTANCE/CHARITY CARE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER RECOGNIZES THE RIGHT TO QUALITY HEALTHCARE REGARDLESS OF AGE, SEX, RACE, RELIGION, NATIONAL ORIGIN, OR ABILITY TO PAY. BUSINESS OFFICE STAFF HELPS PATIENTS SEEK LOCAL, STATE, AND FEDERAL REIMBURSEMENT AT NO CHARGE WHEN NO OTHER SOURCE OF PAYMENT IS AVAILABLE. FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS WITH DEMONSTRATED INABILITY TO PAY FOR MEDICALLY NECESSARY SERVICES. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE.
Schedule I, Part I, Line 2, Procedures for monitoring use of grant funds MOST DISBURSEMENTS IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PROGRAMS ARE MADE DIRECTLY IN THE ACTIVE CONDUCT OF THE ACTIVITIES CONSTITUTING THE EXEMPT PURPOSE OR FUNCTION OF THE ORGANIZATION. OTHERWISE, DISTRIBUTIONS IN FURTHERANCE OF THE INSTITUTION'S EXEMPT PROGRAMS ARE MADE IN ACCORDANCE WITH PROCEDURES SUBJECT TO CONDITIONS ESTABLISHED BY THE INSTITUTION'S GOVERNING BOARD OR MANAGEMENT DESIGNED TO ENSURE THAT RECIPIENTS OF SUCH DISBURSEMENTS FROM THE ORGANIZATION ARE ADEQUATELY INVESTIGATED AND GRANTED TO QUALIFIED RECIPIENTS.
Schedule I (Form 990) 2013


Additional Data


Software ID: 13000248
Software Version: 2013v3.1


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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number

47-0376615
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
Yes
 
b
Any related organization? .........................
6b
Yes
 
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)ANTHONY HATCHERSECRETARY/TREASURER (i)
(ii)		 0
432,222 		0
0 		0
11,333 		0
17,850 		0
16,517 		0
477,922 		0
0
(2)RICHARD HACHTEN IIBOARD MEMBER/ACH PRESIDENT & CEO (i)
(ii)		 0
1,002,940 		0
3,138,518 		0
174,840 		0
53,071 		0
14,053 		0
4,383,422 		0
155,803
(3)CLIFF ROBERTSONBOARD MEMBER/CEO CHI HEALTH (i)
(ii)		 0
575,759 		0
114,665 		0
71,167 		0
77,744 		0
22,702 		0
862,037 		0
48,435
(4)PAUL EDGETT IIIBOARD MEMBER/CHI SVP (i)
(ii)		 0
496,880 		0
515,695 		0
114,019 		0
72,192 		0
22,006 		0
1,220,792 		0
92,265
(5)ROBERT LANIKBOARD MEMBER/CHI NE PRESIDENT/CEO (i)
(ii)		 0
650,100 		0
502,592 		0
161,401 		0
33,702 		0
14,498 		0
1,362,293 		0
28,040
(6)MARTIN M MANCUSO MDBOARD MEMBER (i)
(ii)		 0
368,040 		0
0 		0
48,052 		0
7,500 		0
17,722 		0
441,314 		0
0
(7)MICHAEL ROWAN FACHEBOARD MEMBER/CHI EVP & COO (i)
(ii)		 0
1,098,277 		0
1,471,311 		0
200,128 		0
238,353 		0
19,702 		0
3,027,771 		0
175,028
(8)KENNETH LAWONNACH SVP STRATEGY & TECH (i)
(ii)		 0
355,565 		0
209,304 		0
157,191 		0
23,590 		0
21,386 		0
767,036 		0
107,846
(9)RICK MILLER MDACH SVP/CHIEF QUALITY OFFICER (i)
(ii)		 0
327,056 		0
213,951 		0
74,410 		0
20,952 		0
15,371 		0
651,740 		0
42,174
(10)JOAN NEUHAUSCHI HEALTH SVP COO (i)
(ii)		 0
481,270 		0
260,024 		0
140,611 		0
33,702 		0
2,169 		0
917,776 		0
63,430
(11)RICHARD ROLSTON MDACC CEO (i)
(ii)		 0
494,820 		0
275,304 		0
100,575 		0
65,953 		0
20,173 		0
956,825 		0
67,114
(12)NANCY WALLACESVP HR CHI HEALTH (i)
(ii)		 0
270,444 		0
120,851 		0
50,132 		0
31,152 		0
6,387 		0
478,966 		0
20,943
(13)JEANETTE WOJTALEWICZCFO, CHI HEALTH (i)
(ii)		 0
426,811 		0
51,596 		0
21,578 		0
39,641 		0
20,237 		0
559,863 		0
0
(14)SCOTT WOOTENACH SVP/CFO (i)
(ii)		 0
441,373 		0
249,118 		0
136,313 		0
0 		0
10,063 		0
836,867 		0
102,692
(15)LARRY BROWN MDFORMER ACC CEO (i)
(ii)		 0
352,759 		0
0 		0
29,246 		0
18,716 		0
28,487 		0
429,208 		0
0
(16)FRANK EMSICKFORMER FACILITIES OPS EXEC (i)
(ii)		 0
177,442 		0
12,163 		0
636 		0
0 		0
20,446 		0
210,687 		0
0
(17)PAUL STRAWHECKERFORMER CHIEF DEVEL OFFICER (i)
(ii)		 0
6,412 		0
32,494 		0
239,259 		0
0 		0
0 		0
278,165 		0
15,992
(18)JANE CARMODYCHIEF NURSING OFFICER (i)
(ii)		 0
299,956 		0
130,615 		0
52,188 		0
23,502 		0
6,000 		0
512,261 		0
23,850
(19)JOSEPH HOAGBIN MDCHIEF MEDICAL OFFICER (i)
(ii)		 0
331,857 		0
0 		0
55,026 		0
22,950 		0
10,453 		0
420,286 		0
0
(20)SHEREE KEELYVP BEHAVIORAL (i)
(ii)		 0
137,267 		0
57,462 		0
52,884 		0
19,676 		0
9,401 		0
276,690 		0
25,941
(21)ELIZABETH LLEWELLYNVP MISSION INTEGRATION (i)
(ii)		 0
157,918 		0
68,720 		0
69,164 		0
17,921 		0
10,233 		0
323,956 		0
31,429
(22)PATRICIA MASEKVP MEDICAL AFFAIRS (i)
(ii)		 0
119,121 		0
58,499 		0
79,496 		0
37,520 		0
17,170 		0
311,806 		0
26,283
(23)TIM SCHNACKVP OPERATIONAL FINANCE (i)
(ii)		 0
291,367 		0
141,395 		0
14,556 		0
22,950 		0
22,707 		0
492,975 		0
0
(24)ANN SCHUMACHERPRESIDENT (i)
(ii)		 0
287,309 		0
112,963 		0
81,674 		0
21,477 		0
29,803 		0
533,226 		0
51,778
(25)JASON YUNGTUMVP/REG GENERAL COUNSEL (i)
(ii)		 0
209,106 		0
78,997 		0
34,219 		0
3,269 		0
26,947 		0
352,538 		0
24,139
(26)STEVE HOUSTONSVP STRATEGY AND TECHNOLOGY (i)
(ii)		 0
116,510 		0
24,451 		0
14,109 		0
277,314 		0
20,653 		0
453,037 		0
0
(27)KEVIN BONNEYVP CHIEF DEVELOPMENT OFFICER (i)
(ii)		 0
155,647 		0
30,218 		0
26,223 		0
262,780 		0
15,927 		0
490,795 		0
12,060
(28)AMY HATCHERVP DIVISIONAL FINANCE (i)
(ii)		 0
194,936 		0
141,564 		0
25,479 		0
15,300 		0
14,482 		0
391,761 		0
0
(29)CHRISTOPHER CRISCUOLO MDPHYSICIAN (i)
(ii)		 318,210
0 		0
0 		29,841
0 		0
0 		0
0 		348,051
0 		0
0
(30)AMANDA KEELPHYSICIAN (i)
(ii)		 322,129
0 		1,500
0 		15,426
0 		14,025
0 		9,460
0 		362,540
0 		0
0
(31)TYRUS SOARES MDPHYSICIAN (i)
(ii)		 298,529
0 		1,500
0 		10,696
0 		12,750
0 		15,369
0 		338,844
0 		0
0
(32)WESLEY SMEAL MDPHYSICIAN (i)
(ii)		 228,045
0 		0
0 		19,434
0 		12,059
0 		6,763
0 		266,301
0 		0
0
(33)AISHWARYA PATILPHYSICIAN (i)
(ii)		 222,887
0 		0
0 		15,381
0 		10,195
0 		8,709
0 		257,172
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 I, Line 3, Arrangement used to establish the top management official's compensation CERTAIN TOP MANAGEMENT OFFICIALS WERE COMPENSATED BY ALEGENT CREIGHTON HEALTH, A RELATED ORGANIZATION. ACTING AS PRUDENT STEWARDS OF ITS FINANCIAL RESOURCES, THE ALEGENT CREIGHTON HEALTH BOARD COMPENSATION COMMITTEE RECOMMENDS AND THE BOARD EXECUTIVE COMMITTEE APPROVES THE EXECUTIVE COMPENSATION PHILOSOPHY, POLICY AND GUIDELINES. IT DOES SO WITH THE OBJECTIVE OF ATTRACTING AND RETAINING TOP EXECUTIVE TALENT TO ENSURE ALEGENT CREIGHTON HEALTH IS ABLE TO FULFILL ITS FAITH-BASED MISSION. THE ALEGENT CREIGHTON HEALTH COMPENSATION COMMITTEE FOLLOWS A THOROUGH AND INTENTIONAL PROCESS THAT INCLUDES CONSULTATION WITH INDEPENDENT, EXPERT COUNSEL AND CAREFULLY COMPARES COMPENSATION LEVELS TO MARKET-BASED COMPENSATION OF SIMILAR SIZED, NON-PROFIT AND FOR-PROFIT HEALTH SYSTEMS AND ALSO UTILIZES A BLEND OF NON-PROFIT AND GENERAL INDUSTRY DATA FOR EXECUTIVE ROLES WHERE THE RECRUITING MARKET IS ARGUABLY BROADER THAN THE NON-PROFIT SECTOR. TOTAL COMPENSATION FOR EXECUTIVES PAID BY ALEGENT CREIGHTON HEALTH INCLUDES BASE COMPENSATION, AND ALSO INCLUDES PERFORMANCE-BASED INCENTIVE COMPENSATION FOR ACHIEVING BOARD-SET GOALS FOR CLINICAL QUALITY, PATIENT SAFETY AND SATISFACTION, PHYSICIAN PERCEPTION, STRATEGIC AND FACILITY PLANNING AND FINANCIAL PERFORMANCE. IT MAY ALSO INCLUDE OTHER CASH PAYMENTS SUCH AS ONE-TIME RELOCATION COSTS, AND/OR CASH PAYMENTS FOR DEFERRED COMPENSATION. THE ESTABLISHMENT OF SOME OF THE REPORTABLE INDIVIDUALS COMPENSATION REMAINED WITH ALEGENT CREIGHTON HEALTH DURING 2013. COMPENSATION FOR CERTAIN EXECUTIVES WAS ESTABLISHED AND PAID BY CHI OR FRANCISCAN HEALTH SYSTEM (FHS), RELATED ORGANZIATIONS. CHI AND FHS USED THE FOLLOWING TO ESTABLISH THIS COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4b, Supplemental nonqualified retirement plan DURING THE 2013 CALENDAR YEAR, CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR MARKET BASED ORGANIZATION CEOS AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICPATE IN CHI'S SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN: PAUL EDGETT RICHARD HACHTEN II ROBERT LANIK JOAN NEUHAUS CLIFF ROBERTSON RICHARD ROLSTON MICHAEL ROWAN JEANETTE WOJTALEWICZ SCOTT WOOTEN DURING 2013 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSAITON PLAN: PAUL EDGETT - $43,590 CLIFF ROBERTSON - $49,142 RICHARD ROLSTON - $45,001 MICHAEL ROWEN - $214,851 JEANETTE WOJTALEWICZ - $13,589 DURING 2013 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI FROM THE DEFERRED COMPENSATION PLAN: PAUL EDGETT - $92,265 ROBERT LANIK - $28,040 CLIFF ROBERTSON - $48,435 MICHAEL ROWAN - $175,028 SCOTT WOOTEN - $38,073 DUE TO THE "SUPER" VESTING RULES UNDER THE CHI DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS TERMINATION, AGE, OR YEARS OF SERVICE WERE ELIGIBLE TO RECEIVE THEIR 2013 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION, ON SCHEDULE J, PART II. DURING 2013, THE FOLLOWING CONTRIBUTIONS THAT WOULD HAVE BEEN MADE BY CHI TO THE DEFERRED COMPENSATION PLAN WERE PAID IN CASH: RICHARD HACHTEN II - $133,616 ROBERT LANIK - $101,293 JOAN NEUHAUS - $43,127 DURING THE 2013 CALENDAR YEAR, ALEGENT CREIGHTON HEALTH, A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR SENIOR VICE PRESIDENTS AND VICE PRESIDENTS PAID BY ALEGENT CREIGHTON HEALTH. DURING 2013 THE FOLLOWING DISTRIBUTIONS WERE MADE BY ALEGENT CREIGHTON HEALTH FROM THE DEFERRED COMPENSATION PLAN THESE SUPPLEMENTAL DISTRIBUTIONS WERE INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE AS COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): RICHARD HACHTEN II - $151,803 SCOTT WOOTEN - $64,619 RICK MILLER, MD - $42,174 KENNETH LAWONN - $107,846 JOAN NEUHAUS - $63,430 RICHARD ROLSTON, MD - $67,114 JASON YUNGTUM - $24,139 PATRICIA MASEK - $26,283 JANE CARMODY - $23,850 NANCY WALLACE - $20,943 SHEREE KEELEY - $25,941 ELIZABETH LLEWELLYN - $31,429 ANN SCHUMACHER - $51,778 PAUL STRAWHECKER - $15,992
Schedule J, Part I, Line 6a, Compensation contingent on net earnings of the organization COMPENSATION FOR MEMBERS OF MANAGEMENT OF ALEGENT CREIGHTON HEALTH AND RELATED ENTITIES IS DETERMINED AT A SYSTEM LEVEL. MEMBERS OF MANAGEMENT ARE ELIGIBLE FOR AN ANNUAL INCENTIVE BONUS .INCENTIVE AWARDS ARE BASED ON FOUR INDIVIDUAL PERFORMANCE MEASURES WHICH ARE LINKED TO FOUR SYSTEM PERFORMANCE GOALS. FOR EACH MANAGER, 75% OF THE INCENTIVE AWARD WILL BE DETERMINED BY SYSTEM PERFORMANCE GOALS AND 25% DETERMINED BY INDIVIDUAL PERFORMANCE MEASURES. ONE OF THE FOUR SYSTEM PERFORMANCE GOALS IS DEPENDENT UPON THE FINANCIAL RESULTS OF THE ENTIRE ALEGENT CREIGHTON HEALTH SYSTEM FOR THE FISCAL YEAR.
Schedule J, Part I, Line 6b, Compensation contingent on net earnings of a related organization SEE DISCLOSURE FOR SCHEDULE J, PART I, LINE 6A
SCHEDULE J, PART II, POTENTIAL SEVERANCE PAYMENTS EXECUTIVES PAID BY ALEGENT CREIGHTON HEALTH HAVE A PROVISION IN THEIR COMPENSATION AGREEMENT THAT PROVIDES FOR POTENTIAL SEVERANCE PAYMENTS IN THE EVENT OF TERMINATION WITHOUT CAUSE OR CHANGE OF CONTROL. THE AMOUNT OF SEVERANCE AN EXECUTIVE MAY OR MAY NOT RECEIVE IF TERMINATED ACCORDING TO COMPENSATION AGREEMENT IS REPORTED AS DEFERRED COMPENSATION IN COLUMN C.
Schedule J (Form 990) 2013

Additional Data


Software ID: 13000248
Software Version: 2013v3.1
SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number

47-0376615
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( SHANIA TWAIN IN LAS VEGAS ) X 1 900 COST
26 Other Right pointing arrow large image ( TOMMY GLASS #2 ) X 1 1,400 COST
27 Other Right pointing arrow large image ( ARTISAN BREAD CLASS ) X 1 1,100 COST
28 Other Right pointing arrow large image ( OZARK'S CONDO ) X 1 2,500 COST
Other Right pointing arrow large image ( SOFT COATED WHEATEN TERRIER / IRISH HAIRCOAT ) X 1 955 COST
Other Right pointing arrow large image ( NAPA WINE TOUR ) X 1 4,000 COST
Other Right pointing arrow large image ( BRONZE STATUE "THE DREAM" ) X 1 3,000 COST
Other Right pointing arrow large image ( LAKE PANORAMA WEEKEND ) X 1 2,000 COST
Other Right pointing arrow large image ( CUBS DESTINATION ) X 1 2,140 COST
Other Right pointing arrow large image ( OKOBOJI VACATION HOME ) X 1 2,200 COST
Other Right pointing arrow large image ( LEAVENWORTH CAFE GIFT CERTIFICATE ) X 1 20 COST
Other Right pointing arrow large image ( LUCKY BUCKET BASKET ) X 1 75 COST
Other Right pointing arrow large image ( DISCOVERY FLIGHT CERTIFICATE ) X 1 65 COST
Other Right pointing arrow large image ( PARTY PACK ) X 1 570 COST
Other Right pointing arrow large image ( NIGHT OUT ) X 1 155 COST
Other Right pointing arrow large image ( RESTAURANT GIFT CARDS #2 ) X 1 123 COST
Other Right pointing arrow large image ( RESTAURANT CARDS #1 ) X 1 148 COST
Other Right pointing arrow large image ( OLIVE GARDEN GIFT CARD ) X 1 25 COST
Other Right pointing arrow large image ( THE RUSTIC GIFT CERTIFICATE ) X 1 100 COST
Other Right pointing arrow large image ( PASTA AMORE GIFT CARD ) X 1 50 COST
Other Right pointing arrow large image ( SPENCER'S GIFT CERTIFICATE ) X 1 100 COST
Other Right pointing arrow large image ( TUSSEY'S BRUNCH CERTIFICATE ) X 1 130 COST
Other Right pointing arrow large image ( OMAHA CHILDREN'S MUSEUM FAMILY ADMISSION PASS ) X 1 36 COST
Other Right pointing arrow large image ( HENRY DOORLY ZOO PASSES ) X 1 60 COST
Other Right pointing arrow large image ( OMAHA FIRE DEPARTMENT BIRTHDAY PARTY ) X 1 0 COST
Other Right pointing arrow large image ( FARRELL'S BODY SHAPING PACKAGE ) X 1 430 COST
Other Right pointing arrow large image ( MAKIN WAVES GIFT CERTIFICATE ) X 1 35 COST
Other Right pointing arrow large image ( FACIAL, PEDICURE, AND HAIRCUT GIFT CERTIFICATES ) X 1 70 COST
Other Right pointing arrow large image ( MOTHER/DAUGHTER SPA BASKET ) X 1 200 COST
Other Right pointing arrow large image ( CABELA'S GIFT CARD ) X 1 150 COST
Other Right pointing arrow large image ( COLLEGE WORLD SERIES TICKETS ) X 1 250 COST
Other Right pointing arrow large image ( CREIGHTON AUTOGRAPHED POSTER ) X 1 0 COST
Other Right pointing arrow large image ( CREIGHTON MEN'S BASEBALL SEASON TICKETS ) X 1 336 COST
Other Right pointing arrow large image ( CREIGHTON MEN'S BASKETBALL TICKETS ) X 1 80 COST
Other Right pointing arrow large image ( CREIGHTON WOMEN'S BASKETBALL SEASON TICKETS ) X 1 220 COST
Other Right pointing arrow large image ( CREIGHTON WOMEN'S BASKETBALL SEASON TICKETS ) X 1 220 COST
Other Right pointing arrow large image ( CREIGHTON MEN'S SOCCER SEASON TICKETS ) X 1 220 COST
Other Right pointing arrow large image ( CREIGHTON WOMEN'S VOLLEYBALL SEASON TICKETS ) X 1 200 COST
Other Right pointing arrow large image ( JOHN SMOLTZ AUTOGRAPHED BASEBALL ) X 1 100 COST
Other Right pointing arrow large image ( UNO HOCKEY HELMET & STICK ) X 1 100 COST
Other Right pointing arrow large image ( AUTOGRAPHED NEBRASKA FOOTBALL & DISPLAY CASE ) X 1 125 COST
Other Right pointing arrow large image ( NEBRASKA BAG OF GOODIES ) X 1 180 COST
Other Right pointing arrow large image ( PEGGY KARR NEBRASKA PLATE ) X 1 58 COST
Other Right pointing arrow large image ( CATSTUDIO NEBRASKA TUMBLERS #1 ) X 1 56 COST
Other Right pointing arrow large image ( CATSTUDIO NEBRASKA TUMBLERS #2 ) X 1 56 COST
Other Right pointing arrow large image ( SOZO OWL BLANKET & OUTFIT ) X 1 92 COST
Other Right pointing arrow large image ( CROCHETED BABY BLANKET/SWEATER/CAP ) X 1 50 COST
Other Right pointing arrow large image ( SPACEFORM BABY FRAME ) X 1 60 COST
Other Right pointing arrow large image ( NAHOKU GOLD NECKLACE ) X 1 479 COST
Other Right pointing arrow large image ( ARTHUR COURT JEWELRY SET ) X 1 287 COST
Other Right pointing arrow large image ( BRIGHTON JEWELRY SET ) X 1 120 COST
Other Right pointing arrow large image ( DAVID YURMAN NECKLACE ) X 1 650 COST
Other Right pointing arrow large image ( SPARTINA SHOULDER BAG AND WRISTLET ) X 1 180 COST
Other Right pointing arrow large image ( THIRTY-ONE BAG AND SPA CERTIFICATES ) X 1 270 COST
Other Right pointing arrow large image ( FRAMED ARTWORK ) X 1 25 COST
Other Right pointing arrow large image ( NAMBE COPPER CANYON BOWL ) X 1 100 COST
Other Right pointing arrow large image ( FRAMED AUTUMN GLOW PRINT ) X 1 200 COST
Other Right pointing arrow large image ( FRAMED ART AND WINE ) X 1 40 COST
Other Right pointing arrow large image ( GARDEN ART ) X 1 100 COST
Other Right pointing arrow large image ( SAGAFORM DISH AND BROWNIES ) X 1 88 COST
Other Right pointing arrow large image ( FRAMED BUTTERFLY PHOTO ) X 1 250 COST
Other Right pointing arrow large image ( TOMMY GLASS - FOOTED SUSHI PLATE ) X 1 250 COST
Other Right pointing arrow large image ( COTON COLORS EVERYTHING ) X 1 170 COST
Other Right pointing arrow large image ( AFGHANISTAN RUG ) X 1 100 COST
Other Right pointing arrow large image ( KOZY LAWN CARE GIFT CERTIFICATE ) X 1 75 COST
Other Right pointing arrow large image ( OIL PAINTING ) X 1 275 COST
Other Right pointing arrow large image ( MANDARIN BLOSSOM VASE ) X 1 82 COST
Other Right pointing arrow large image ( BOTTLE OF WINE ) X 1 150 COST
Other Right pointing arrow large image ( COLEMAN GRILL AND ACCESSORIES ) X 1 155 COST
Other Right pointing arrow large image ( CHERUB AND PLANT ) X 1 115 COST
Other Right pointing arrow large image ( HANDMADE QUILT ) X 1 150 COST
Other Right pointing arrow large image ( COPPLEBERRY FARMS BASKET ) X 1 40 COST
Other Right pointing arrow large image ( AMERICAN FLAG AND CERTIFICATE ) X 1 0 COST
Other Right pointing arrow large image ( SLINGBOX ) X 1 270 COST
Other Right pointing arrow large image ( APPLE TV ) X 1 100 COST
Other Right pointing arrow large image ( WATERFORD WINE COOLER ) X 1 190 COST
Other Right pointing arrow large image ( WATERFORD FLUTES ) X 1 135 COST
Other Right pointing arrow large image ( TRADER JOE'S BASKET ) X 1 40 COST
Other Right pointing arrow large image ( SET OF WILLA CATHER BOOKS ) X 1 121 COST
Other Right pointing arrow large image ( EC DESIGN GIFT CERTIFICATE ) X 1 50 COST
Other Right pointing arrow large image ( EC DESIGN GIFT CERTIFICATE ) X 1 50 COST
Other Right pointing arrow large image ( JAMIE OLSEN PHOTOGRAPHY CERTIFICATE ) X 1 1,000 COST
Other Right pointing arrow large image ( STORM TECH LEATHER JACKETS ) X 1 500 COST
Other Right pointing arrow large image ( HUSKER WINE AUTOGRAPHED ) X 1 30 COST
Other Right pointing arrow large image ( CREIGHTON FLAG WITH 6 ) X 1 70 COST
Other Right pointing arrow large image ( OTHER MISC CONTRIBUTIONS ) X 1 14,692 COST
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that
it must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
 
No
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2013)
Schedule M (Form 990) (2013)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SHANIA TWAIN IN LAS VEGAS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=TOMMY GLASS #2 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=ARTISAN BREAD CLASS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OZARK'S CONDO :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SOFT COATED WHEATEN TERRIER / IRISH HAIRCOAT :
Schedule M (Form 990) (2013)
Additional Data


Software ID: 13000248
Software Version: 2013v3.1
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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number

47-0376615
Return Reference Explanation
FORM 990, PART V, LINE 1C, PAYMENTS TO VENDORS PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF THE ALEGENT CREIGHTON HEALTH SYSTEM ARE MADE BY ALEGENT CREIGHTON HEALTH, THEREFORE NO FORM 1099S ARE ISSUED BY ALEGENT HEALTH - IMMANUEL MEDICAL CENTER. ALEGENT CREIGHTON HEALTH FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY ALEGENT CREIGHTON HEALTH ON BEHALF OF ALEGENT HEALTH - IMMANUEL MEDICAL CENTER ARE REPORTED TO THE IRS.
FORM 990, PART V, LINE 2A, EMLOYEES OF ALEGENT HEALTH-IMMANUEL MEDICAL CENTER THE EMPLOYEES LISTED IN PART I, LINE 5A AND PART V, LINE 2A ARE EMPLOYED BY ALEGENT HEALTH - IMMANUEL MEDICAL CENTER. HOWEVER, THROUGH A COMMON PAY AGENT AGREEMENT, THE EMPLOYEES ARE PAID BY ALEGENT CREIGHTON HEALTH AND PAYROLL EXPENSES ARE ALLOCATED TO ALEGENT HEALTH - IMMANUEL MEDICAL CENTER.
Form 990, Part VI, Sec A, Line 2, Family/business relationships amongst interested persons ANTHONY HATCHER AND AMY HATCHER - FAMILY RELATIONSHIP
Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders THE SOLE MEMBER OF THE CORPORATION SHALL BE IMMANUEL HEALTH SYSTEMS (IHS). IMMANUEL HEALTH SYSTEMS SHALL NOT HAVE ANY VOTING RIGHTS AS A MEMBER OF THE CORPORATION.
Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body THE BUSINESS AND AFFAIRS OF THE CORPORATION SHALL BE MANAGED BY OR UNDER THE DIRECTION OF THE ALEGENT CREIGHTON HEALTH BOARD OF DIRECTORS, AND THE CORPORATION HEREBY DELEGATES TO THE ALEGENT CREIGHTON HEALTH BOARD OF DIRECTORS, TO THE EXTENT PERMITTED BY LAW, COMPLETE GOVERNANCE AUTHORITY OVER IT, SUBJECT ONLY TO THE APPROVAL POWERS OF THE ALEGENT CREIGHTON HEALTH CORPORATE MEMBERS SET FORTH IN THE ARTICLES OF INCORPORATION AND BYLAWS. DIRECTORS SHALL BE APPOINTED BY THE ALEGENT CREIGHTON HEALTH BOARD IMMEDIATELY FOLLOWING THE APPOINTMENT AND RATIFICATION BY ALEGENT CREIGHTON HEALTH CORPORATE MEMBERS OF THE ALEGENT CREIGHTON HEALTH DIRECTORS PURSUANT TO THE ARTICLES OF INCORPORATION AND BYLAWS OF ALEGENT CREIGHTON HEALTH. THE ALEGENT CREIGHTON HEALTH BOARD SHALL APPOINT DIRECTORS SUCH THAT, AT ALL TIMES, ALL OF THE PERSONS SERVING AS ALEGENT CREIGHTON HEALTH DIRECTORS ALSO SHALL BE SERVING AS DIRECTORS OF THE CORPORATION.
Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders THE FOLLOWING ACTIONS SHALL BE EFFECTIVE ONLY IF APPROVED BY THE ALEGENT BOARD AND BY BOTH IMMANUEL HEALTH SYSTEMS (IHS) AND CATHOLIC HEALTH INITIATIVES (CHI) IN THEIR CAPACITIES AS ALEGENT CORPORATE MEMBERS: A. ADOPTION OR AMENDMENT OF THE UNFIIED PHILOSOPHY AND MISSION OF THE CORPORATION; B. SALE, LEASE, TRANSFER, ENCUMBRANCE OR DISPOSITION OF THE TANGIBLE PROPERTY OR INVESTMENTS OF THE CORPORATION HAVING A FAIR MARKET VALUE IN ANY INDIVIDUAL TRANSACTION IN EXCESS OF $3 MILLION OR SUCH GREATER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS, PROVIDED THAT TRANSFERS OF INVESTMENTS BETWEEN THE CORPORATION AND ANOTHER PARTICIPANT SHALL NOT REQUIRE THE APPROVAL OF CHI AND IHS; AND PROVIDED FURTHER THAT APPROVAL OF CHI AND IHS SHALL NOT BE REQUIRED FOR ANY TRANSFER OF ASSETS TO CHI BY THE CORPORATION PURSUANT TO THE TERMS OF THE ALEGENT FINANCING AGREEMENT (AFA); C. INCURRENCE, ASSUMPTION OR GUARANTY BY THE CORPORATION IN ANY INDIVIDUAL TRANSACTION OF LONG-TERM INDEBTEDNESS, INCLUDING CAPITAL LEASES, OUTSTANDING FOR MORE THAN 365 DAYS, IN EXCESS OF THE GREATER OF $2 MILLION OR 2% OF THE TOTAL LONG-TERM INDEBTEDNESS OF ALL THE PARTICIPANTS, OR SUCH GREATER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS; D. MERGER, DISSOLUTION, CONSOLIDATION OR SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION EXCEPT FOR A MERGER IN WHICH (I) THE CORPORATION IS THE SURVIVING ENTITY, AND (II) THE TOTAL BOOK VALUE OF THE ASSETS OF THE MERGING ENTITY DOES NOT EXCEED 2% OF THE TOTAL BOOK VALUE OF THE ASSETS OF ALL THE PARTICIPANTS, OR SUCH GREATER VALUE AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS; AND E. NOTWITHSTANDING ANY OTHER PROVISIONS IN THE BYLAWS TO THE CONTRARY. THE ACTIONS THAT CAN BE TAKEN WITHOUT THE APPROVAL OF IHS AND CHI INCLUDE, WITHOUT LIMITATION: (I) TERMINATION OF THE AFA IN ACCORDANCE WITH ITS TERMS. (II) FORMATION OF THE UNIFIED ALEGENT CREIGHTON HEALTH SYSTEM (AS THAT TERM IS DEFINED IN THE AFA) (III) PREPAYMENT BY THE CORPORATION OF THE FULL AMOUNTS OUTSTANDING ON ITS NOTES TO CHI UNDER THE AFA, FOR PURPOSES OF EXERCISING THE RIGHTS OF TERMINATION OF THE AFA, OR FORMATION OF THE UNIFIED ALEGENT CREIGHTON HEALTH SYSTEM CREDIT, AND THE TAKING OF ALL ACTIONS NECESSARY OR APPROPRIATE TO OBTAIN FUNDING OR OTHERWISE MAKE ARRANGEMENTS TO PREPAY SUCH NOTES INCLUDING WITHOUT LIMITATION INCURRENCE OF INDEBTEDNESS NECESSARY OR APPROPRIATE TO PREPAY THE NOTES OUTSTANDING.
Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body FOLLOWING THE PREPARATION OF THE FORM 990 BY TAX ANALYSTS OF CATHOLIC HEALTH INITIATIVES, A RELATED ORGANIZATION, THE RETURN IS REVIEWED BY THE CHI TAX DIRECTOR AND THE LOCAL CHIEF FINANCIAL OFFICER. AFTER INCORPORATION OF ANY CHANGES RESULTING FROM THIS REVIEW, THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND MEMBERS OF THE FINANCE COMMITTEE OF THE BOARD A WEEK IN ADVANCE OF THE FINANCE COMMITTEE MEETING. THE FORM 990 IS REVIEWED AT THE FINANCE COMMITTEE MEETING AND THE CHIEF FINANCIAL OFFICER AND CHI TAX DIRECTOR ARE PRESENT AT THE MEETING TO ANSWER QUESTIONS. ADDITIONALLY, THE BOARD OF DIRECTORS ARE PROVIDED THE FINAL FORM 990 AND RELATED SCHEDULES TO REVIEW AND ARE ABLE TO ASK THE CHIEF FINANCIAL OFFICER AND TAX DIRECTOR QUESTIONS PRIOR TO FILING WITH THE IRS. UPON CHIEF FINANCIAL OFFICER APPROVAL AND SIGNATURE, THE TAX DIRECTOR FILES THE FINAL FORM 990 AS PRESENTED TO THE BOARD AND FINANCE COMMITTEE, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY IN ORDER TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy ALEGENT HEALTH - IMMANUEL MEDICAL CENTER HAS ADOPTED THE CONFLICT OF INTEREST POLICY AND CONFLICT INVESTIGATION PROCESS OF CATHOLIC HEALTH INITIATIVES, A RELATED ORGANIZATION. ALL OFFICERS, TRUSTEES AND EMPLOYEES ARE COVERED BY A CONFLIC T OF INTEREST POLICY. ADDITIONALLY, ALL OFFICERS, TRUSTEES AND EMPLOYEES ARE REQUIRED TO ACT IN ACCORDANCE WITH CHI'S STATNDARDS OF CONDUCT, WHICH INCLUDE THE AVOIDANCE OF CONFLICTS OF INTEREST OR THE APPEARANCE OF CONFLICTS. THE CHI CONFLICT OF INTEREST POLICY PROVIDES THAT ALL MEMBERS OF THE BOARD OF DIRECTORS AND OF ANY BOARD COMMITTEE ARE REQUIRED TO PROMPTLY AND FULLY DISCLOSE TO THE ENTITIES BOARD CHAIR SITUATIONS THAT MAY CREATE A CONFLICT OF INTEREST WHEN THEY BECOME AWARE OF THE SITUATION. IN ADDITION, ALL MEMBERS OF THE BOARD ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST VIA COMPLETION OF THE CONFLICT OF INTEREST DISCLOSURE FORM WHICH IS REVIEWED BY THE CORPORATE RESPONSIBILITY TEAM AND GENERAL COUNSEL. ANY IDENTIFIED POTENTIAL CONFLICTS ARE REPORTED TO THE ENTITIES BOARD CHAIR, WHO IS CHARGED WITH FURTHER INVESTIGATION OF THE CONFLICT(S). AS HE OR SHE DEEMS APPROPRIATE: DOCUMENTATION OF CONCLUSIONS WITH RESPECT TO THE EXISTENCE OF A CONFLICT (INCLUDING RELEVANT FACTS AND CIRCUMSTANCES); AND REPORTING TO THE BOARD EXECUTIVE COMMITTEE CONCERNING THE REVIEW, EVALUATION AND CONFLICT DETERMINATION. TO THE EXTENT THAT THE BOARD CHAIR AND ANY OTHER TRUSTEE DISAGREE AS TO WHETHER A CIRCUMSTANCE GIVES RISE TO A CONFLICT, THE BOARD EXECUTIVE COMMITTEE MAKES THE FINAL DETERMINATION AS TO THE EXISTENCE OF A CONFLICT. THE CONFLICTED TRUSTEE IS EXCLUDED FROM VOTING AS TO THE EXISTENCE OF A CONFLICT, AND IS EXCUSED FROM THE ROOM WHILE VOTING CONCERNING THE MATTER IS CONDUCTED. IN ANY CIRCUMSTANCE WHERE A TRUSTEE HAS BEEN IDENTIFIED AS HAVING A CONFLICT OF INTEREST WITH RESPECT TO A PARTICULAR TRANSACTION, THAT TRUSTEE IS ALSO EXCLUDED FROM VOTING WITH RESPECT THAT PARTICULAR TRANSACTION. THE CONFLICT OF INTEREST POLICY WITH RESPECT TO EMPLOYEES REQUIRES THAT ALL EMPLOYEES COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE FORM AT THE TIME OF HIRING. THEREAFTER, DIRECTOR LEVEL AND ABOVE EMPLOYEES MUST ANNUALLY CERTIFY AS PART OF THE PERFORMANCE EVALUATION PROCESS THAT THEY HAVE NO CONFLICTS OF INTEREST. FURTHER, ALL EMPLOYEES, REGARDLESS OF EMPLOYMENT LEVEL, ARE SUBJECT TO A GENERAL OBLIGATION TO DISCLOSE TO THEIR SUPERVISOR ANY CONFLICTS THAT ARISE DURING THE YEAR. FAILURE TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS MAY RESULT IN DISCIPLINARY ACTION.
Form 990, Part VI, Sec B, Line 15a, Process to establish compensation of top management official CERTAIN EXECUTIVES AND MEMBERS OF MANAGEMENT WERE PAID BY CHI, A RELATED ORGANIZATION, DURING CALENDAR YEAR 2013. FOR THOSE PAID BY CHI, COMPENSATION WAS DETERMINED UNDER THE COMPENSATION PHILOSOPHY OF CHI. UNDER CHI'S PHILOSOPHY, BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. CHI USES THE HAY GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE HAY GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO CHI'S COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVEREC BY THE HAY GROUP TO THE HR COMMITTEE OF THE CHI BOARD OF STEWARDSHIP TRUSTEES ANNUALLY AT THEIR SEPTEMBER MEETING AND MINUTES ARE SHARED WITH THE FULL BOARD AT THE DECEMBER MEETING. IN ADDITION, THE HAY GROUP COMPLETES A COMPREHENSIVE ANNUAL REVIEW OF ALL CHI POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE COMPENSATION LEVELS ARE REVISED ANNUALLY BASED ON MARKET DATA, WHERE APPLICABLE. FOR OTHER MEMBERS OF MANAGEMENT WHO WERE PAID UNDER ALEGENT CREIGHTON HEALTH FOR CALENDAR YEAR 2013, ALEGENT CREIGHTON HEALTH HUMAN RESOURCES COMPLETES A COMPENSATION MARKET STUDY TO DETERMINE SALARY. ADDITIONALLY, CLIFF ROBERTSON'S COMPENSATION IS PAID BY FHS, A RELATED ORGANIZATION. FHS USES AN EXTERNAL COMPENSATION FIRM WHO UTILIZES ACTUAL MARKET DATA COMPENSATION FROM SIMILAR INSTITUTIONS WITH COMPARABLE POSITIONS AND COMPENSATION LEVELS AND CONSIDERING THE ORGANIZATION'S GEOGRAPHIC LOCATION. THE EXECUTIVE COMMITTEE OF THE BOARD ANNUALLY EVALUATES AND APPROVES THE EXECUTIVE COMPENSATION ARRANGEMENT FOR EACH EXECUTIVE FOR FAIR MARKET VALUE ALONG WITH OTHER APPLICABLE FACTORS RELIED ON BY THE BOARD'S DETERMINATION. THE SUPPORTING DOCUMENTATION BECOMES PART OF THE MINUTES OF THE MEETING. THIS PROCESS IS COMPLETED YEARLY.
Form 990, Part VI, Sec B, Line 15b, Process to establish compensation of other employees SEE DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A
FORM 990, PART VI, LINE 16A, WRITTEN POLICY FOR JOINT VENTURE AGREEMENTS ALEGENT HEALTH - IMMANUEL MEDICAL CENTER HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER,CHI'S SYSTEM WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S-LENGTH, WITH PRICES SET AT FAIR MARKET VALUE. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL.
Form 990, Part VI, Sec C, Line 19, Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATION DEPARTMENT. IN ADDITION, THE ARTICLES OF INCORPORATION ARE AVAILABLE FROM THE NEBRASKA (IOWA) SCRETARY OF STATE WEBSITE HTTP://WWW.SOS.NE.GOV/BUSINESS. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.ORG.
Form 990 , Part XI, Line 9, Other changes in net assets or fund balances TRANSFER OF GOODWILL TO ALEGENT CREIGHTON HEALTH - -925053;
Form 990, Part XII, Line 2c, Change of oversight process or selection process FOR FISCAL YEAR ENDING JUNE 30, 2014, THE FINANCIAL STATEMENTS OF ALEGENT HEALTH-IMMANUEL MEDICAL CENTER ARE INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI). THE CHI FINANCE COMMITTEE OVERSEES THE INDEPENDENT AUDIT PROCESS AND SELECT THE INDEPENDENT AUDITOR TO CONDUCT THE CONSOLIDATED FINANCIAL STATEMENT AUDIT.
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=NAPA WINE TOUR :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=BRONZE STATUE "THE DREAM" :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=LAKE PANORAMA WEEKEND :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CUBS DESTINATION :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OKOBOJI VACATION HOME :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=LEAVENWORTH CAFE GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=LUCKY BUCKET BASKET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=DISCOVERY FLIGHT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=PARTY PACK :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=NIGHT OUT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=RESTAURANT GIFT CARDS #2 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=RESTAURANT CARDS #1 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OLIVE GARDEN GIFT CARD :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=THE RUSTIC GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=PASTA AMORE GIFT CARD :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SPENCER'S GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=TUSSEY'S BRUNCH CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OMAHA CHILDREN'S MUSEUM FAMILY ADMISSION PASS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=HENRY DOORLY ZOO PASSES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OMAHA FIRE DEPARTMENT BIRTHDAY PARTY :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FARRELL'S BODY SHAPING PACKAGE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=MAKIN WAVES GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FACIAL, PEDICURE, AND HAIRCUT GIFT CERTIFICATES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=MOTHER/DAUGHTER SPA BASKET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CABELA'S GIFT CARD :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=COLLEGE WORLD SERIES TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON AUTOGRAPHED POSTER :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON MEN'S BASEBALL SEASON TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON MEN'S BASKETBALL TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON WOMEN'S BASKETBALL SEASON TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON WOMEN'S BASKETBALL SEASON TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON MEN'S SOCCER SEASON TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON WOMEN'S VOLLEYBALL SEASON TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=JOHN SMOLTZ AUTOGRAPHED BASEBALL :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=UNO HOCKEY HELMET & STICK :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=AUTOGRAPHED NEBRASKA FOOTBALL & DISPLAY CASE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=NEBRASKA BAG OF GOODIES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=PEGGY KARR NEBRASKA PLATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CATSTUDIO NEBRASKA TUMBLERS #1 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CATSTUDIO NEBRASKA TUMBLERS #2 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SOZO OWL BLANKET & OUTFIT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CROCHETED BABY BLANKET/SWEATER/CAP :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SPACEFORM BABY FRAME :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=NAHOKU GOLD NECKLACE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=ARTHUR COURT JEWELRY SET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=BRIGHTON JEWELRY SET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=DAVID YURMAN NECKLACE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SPARTINA SHOULDER BAG AND WRISTLET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=THIRTY-ONE BAG AND SPA CERTIFICATES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FRAMED ARTWORK :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=NAMBE COPPER CANYON BOWL :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FRAMED AUTUMN GLOW PRINT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FRAMED ART AND WINE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=GARDEN ART :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SAGAFORM DISH AND BROWNIES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FRAMED BUTTERFLY PHOTO :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=TOMMY GLASS - FOOTED SUSHI PLATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=COTON COLORS EVERYTHING :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=AFGHANISTAN RUG :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=KOZY LAWN CARE GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OIL PAINTING :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=MANDARIN BLOSSOM VASE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=BOTTLE OF WINE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=COLEMAN GRILL AND ACCESSORIES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CHERUB AND PLANT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=HANDMADE QUILT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=COPPLEBERRY FARMS BASKET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=AMERICAN FLAG AND CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SLINGBOX :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=APPLE TV :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=WATERFORD WINE COOLER :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=WATERFORD FLUTES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=TRADER JOE'S BASKET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SET OF WILLA CATHER BOOKS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=EC DESIGN GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=EC DESIGN GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=JAMIE OLSEN PHOTOGRAPHY CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=STORM TECH LEATHER JACKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=HUSKER WINE AUTOGRAPHED :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON FLAG WITH 6 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OTHER MISC CONTRIBUTIONS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SHANIA TWAIN IN LAS VEGAS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=TOMMY GLASS #2 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=ARTISAN BREAD CLASS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OZARK'S CONDO :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SOFT COATED WHEATEN TERRIER / IRISH HAIRCOAT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=NAPA WINE TOUR :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=BRONZE STATUE "THE DREAM" :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=LAKE PANORAMA WEEKEND :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CUBS DESTINATION :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OKOBOJI VACATION HOME :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=LEAVENWORTH CAFE GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=LUCKY BUCKET BASKET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=DISCOVERY FLIGHT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=PARTY PACK :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=NIGHT OUT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=RESTAURANT GIFT CARDS #2 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=RESTAURANT CARDS #1 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OLIVE GARDEN GIFT CARD :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=THE RUSTIC GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=PASTA AMORE GIFT CARD :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SPENCER'S GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=TUSSEY'S BRUNCH CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OMAHA CHILDREN'S MUSEUM FAMILY ADMISSION PASS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=HENRY DOORLY ZOO PASSES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OMAHA FIRE DEPARTMENT BIRTHDAY PARTY :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FARRELL'S BODY SHAPING PACKAGE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=MAKIN WAVES GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FACIAL, PEDICURE, AND HAIRCUT GIFT CERTIFICATES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=MOTHER/DAUGHTER SPA BASKET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CABELA'S GIFT CARD :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=COLLEGE WORLD SERIES TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON AUTOGRAPHED POSTER :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON MEN'S BASEBALL SEASON TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON MEN'S BASKETBALL TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON WOMEN'S BASKETBALL SEASON TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON WOMEN'S BASKETBALL SEASON TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON MEN'S SOCCER SEASON TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON WOMEN'S VOLLEYBALL SEASON TICKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=JOHN SMOLTZ AUTOGRAPHED BASEBALL :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=UNO HOCKEY HELMET & STICK :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=AUTOGRAPHED NEBRASKA FOOTBALL & DISPLAY CASE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=NEBRASKA BAG OF GOODIES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=PEGGY KARR NEBRASKA PLATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CATSTUDIO NEBRASKA TUMBLERS #1 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CATSTUDIO NEBRASKA TUMBLERS #2 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SOZO OWL BLANKET & OUTFIT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CROCHETED BABY BLANKET/SWEATER/CAP :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SPACEFORM BABY FRAME :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=NAHOKU GOLD NECKLACE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=ARTHUR COURT JEWELRY SET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=BRIGHTON JEWELRY SET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=DAVID YURMAN NECKLACE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SPARTINA SHOULDER BAG AND WRISTLET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=THIRTY-ONE BAG AND SPA CERTIFICATES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FRAMED ARTWORK :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=NAMBE COPPER CANYON BOWL :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FRAMED AUTUMN GLOW PRINT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FRAMED ART AND WINE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=GARDEN ART :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SAGAFORM DISH AND BROWNIES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=FRAMED BUTTERFLY PHOTO :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=TOMMY GLASS - FOOTED SUSHI PLATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=COTON COLORS EVERYTHING :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=AFGHANISTAN RUG :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=KOZY LAWN CARE GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OIL PAINTING :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=MANDARIN BLOSSOM VASE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=BOTTLE OF WINE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=COLEMAN GRILL AND ACCESSORIES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CHERUB AND PLANT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=HANDMADE QUILT :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=COPPLEBERRY FARMS BASKET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=AMERICAN FLAG AND CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SLINGBOX :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=APPLE TV :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=WATERFORD WINE COOLER :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=WATERFORD FLUTES :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=TRADER JOE'S BASKET :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=SET OF WILLA CATHER BOOKS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=EC DESIGN GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=EC DESIGN GIFT CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=JAMIE OLSEN PHOTOGRAPHY CERTIFICATE :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=STORM TECH LEATHER JACKETS :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=HUSKER WINE AUTOGRAPHED :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=CREIGHTON FLAG WITH 6 :
Schedule M, part I, column (b), Line other, Number of contributions or items contributed. OTHER=OTHER MISC CONTRIBUTIONS :
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: 13000248
Software Version: 2013v3.1
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
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Employer identification number

47-0376615
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










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) ALEGENT CREIGHTON CLINIC

12809 W DODGE RD

OMAHA,NE68154
47-0765154 		HEALTHCARE NE 501(C)(3) 3 ACH
 
Yes
 
(2) ALEGENT CREIGHTON HEALTH

12809 W DODGE RD

OMAHA,NE68154
47-0757164 		HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(3) ALEGENT CREIGHTON HEALTH FOUNDATION

12809 W DODGE RD

OMAHA,NE68154
47-0648586 		FUNDRAISING NE 501(C)(3) 7 ACH
 
Yes
 
(4) ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM

7500 MERCY RD

OMAHA,NE68124
47-0484764 		HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(5) ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA

631 N 8TH ST

MISSOURI VALLEY,IA51555
42-0776568 		HEALTHCARE IA 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(6) ALEGENT HEALTH - IMMANUEL MEDICAL CENTER

6901 N 72ND ST

OMAHA,NE68122
47-0376615 		HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(7) ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER

104 W 17TH ST

SCHUYLER,NE68661
47-0399853 		HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(8) ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA

PO BOX 368

CORNING,IA50841
42-0782518 		HEALTHCARE IA 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(9) ALVERNA APARTMENTS

300 SE 8TH AVE

LITTLE FALLS,MN56345
41-1351177 		LTERM CARE MN 501(C)(3) 9 CHI
 
Yes
 
(10) APPLETREE COURT

601 OAK ST

BRECKENRIDGE,MN56520
41-1850500 		SENIOR LIVING MN 501(C)(3) 9 SFH
 
Yes
 
(11) BISHOP DRUMM RETIREMENT CENTER

1111 6TH AVE

DES MOINES,IA50314
42-0725196 		LTERM CARE IA 501(C)(3) 9 CHI-IA CORP
 
Yes
 
(12) BORNEMANN HEALTHCARE CORPORATION

2500 BERNVILLE RD PO BOX 316

READING,PA19603
23-2187242 		HEALTHCARE PA 501(C)(3) 11 - Type I CHI
 
Yes
 
(13) CARRINGTON HEALTH CENTER

800 N 4TH ST

CARRINGTON,ND58421
45-0227311 		HEALTHCARE ND 501(C)(3) 3 CHI
 
Yes
 
(14) CATHOLIC HEALTH INITIATIVES

198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
47-0617373 		HEALTHCARE CO 501(C)(3) 9 NA
 
Yes
 
(15) CATHOLIC HEALTH INITIATIVES - COLORADO

188 INVERNESS DRIVE WEST STE 500

ENGLEWOOD,CO80112
84-0405257 		HEALTHCARE CO 501(C)(3) 3 CHI
 
Yes
 
(16) CATHOLIC HEALTH INITIATIVES - IOWA CORP

1111 6TH AVE

DES MOINES,IA50314
42-0680448 		HEALTHCARE IA 501(C)(3) 3 CHI
 
Yes
 
(17) CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION

6385 CORPORATE DR STE 301

COLORADO SPRINGS,CO80919
84-0902211 		FUNDRAISING CO 501(C)(3) 7 CHIC
 
Yes
 
(18) CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION

6385 CORPORATE DR

COLORADO SPRINGS,CO80919
27-0930004 		FUNDRAISING CO 501(C)(3) 11 - Type I CHI
 
Yes
 
(19) CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES

198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
46-0992796 		HEALTHCARE CO 501(C)(3) 11 - Type I CHINS
 
Yes
 
(20) CENTENNIAL MEDICAL GROUP INC

2700 STEWART PKWY

ROSEBURG,OR97471
26-3946191 		PHYSICIANS OR 501(C)(3) 9 MMC
 
Yes
 
(21) CENTRAL KANSAS MEDICAL CENTER

3515 BROADWAY

GREAT BEND,KS67530
48-0543724 		SURGERY CENTER KS 501(C)(3) 3 CHI
 
Yes
 
(22) CHI HEALTH CONNECT AT HOME - FARGO

4816 AMBER VALLEY PKWY S

FARGO,ND58104
27-1966847 		HEALTHCARE MN 501(C)(3) 9 CHI
 
Yes
 
(23) CHI INSTITUTE FOR RESEARCH AND INNOVATION

198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
27-1050565 		HEALTHCARE CO 501(C)(3) 11 - Type I CHI
 
Yes
 
(24) CHI KENTUCKY INC

3900 OLYMPIC BLVD STE 400

ERLANGER,KY41018
20-2741651 		HEALTHCARE KY 501(C)(3) 11 - Type I CHI
 
Yes
 
(25) CHI NATIONAL HOME CARE

198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
45-1261716 		HEALTHCARE CO 501(C)(3) 9 CHI NS
 
Yes
 
(26) CHI NATIONAL SERVICES

198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
45-2532084 		HEALTHCARE CO 501(C)(3) 11 - Type I CHI
 
Yes
 
(27) CHI NEBRASKA

6940 O ST STE 200

LINCOLN,NE68510
36-3233121 		HEALTHCARE NE 501(C)(3) 11 - Type III - FI CHI
 
Yes
 
(28) CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER

6624 FANNIN ST

HOUSTON,TX77030
74-1161938 		HEALTHCARE TX 501(C)(3) 3 SLHS
 
Yes
 
(29) CHI ST VINCENT HOSPITAL HOT SPRINGS

300 WERNER ST

HOT SPRINGS,AR71913
71-0236913 		HEALTHCARE AR 501(C)(3) 3 CHISVHS
 
Yes
 
(30) CHI ST VINCENT HOT SPRINGS

300 WERNER ST

HOT SPRINGS,AR71913
26-1125064 		HOLDING CO AR 501(C)(3) 11 - Type II SVIMC
 
Yes
 
(31) CHI ST VINCENT MEDICAL GROUP HOT SPRINGS

1 MERCY LANE STE 201

HOT SPRINGS,AR71913
26-1125131 		HEALTHCARE AR 501(C)(3) 3 CHISVHS
 
Yes
 
(32) COMMUNITY LIMITED CARE DIALYSIS CENTER

619 OAK ST ACCOUNTING-3 W

CINCINNATI,OH45206
23-7419853 		HOLDING CO OH 501(C)(2) N/A GSH
 
Yes
 
(33) COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION

631 N 8TH ST

MISSOURI VALLEY,IA51555
42-1294399 		FUNDRAISING IA 501(C)(3) 11 - Type I AH-CMHMV
 
Yes
 
(34) CONTINUING CARE HOSPITAL

150 NORTH EAGLE CREEK DR

LEXINGTON,KY40509
61-1400619 		LT ACH KY 501(C)(3) 3 SJHS
 
Yes
 
(35) COVENANT HOME CARE

198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
23-2028429 		HOME HEALTH PA 501(C)(3) 11 - Type II CHI NHC
 
Yes
 
(36) ENUMCLAW REGIONAL HOSPITAL ASSOCIATION

1450 BATTERSBY AVE

ENUMCLAW,WA98022
91-0715805 		HEALTHCARE WA 501(C)(3) 3 FHS
 
Yes
 
(37) FLAGET HEALTHCARE INC

4305 NEW SHEPHERDSVILLE RD

BARDSTOWN,KY40004
61-1345363 		HEALTHCARE KY 501(C)(3) 3 KOH
 
Yes
 
(38) FLAGET MEMORIAL HOSPITAL FOUNDATION INC

4305 NEW SHEPHERDSVILLE RD

BARDSTOWN,KY40004
56-2351341 		FUNDRAISING KY 501(C)(3) 11 - Type I FH
 
Yes
 
(39) FRANCISCAN FOUNDATION

1717 SOUTH J ST

TACOMA,WA98405
91-1145592 		FUNDRAISING WA 501(C)(3) 9 FHS
 
Yes
 
(40) FRANCISCAN HEALTH SYSTEM

1717 SOUTH J ST

TACOMA,WA98405
91-0564491 		HEALTHCARE WA 501(C)(3) 3 CHI
 
Yes
 
(41) FRANCISCAN HEALTH VENTURES FKA SJMGROUP

TACOMA FNC CTR BLDG 1145 BROADWAY

TACOMA,WA98402
43-1882377 		PHYSICIANS MO 501(C)(3) 9 CHI
 
Yes
 
(42) FRANCISCAN MEDICAL GROUP

1313 BROADWAY STE 200

TACOMA,WA98402
91-1939739 		HEALTHCARE WA 501(C)(3) 9 FHS
 
Yes
 
(43) FRANCISCAN VILLA OF SOUTH MILWAUKEE INC

3601 S CHICAGO AVE

SOUTH MILWAUKEE,WI53172
39-1093829 		HEALTHCARE WI 501(C)(3) 9 CHI
 
Yes
 
(44) GLOBAL HEALTH INITIATIVES

198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
20-1536108 		MINISTRIES CO 501(C)(3) 11 - Type I CHI
 
Yes
 
(45) GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE

619 OAK ST ACCOUNTING-3 W

CINCINNATI,OH45206
31-1778403 		EDUCATION OH 501(C)(3) 2 GSH
 
Yes
 
(46) GOOD SAMARITAN FOUNDATION OF CINCINNATI INC

619 OAK ST ACCOUNTING-3 W

CINCINNATI,OH45206
31-1206047 		FUNDRAISING OH 501(C)(3) 11 - Type I GSH
 
Yes
 
(47) GOOD SAMARITAN HOSPITAL

PO BOX 1990

KEARNEY,NE68848
47-0379755 		HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(48) GOOD SAMARITAN HOSPITAL FOUNDATION

111 W 31ST ST

KEARNEY,NE68847
47-0659443 		FUNDRAISING NE 501(C)(3) 7 GSH
 
Yes
 
(49) GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON

110 N MAIN ST STE 500

DAYTON,OH45402
23-7296923 		FUNDRAISING OH 501(C)(3) 7 SHP
 
Yes
 
(50) HARRISON MEDICAL CENTER

2520 CHERRY AVE

BREMERTON,WA98310
91-0565546 		HEALTHCARE WA 501(C)(3) 3 FHS
 
Yes
 
(51) HARRISON MEDICAL CENTER FOUNDATION

2520 CHERRY AVE

BREMERTON,WA98310
91-1197626 		FUNDRAISING WA 501(C)(3) 7 HMC
 
Yes
 
(52) HEALTH SET

2420 W 26TH AVE STE 460D

DENVER,CO80211
84-1102943 		LOW INC CARE CO 501(C)(3) 7 CHIC
 
Yes
 
(53) HEALTHCARE AND WELLNESS FOUNDATION

2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
76-0761782 		FUNDRAISING MN 501(C)(3) 11 - Type I SFMC
 
Yes
 
(54) HIGHLINE MEDICAL CENTER

16251 SYLVESTER RD SW

BURIEN,WA98166
91-0712166 		HEALTHCARE WA 501(C)(3) 3 FHS
 
Yes
 
(55) HOUSE OF MERCY

1111 6TH AVE

DES MOINES,IA50314
42-1323808 		SHELTER IA 501(C)(3) 7 CHI-IA CORP
 
Yes
 
(56) JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC

539 S 4TH ST

LOUISVILLE,KY40202
61-1029768 		HEALTHCARE KY 501(C)(3) 3 KOH
 
Yes
 
(57) KENTUCKYONE HEALTH MEDICAL GROUP INC

539 S 4TH ST

LOUISVILLE,KY40202
61-1352729 		HEALTHCARE KY 501(C)(3) 9 JHSMH
 
Yes
 
(58) KENTUCKYONE HEALTH INC

200 ABRAHAM FLEXNER WAY

LOUISVILLE,KY40202
61-1029769 		HEALTHCARE KY 501(C)(3) 9 CHI
 
Yes
 
(59) LAKEWOOD HEALTH CENTER

600 MAIN AVE S

BAUDETTE,MN56623
41-0758434 		HEALTHCARE MN 501(C)(3) 3 CHI
 
Yes
 
(60) LINUS OAKES INC

2700 STEWART PKWY

ROSEBURG,OR97471
93-0821381 		SENIOR LIVING OR 501(C)(3) 9 MMC
 
Yes
 
(61) LISBON AREA HEALTH SERVICES

905 MAIN ST

LISBON,ND58054
82-0558836 		HEALTHCARE ND 501(C)(3) 3 CHI
 
Yes
 
(62) LUFKIN VISION ACQUISITIONS

PO BOX 1447

LUFKIN,TX75901
82-0563768 		PROPERTY MGMT TX 501(C)(3) 11 - Type III - FI MHSET
 
Yes
 
(63) MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC

2525 DE SALES AVE

CHATTANOOGA,TN37404
62-1839548 		FUNDRAISING TN 501(C)(3) 7 MHCS
 
Yes
 
(64) MEMORIAL HEALTH CARE SYSTEM INC

2525 DE SALES AVE

CHATTANOOGA,TN37404
62-0532345 		HEALTHCARE TN 501(C)(3) 3 CHI
 
Yes
 
(65) MEMORIAL HEALTH PARTNERS FOUNDATION INC

5600 BRAINERD RD STE 500

CHATTANOOGA,TN37411
03-0417049 		HEALTHCARE TN 501(C)(3) 9 MHCS
 
Yes
 
(66) MEMORIAL HEALTH SYSTEM OF EAST TEXAS

PO BOX 1447

LUFKIN,TX75902
75-0755367 		HEALTHCARE TX 501(C)(3) 3 CHI
 
Yes
 
(67) MEMORIAL MEDICAL CENTER - LIVINGSTON

PO BOX 1447

LUFKIN,TX75902
76-0436439 		HEALTHCARE TX 501(C)(3) 3 MHSET
 
Yes
 
(68) MEMORIAL MEDICAL CENTER - SAN AUGUSTINE

PO BOX 1447

LUFKIN,TX75902
75-2663904 		HEALTHCARE TX 501(C)(3) 3 MHSET
 
Yes
 
(69) MEMORIAL MULTISPECIALTY ASSOCIATES

1201 FRANK AVE

LUFKIN,TX95904
75-2721155 		PHYSICIANS TX 501(C)(3) 11 - Type III - FI MHSET
 
Yes
 
(70) MEMORIAL SPECIALTY HOSPITAL

PO BOX 1447

LUFKIN,TX95902
75-2492741 		HEALTHCARE TX 501(C)(3) 3 MHSET
 
Yes
 
(71) MERCY AUXILIARY OF CENTRAL IOWA

1111 6TH AVE

DES MOINES,IA50314
42-6076069 		AUXILIARY IA 501(C)(3) 11 - Type I MF-DM IA
 
Yes
 
(72) MERCY CLINICS INC

1111 6TH AVE

DES MOINES,IA50314
42-1193699 		PHYSICIANS IA 501(C)(3) 9 CHI-IA CORP
 
Yes
 
(73) MERCY COLLEGE OF HEALTH SCIENCES

1111 6TH AVE

DES MOINES,IA50314
42-1511682 		EDUCATION IA 501(C)(3) 2 CHI-IA CORP
 
Yes
 
(74) MERCY FOUNDATION OF DES MOINES IA

1111 6TH AVE

DES MOINES,IA50314
23-7358794 		FUNDRAISING IA 501(C)(3) 7 CHI-IA CORP
 
Yes
 
(75) MERCY FOUNDATION INC

2700 STEWART PKWY

ROSEBURG,OR97471
93-6088946 		FUNDRAISING OR 501(C)(3) 7 MMC
 
Yes
 
(76) MERCY HEALTH CARE FOUNDATION

PO BOX 368

CORNING,IA50841
42-1461064 		FUNDRAISING IA 501(C)(3) 11 - Type I AHMH-CORNING
 
Yes
 
(77) MERCY HEALTHCARE FOUNDATION

570 CHAUTAUQUA BLVD

VALLEY CITY,ND58072
45-0435338 		FUNDRAISING ND 501(C)(3) 11 - Type III - FI MHVC
 
Yes
 
(78) MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS

800 MERCY DR

COUNCIL BLUFFS,IA51503
42-1178204 		FUNDRAISING IA 501(C)(3) 11 - Type I AHBMHS
 
Yes
 
(79) MERCY HOSPITAL OF DEVILS LAKE

1031 7TH ST NE

DEVILS LAKE,ND58301
45-0227012 		HEALTHCARE ND 501(C)(3) 3 CHI
 
Yes
 
(80) MERCY HOSPITAL OF DEVILS LAKE FOUNDATION

1031 7TH ST NE

DEVILS LAKE,ND58301
35-2367360 		FUNDRAISING ND 501(C)(3) 7 MHDL
 
Yes
 
(81) MERCY HOSPITAL OF VALLEY CITY

570 CHAUTAUQUA BLVD

VALLEY CITY,ND58072
45-0226553 		HEALTHCARE ND 501(C)(3) 3 CHI
 
Yes
 
(82) MERCY MEDICAL CENTER

1301 15TH AVE WEST

WILLISTON,ND58801
45-0231183 		HEALTHCARE ND 501(C)(3) 3 CHI
 
Yes
 
(83) MERCY MEDICAL CENTER - CENTERVILLE

ONE ST JOSEPHS DRIVE

CENTERVILLE,IA52544
42-0680308 		HEALTHCARE IA 501(C)(3) 3 CHI-IA CORP
 
Yes
 
(84) MERCY MEDICAL CENTER INC

2700 STEWART PKWY

ROSEBURG,OR97471
93-0386868 		HEALTHCARE OR 501(C)(3) 3 CHI
 
Yes
 
(85) MERCY MEDICAL FOUNDATION

1301 15TH AVE WEST

WILLISTON,ND58801
45-0381803 		FUNDRAISING ND 501(C)(3) 11 - Type I MMC
 
Yes
 
(86) MERCY PROFESSIONAL PRACTICE ASSOCIATES INC

1111 6TH AVE

DES MOINES,IA50314
42-1470935 		PHYSICIANS IA 501(C)(3) 9 CHI-IA CORP
 
Yes
 
(87) NEBRASKA HEART HOSPITAL

7500 S 91ST ST

LINCOLN,NE68526
39-2031968 		HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(88) OAKES COMMUNITY HOSPITAL

1200 N 7TH ST

OAKES,ND58474
45-0231675 		HEALTHCARE ND 501(C)(3) 3 CHI
 
Yes
 
(89) OAKES COMMUNITY HOSPITAL FOUNDATION

1200 N 7TH ST

OAKES,ND58474
71-0966606 		FUNDRAISING ND 501(C)(3) 11 - Type I OCH
 
Yes
 
(90) PINEYWOODS MEDICAL DEVELOPMENT CORP

PO BOX 1447

LUFKIN,TX75902
75-2493116 		PROPERTY MGMT TX 501(C)(3) 11 - Type III - FI MHSET
 
Yes
 
(91) PUEBLO STEPUP

1925 E ORMAN AVE STE G52

PUEBLO,CO81004
84-1234295 		COMMUNITY CO 501(C)(3) 7 CHIC
 
Yes
 
(92) REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE

12844 MILITARY RD S

TUKWILA,WA98168
91-1170040 		HEALTHCARE WA 501(C)(3) 3 FHS
 
Yes
 
(93) SET OF COLORADO SPRINGS INC

2864 S CIRCLE DR STE 450

COLORADO SPRINGS,CO80906
84-1183335 		LTERM CARE CO 501(C)(3) 7 CHIC
 
Yes
 
(94) SAINT CLARE'S COMMUNITY CARE INC

25 POCONO RD

DENVILLE,NJ07834
22-2876836 		HEALTHCARE NJ 501(C)(3) 11 - Type II SCHS
 
Yes
 
(95) SAINT CLARE'S FOUNDATION INC

25 POCONO RD

DENVILLE,NJ07834
22-2502997 		FUNDRAISING NJ 501(C)(3) 7 SCHS
 
Yes
 
(96) SAINT CLARE'S HEALTH SERVICES INC

25 POCONO RD

DENVILLE,NJ07834
22-3639733 		MANAGEMENT NJ 501(C)(3) 11 - Type II CHI
 
Yes
 
(97) SAINT CLARE'S HOSPITAL INC

25 POCONO RD

DENVILLE,NJ07834
22-3319886 		HEALTHCARE NJ 501(C)(3) 3 SCHS
 
Yes
 
(98) SAINT ELIZABETH FOUNDATION

555 S 70TH ST

LINCOLN,NE68510
47-0625523 		FUNDRAISING NE 501(C)(3) 7 SERMC
 
Yes
 
(99) SAINT ELIZABETH HEALTH SERVICES

555 S 70TH ST

LINCOLN,NE68510
36-3233120 		HEALTHCARE NE 501(C)(3) 3 SERMC
 
Yes
 
(100) SAINT ELIZABETH REGIONAL MEDICAL CENTER

555 S 70TH ST

LINCOLN,NE68510
47-0379836 		HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(101) SAINT FRANCIS MEDICAL CENTER

2620 W FAIDLEY

GRAND ISLAND,NE68803
47-0376601 		HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(102) SAINT FRANCIS MEDICAL CENTER FOUNDATION

PO BOX 9804

GRAND ISLAND,NE68802
47-0630267 		FUNDRAISING NE 501(C)(3) 7 SFMC
 
Yes
 
(103) SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC

305 ESTILL ST

BEREA,KY40403
26-0152877 		FUNDRAISING KY 501(C)(3) 7 SJHS
 
Yes
 
(104) SAINT JOSEPH HEALTH SYSTEM INC

424 LEWIS HARGETT CIRCLE STE 160

LEXINGTON,KY40503
61-1334601 		HEALTHCARE KY 501(C)(3) 3 KOH
 
Yes
 
(105) SAINT JOSEPH HOSPITAL FOUNDATION INC

ONE SAINT JOSEPH DRIVE

LEXINGTON,KY40504
61-1159649 		FUNDRAISING KY 501(C)(3) 11 - Type I SJHS
 
Yes
 
(106) SAINT JOSEPH LONDON FOUNDATION INC

1001 SAINT JOSEPH LANE

LONDON,KY40741
26-0438748 		FUNDRAISING KY 501(C)(3) 7 SJHS
 
Yes
 
(107) SAINT JOSEPH MEDICAL FOUNDATION INC

200 ABRAHAM FLEXNER WAY

LOUISVILLE,KY40202
31-1539059 		PHYSICIANS KY 501(C)(3) 3 SJHS
 
Yes
 
(108) SAINT JOSEPH MOUNT STERLING FOUNDATION INC

225 FALCON DR

MOUNT STERLING,KY40353
27-2884584 		FUNDRAISING KY 501(C)(3) 7 SJHS
 
Yes
 
(109) SAINT JOSEPH'S HOSPITAL FOUNDATION

30 WEST 7TH ST

DICKINSON,ND58601
36-3418207 		FUNDRAISING ND 501(C)(3) 11 - Type I SJHHC
 
Yes
 
(110) SAMARITAN BEHAVIORAL HEALTH INC

601 S EDWIN C MOSES BLVD

DAYTON,OH45417
02-0633634 		HEALTHCARE OH 501(C)(3) 7 SHP
 
Yes
 
(111) SAMARITAN HEALTH PARTNERS

110 N MAIN ST STE 500

DAYTON,OH45402
31-1107411 		HEALTHCARE OH 501(C)(3) 11 - Type I CHI
 
Yes
 
(112) SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC

104 W 17TH ST

SCHUYLER,NE68661
36-3630014 		FUNDRAISING NE 501(C)(3) 11 - Type I AHMHS
 
Yes
 
(113) SJRMC JOPLIN MISSOURI

198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
44-0545809 		HEALTHCARE MO 501(C)(3) 3 CHI
 
Yes
 
(114) SL AUGUSTA CORP

PO BOX 20269

HOUSTON,TX77225
76-0226623 		TITLE HOLDING TX 501(C)(2) N/A SLPC
 
Yes
 
(115) ST ANTHONY HOSPITAL

1601 SE COURT AVE

PENDLETON,OR97801
93-0391614 		HEALTHCARE OR 501(C)(3) 3 CHI
 
Yes
 
(116) ST ANTHONY HOSPITAL FOUNDATION

1601 SE COURT AVE

PENDLETON,OR97801
93-0992727 		FUNDRAISING OR 501(C)(3) 11 - Type I SAH
 
Yes
 
(117) ST ANTHONY'S HOSPITAL ASSOCIATION

FOUR HOSPITAL DR

MORRILTON,AR72110
71-0245507 		HEALTHCARE AR 501(C)(3) 3 SVIMC
 
Yes
 
(118) ST CATHERINE HOSPITAL

401 EAST SPRUCE ST

GARDEN CITY,KS67846
48-0543721 		HEALTHCARE KS 501(C)(3) 3 CHI
 
Yes
 
(119) ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION

401 EAST SPRUCE ST

GARDEN CITY,KS67846
20-0598702 		FUNDRAISING KS 501(C)(3) 11 - Type I SCH
 
Yes
 
(120) ST DOMINIC OF ONTARIO OREGON

198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
93-0433692 		HEALTHCARE OR 501(C)(4) N/A CHI
 
Yes
 
(121) ST FRANCIS HOME

2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
41-0729978 		LTERM CARE MN 501(C)(3) 9 CHI
 
Yes
 
(122) ST FRANCIS LIFE CARE CORPORATION

19 POCONO RD

DENVILLE,NJ07834
22-2536017 		ELDERLY CARE NJ 501(C)(3) 9 SCHS
 
Yes
 
(123) ST FRANCIS MEDICAL CENTER

2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
41-0695598 		HEALTHCARE MN 501(C)(3) 3 CHI
 
Yes
 
(124) ST FRANCIS OF BAKER CITY

198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
93-0412495 		HEALTHCARE OR 501(C)(3) 3 CHI
 
Yes
 
(125) ST JOSEPH COMMUNITY HEALTH

1516 5TH ST NW

ALBUQUERQUE,NM87102
71-0897107 		COMMUNITY NM 501(C)(3) 11 - Type I CHI
 
Yes
 
(126) ST JOSEPH HEALTH MINISTRIES

1929 LINCOLN HWY E STE 150

LANCASTER,PA17602
23-2342997 		HEALTHCARE PA 501(C)(3) 11 - Type I CHI
 
Yes
 
(127) ST JOSEPH MEDICAL CENTER FOUNDATION

2500 BERNVILLE RD PO BOX 316

READING,PA19603
23-2649362 		FUNDRAISING PA 501(C)(3) 11 - Type I SJRHN
 
Yes
 
(128) ST JOSEPH MEDICAL CENTER INC

201 INTERNATIONAL CIRCLE STE 212

HUNT VALLEY,MD21030
52-0591461 		HEALTHCARE MD 501(C)(3) 3 CHI
 
Yes
 
(129) ST JOSEPH MEDICAL GROUP

2500 BERNVILLE RD PO BOX 316

READING,PA19603
20-8544021 		HEALTHCARE PA 501(C)(3) 9 BHC
 
Yes
 
(130) ST JOSEPH PHYSICIAN ENTERPRISE INC

201 INTERNATIONAL CIRCLE STE 212

HUNT VALLEY,MD21030
52-1311775 		PHYSICIANS MD 501(C)(3) 11 - Type I SJMC
 
Yes
 
(131) ST JOSEPH REGIONAL HEALTH NETWORK

2500 BERNVILLE RD PO BOX 316

READING,PA19603
23-1352211 		HEALTHCARE PA 501(C)(3) 3 CHI
 
Yes
 
(132) ST JOSEPH'S AREA HEALTH SERVICES

600 PLEASANT AVE

PARK RAPIDS,MN56470
41-0695603 		HEALTHCARE MN 501(C)(3) 3 CHI
 
Yes
 
(133) ST JOSEPH'S HOSPITAL AND HEALTH CENTER

30 WEST 7TH ST

DICKINSON,ND58601
45-0226429 		HEALTHCARE ND 501(C)(3) 3 CHI
 
Yes
 
(134) ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION

6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-0274448 		MANAGEMENT TX 501(C)(3) 11 - Type I SLHS
 
Yes
 
(135) ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC

6624 FANNIN ST STE 2505

HOUSTON,TX77030
27-3733278 		HEALTHCARE TX 501(C)(3) 3 SLCDC
 
Yes
 
(136) ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND

6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-1947374 		HEALTHCARE TX 501(C)(3) 3 SLHS
 
Yes
 
(137) ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS

6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-0335902 		HEALTHCARE TX 501(C)(3) 3 SLCDC
 
Yes
 
(138) ST LUKE'S COMMUNITY HEALTH SERVICES

6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0536234 		HEALTHCARE TX 501(C)(3) 3 SLHS
 
Yes
 
(139) ST LUKE'S FOUNDATION

1213 HERMANN DRIVE STE 855

HOUSTON,TX77004
45-3811485 		FUNDRAISING TX 501(C)(3) 7 SLHS
 
Yes
 
(140) ST LUKE'S HEALTH SYSTEM CORPORATION

6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0536232 		MANAGEMENT TX 501(C)(3) 11 - Type I CHI
 
Yes
 
(141) ST LUKE'S HEALTH SYSTEM FOUNDATION

6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0127715 		INVESTMENT MGMT TX 501(C)(3) 11 - Type I SLHS
 
Yes
 
(142) ST LUKE'S HOSPITAL AT THE VINTAGE

6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-3734606 		HEALTHCARE TX 501(C)(3) 3 SLHS
 
Yes
 
(143) ST LUKE'S MEDICAL GROUP

6624 FANNIN ST

HOUSTON,TX77030
76-0458535 		PHYSICIANS TX 501(C)(3) 3 SLHS
 
Yes
 
(144) ST LUKE'S MEDICAL TOWER CORPORATION

6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0531713 		PROPERTY MGMT TX 501(C)(3) 11 - Type I CHI-SLH
 
Yes
 
(145) ST LUKE'S PROPERTIES CORPORATION

6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0531716 		PROPERTY MGMT TX 501(C)(3) 11 - Type I SLHS
 
Yes
 
(146) ST LUKE'S SUGAR LAND PROPERTIES CORPORATION

6624 FANNIN ST STE 2505

HOUSTON,TX77030
45-4120549 		PROPERTY MGMT TX 501(C)(3) 11 - Type I SLCDC-SL
 
Yes
 
(147) ST MARY'S COMMUNITY HOSPITAL

1314 3RD AVE

NEBRASKA CITY,NE68410
47-0443636 		HEALTHCARE NE 501(C)(3) 3 CHI NEBRASKA
 
Yes
 
(148) ST MARY'S HOSPITAL FOUNDATION

1314 3RD AVE

NEBRASKA CITY,NE68410
47-0707604 		FUNDRAISING NE 501(C)(3) 7 SMCH
 
Yes
 
(149) ST VINCENT FOUNDATION

TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
51-0169537 		FUNDRAISING AR 501(C)(3) 11 - Type I SVIMC
 
Yes
 
(150) ST VINCENT INFIRMARY MEDICAL CENTER

TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
71-0236917 		HEALTHCARE AR 501(C)(3) 3 CHI
 
Yes
 
(151) ST VINCENT MEDICAL GROUP

TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
71-0830696 		HEALTHCARE AR 501(C)(3) 9 SVIMC
 
Yes
 
(152) THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH

619 OAK ST ACCOUNTING-3 W

CINCINNATI,OH45206
31-0537486 		HEALTHCARE OH 501(C)(3) 3 CHI
 
Yes
 
(153) THE PHYSICIAN NETWORK

2000 Q ST STE 500

LINCOLN,NE68503
47-0780857 		PHYSICIANS NE 501(C)(3) 11 - Type I CHI NEBRASKA
 
Yes
 
(154) TOTAL HEALTHCARE

188 INVERNESS DRIVE WEST STE 500

ENGLEWOOD,CO80112
84-0927232 		HEALTHCARE CO 501(C)(3) 3 CHIC
 
Yes
 
(155) UNITY FAMILY HEALTHCARE

815 SE 2ND ST

LITTLE FALLS,MN56345
41-0721642 		HEALTHCARE MN 501(C)(3) 3 CHI
 
Yes
 
(156) VILLA NAZARETH INC

801 PAGE DR

FARGO,ND58103
45-0226714 		LTERM CARE ND 501(C)(3) 9 CHI
 
Yes
 
(157) VISITING NURSE ASSOCIATION OF ST CLARE'S INC

191 WOODPORT RD

SPARTA,NJ07871
22-1768334 		HOME HEALTH NJ 501(C)(3) 9 SCHS
 
Yes
 
(158) WOODLANDS DOCTOR GROUP

17200 ST LUKES WAY STE 170

THE WOODLANDS,TX77384
27-4499340 		PHYSICIANS TX 501(C)(3) 9 SLCHS
 
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) ALEGENT HEALTH NORTHWEST IMAGING CENTER LLC

3606 N 156TH ST
OMAHA,NE68116
06-1786985 		OP DIAGNOSTICS NE ACH
  		RELATED 116,752 776,649   No 0 Yes   51 %
(2) AUDUBON LAND COMPANY LLC

5390 N ACADEMY BLVD STE 300
COLORADO SPRINGS,CO80918
84-1513085 		REAL ESTATE CO CHIC
  		RELATED 34,991 8,665,388   No 0   No 50.1 %
(3) AVANTAS LLC

11128 JOHN GALT BLVD STE 400
OMAHA,NE68137
39-2045003 		STAFFING OF NURSES NE AHBMHS
  		RELATED -319,683 4,762,246   No -439,535   No 95 %
(4) BERGAN MERCY SURGERY CENTER LLC

7710 MERCY RD STE 200
OMAHA,NE68124
20-8671994 		AMBUL SURG CTR NE ACH
  		RELATED 142,085 3,294,472   No 0   No 63.94 %
(5) BERYWOOD OFFICE PROPERTIES LLC

400 BERYWOOD TRAIL
CLEVELAND,TN37312
62-1875199 		PHYS OFFICE TN MHCS
  		RELATED 57,545 1,013,237   No 0 Yes   63 %
(6) BLUEGRASS REGIONAL IMAGING CENTER

1218 SOUTH BRDWAY STE 310
LEXINGTON,KY40504
61-1386736 		DIAGNOSTIC IMAGING KY SJHS
  		RELATED 308,428 3,317,191   No 0   No 65 %
(7) CATHOLIC HEALTH INITIATIVES PHYSICIAN SERVICES LLC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-2945938 		PRACTICE MGMT SRVC DE CHI
  		RELATED 2,478 4,571,498   No 0 Yes   80 %
(8) CENTRAL NEBRASKA HOME CARE SERVICES

PO BOX 1146 4502 N SECOND AVE
KEARNEY,NE68848
47-0692112 		HEALTHCARE SRVC NE NA
  		RELATED -195,425 216,945   No -77,269 Yes   100 %
(9) CENTRAL NEBRASKA REHAB SERVICE

620 DIERS AVE STE 300
GRAND ISLAND,NE68803
81-0653461 		PHYSICAL THERAPY NE SFMC
  		RELATED 2,132,606 3,494,427   No 0   No 51 %
(10) CHI OPERATING INVESTMENT PROGRAM LP

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
47-0727942 		INVESTMENTS CO CHI
  		UNRELATED 344,962,532 4,617,413,792   No 0 Yes   92.8 %
(11) CHICAMSURG SURGERY CENTERS LLC

188 INVERNESS DRIVE WEST 500
ENGLEWOOD,CO80112
11-1222333 		SURGERY CENTER CO CHIC
  		RELATED 0 0   No 0   No 51 %
(12) HC SL VINTAGE I LLC

18000 W SARAH LANE STE 250
BROOKFIELD,WI53045
27-0453767 		PROPERTY HOLDING WI SL CDC-V
  		RELATED 1,027,057 105,658,490   No 0   No 51 %
(13) HEALTHCARE SUPPORT SERVICES

PO BOX 9804
GRAND ISLAND,NE68802
72-1546196 		LAUNDRY NE NA
  		RELATED 98,584 3,190,678   No 97,006   No 100 %
(14) HEARTLAND ONCOLOGY LLC

2337 E CRAWFORD ST
SALINA,KS67401
22-2333444 		ONCOLOGY KS SCH
  		RELATED 0 0   No 0   No 51 %
(15) HIGHLINE IMAGING LLC

275 SW 160TH ST
BURIEN,WA98166
20-0460005 		DIAGNOSTIC IMAGING WA HMC
  		RELATED 375,761 1,784,057   No 0   No 80 %
(16) LAKESIDE AMBULATORY SURGICAL CENTER LLC

17031 LAKESIDE HILLS DR
OMAHA,NE68130
20-4267902 		AMBUL SURG CTR NE ACH
  		RELATED 3,465,880 1,951,221   No 0   No 51 %
(17) LAKESIDE ENDOSCOPY CENTER LLC

17001 LAKESIDE HILLS PLZ STE 201
OMAHA,NE68130
20-5544496 		ENDOSCOPY SRVC NE ACH
  		RELATED 1,455,294 1,013,126   No 0   No 52.28 %
(18) LINCOLN CK LEASING LLC

6003 OLD CHENEY RD
LINCOLN,NE68516
26-2496856 		REAL ESTATE NE SERMC
  		RELATED 574,064 425,034   No 0   No 53.76 %
(19) LOUISVILLE SC LTD

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
06-2119566 		SURGERY CENTER AL SCOFL
  		RELATED 417,359 478,373   No 0 Yes   61.1 %
(20) NEBRASKA SPINE HOSPITAL LLC

6901 N 72ND ST
OMAHA,NE68122
27-0263191 		SPINE HOSPITAL NE ACH
  		RELATED 10,501,730 17,301,869   No 0   No 51 %
(21) NORTH RIVER SURGERY CENTER LLC

2209 WILDWOOD AVE
SHERWOOD,AR72120
71-0799771 		AMBUL SURG CTR AR SVIMC
  		RELATED 81,071 1,077,536   No 0   No 57.45 %
(22) ORTHOCOLORADO LLC

11650 WEST 2ND PLACE
LAKEWOOD,CO80255
37-1577105 		ORTHO HOSPITAL CO THC
  		RELATED 1,846,183 8,411,844   No 0   No 60 %
(23) PENINSULA RADIATION ONCOLOGY LLC

315 MLK JR WAY STE 111
TACOMA,WA98405
87-0808610 		HEALTHCARE SRVC WA FHS
  		RELATED 256,567 3,262,002   No 0   No 60 %
(24) PENRAD IMAGING

1390 KELLY JOHNSON BLVD
COLORADO SPRINGS,CO80920
84-1072619 		MEDICAL IMAGING CO CHIC
  		RELATED 715,094 3,489,436   No 0   No 70 %
(25) PMC HOSPITAL LLC

4600 E SAM HOUSTON PKWY
SOUTH PASADENA,TX77505
27-3280598 		HOSPITAL TX SL CDC-PMC
  		RELATED 1,092,540 20,751,174   No 0 Yes   51 %
(26) PRAIRIE HEALTH VENTURES LLC

421 S 9TH ST STE 102
LINCOLN,NE68508
20-4962103 		TECH SRVC NE AH-IMC
  		RELATED 1,011,804 5,564,586   No 68,565 Yes   65.75 %
(27) PREMIER SURGERY CENTER OF LOUISVILLE LP

3000 RIVERCHASE GALLERIA STE 500
BIRMINGHAM,AL35244
72-1378216 		SURGERY CENTER AL SCA
  		RELATED 88,900 254,399   No 0 Yes   51 %
(28) PUEBLO AMBULATORY SURGERY CENTER LLC

188 INVERNESS DRIVE WEST 500
ENGLEWOOD,CO80112
62-1488737 		SURGERY CENTER CO CHIC
  		RELATED 0 0   No 0   No 51 %
(29) SAINT JOSEPH - PAML LLC

424 LEWIS HARGETT CIRCLE STE 160
LEXINGTON,KY40503
45-2116736 		MGMT SVCS KY SJHS
  		RELATED -52,573 93,769   No 0 Yes   62.5 %
(30) SAINT JOSEPH - SCA HOLDINGS LLC

1451 HARRODSBURG RD
LEXINGTON,KY40503
45-3801157 		OP SURGERY DE SJHS
  		RELATED 0 0   No 0 Yes   51 %
(31) SAINT JOSEPH-ANC HOME CARE SERVICES

1700 EDISON DR
MILFORD,OH45150
26-3330545 		HOME HEALTH KY JH
  		RELATED 88,608 256,606   No 0   No 100 %
(32) SCA PREMIER SURGERY CENTER OF LOUISVILLE LLC

200 ABRAHAM FLEXNER WAY
LOUISVILLE,KY40202
72-1386840 		SURGERY CENTER KY JH
  		RELATED 42,319 631,595   No 0 Yes   51 %
(33) ST FRANCIS LAND COMPANY

5390 N ACADEMY BLVD STE 300
COLORADO SPRINGS,CO80918
26-3134100 		REAL ESTATE CO CHIC
  		RELATED -130,967 13,823,763   No 0   No 51 %
(34) ST FRANCIS MEDICAL CENTER ASSOCIATES

1717 SOUTH J ST
TACOMA,WA98405
91-1352698 		MED OFFICE WA FHS
  		RELATED 238,717 19,017,063   No 0   No 54.21 %
(35) ST LUKE'S DIAGNOSTIC CATH LAB LLP

6620 MAIN ST STE 1520
HOUSTON,TX77030
71-0959365 		DIAGNOSTICS TX SLHS HOLDINGS
  		RELATED 273,448 868,814   No 0   No 57.3 %
(36) ST LUKE'S HOSPITAL AT THE VINTAGE LLC

6624 FANNIN STE 2505
HOUSTON,TX77030
26-3734516 		HOSPITAL TX SLHS
  		RELATED -19,253,743 69,158,748   No 0 Yes   51 %
(37) ST LUKE'S LAKESIDE HOSPITAL LLC

6624 FANNIN STE 2505
HOUSTON,TX77030
30-0427437 		HOSPITAL TX SL CDC-W
  		RELATED 1,106,628 25,874,619   No 0 Yes   51 %
(38) ST LUKE'S THE WOODLANDS SLEEP CENTER LLC

6624 FANNIN STE 800
HOUSTON,TX77030
46-2795726 		DIAGNOSTICS TX SLHSH
  		RELATED 0 0   No 0 Yes   50 %
(39) SUPERIOR MEDICAL IMAGING LLC

5000 NORTH 26TH ST
LINCOLN,NE68521
26-2884555 		OP DIAGNOSTICS NE SERMC
  		RELATED -200,323 821,112   No 0 Yes   51 %
(40) SURGERY CENTER OF LEXINGTON LLC

424 LEWIS HARGETT CIRCLE STE 160
LEXINGTON,KY40503
62-1179539 		SURGERY CENTER DE SJHS
  		RELATED -200,318 4,079,584   No 0 Yes   51 %
(41) SURGERY CENTER OF LOUISVILLE LLC

200 ABRAHAM FLEXNER WAY
LOUISVILLE,KY40202
62-1179537 		SURGERY CENTER KY JH
  		RELATED -15,452 396,101   No 0 Yes   51 %
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) ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SERVICES INC

12809 WEST DODGE RD
OMAHA,NE68154
47-0802396 		MANAGED CARE NE CHI NEBRASKA
  		C CORPORATION 5,312,313 4,520,865 100 % Yes  
(2) ALL SAINTS INSURANCE COMPANY SPC LTD

 
 
INSURANCE CJ CHI
  		C CORPORATION 0 43,866,961 100 % Yes  
(3) ALTERNATIVE INSURANCE MANAGEMENT SERVICE

3900 OLYMPIC BLVD STE 400
ERLANGER,KY41018
84-1112049 		MANAGEMENT SERVICES CO CHI
  		C CORPORATION 0 6,272,746 100 % Yes  
(4) AMERICAN NURSING CARE INC

1700 EDISON DR
MILFORD,OH45150
31-1085414 		HOME HEALTH OH CHS
  		C CORPORATION 5,118,606 51,920,207 100 % Yes  
(5) AMERIMED INC

1700 EDISON DR
MILFORD,OH45150
31-1158699 		HOME HEALTH OH ANC
  		C CORPORATION 2,134,392 14,669,219 100 % Yes  
(6) BC HOLDING COMPANY INC

1850 BLUEGRASS AVE
LOUISVILLE,KY40215
31-1542851 		FITNESS CLUB KY JHSMH
  		C CORPORATION 0 0 100 % Yes  
(7) CADUCEUS MEDICAL ASSOCIATES INC

2525 DE SALES AVE
CHATTANOOGA,TN37404
62-1570736 		HEALTHCARE TN MHCS
  		C CORPORATION 0 1,008 100 % Yes  
(8) CAPTIVE MANAGEMENT INITIATIVES LTD

PO BOX 10073 APO
GEORGETOWN,GRAND CAYMANKY1-1001
CJ
98-0663022 		CAPTIVE MANAGEMENT CJ CHI
  		C CORPORATION 0 0 100 % Yes  
(9) CARMONA-DESOTO BUILDING HORIZONTAL PROPERTY REGIME INC

300 WERNER ST
HOT SPRINGS,AR71913
71-0771076 		HEALTHCARE AR CHI-SVHS
  		C CORPORATION 0 0 100 % Yes  
(10) CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
27-2269511 		RESEARCH CO CIRI
  		TRUST -2,286,538 1,241,259 100 % Yes  
(11) CGH REALTY COMPANY INC

2500 BERNVILLE RD
READING,PA19603
23-2326801 		REAL ESTATE PA SJHM
  		C CORPORATION 0 0 100 % Yes  
(12) CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER CONDO ASSOC

6624 FANNIN STE 2505
HOUSTON,TX77030
45-5079545 		CONDO ASSOC TX CHI-SLHBCM
  		C CORPORATION 0 0 100 % Yes  
(13) CLEARRIVER HEALTH

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-4495960 		INSURANCE TN PHPSI
  		C CORPORATION 0 0 100 % Yes  
(14) COMCARE SERVICES INC

5570 DTC PARKWAY
ENGLEWOOD,CO80111
84-0904813 		INACTIVE CO CHIC
  		C CORPORATION 0 0 100 % Yes  
(15) CONSOLIDATED HEALTH SERVICES

1700 EDISON DR
MILFORD,OH45150
31-1378212 		HOME HEALTH OH CHI
  		C CORPORATION -879,467 52,379,487 100 % Yes  
(16) DES MOINES MEDICAL CENTER INC

1111 6TH AVE
DES MOINES,IA50314
42-0837382 		REAL ESTATE IA CHI-IA CORP
  		C CORPORATION 67,314 1,064,032 92.98 % Yes  
(17) EAST TEXAS CLINICAL SERVICES INC

2801 VIA FORTUNA 500
AUSTIN,TX78746
45-4736213 		HEALTHCARE TX MHSET
  		C CORPORATION 632,545 16,782 100 % Yes  
(18) FIRST INITIATIVES INSURANCE LTD

PO BOX 10073 APO
GEORGETOWN,GRAND CAYMANKY1-1001
CJ
98-0203038 		INSURANCE CJ CHI
  		C CORPORATION 0 0 100 % Yes  
(19) FRANCISCAN SERVICES INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
23-2487967 		HEALTHCARE CO CHI
  		C CORPORATION 434,854 718,254 100 % Yes  
(20) GOOD SAMARITAN OUTREACH SERVICES

PO BOX 1990
KEARNEY,NE68848
47-0659440 		MEDICAL CLINIC NE CHI NEBRASKA
  		C CORPORATION -7,280 180,468 100 % Yes  
(21) HEALTH SYSTEMS ENTERPRISES INC

PO BOX 1990
KEARNEY,NE68848
47-0664558 		MGMT NE GSH
  		C CORPORATION 87,278 1,377,820 100 % Yes  
(22) HEALTHCARE MGMT SERVICES ORGANIZATION INC

1717 SOUTH J ST
TACOMA,WA98405
91-1865474 		HEALTH ORG. WA FHS
  		C CORPORATION 0 0 100 % Yes  
(23) HEARTLANDPLAINS HEALTH

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-4368223 		INSURANCE NE PHPSI
  		C CORPORATION 0 0 100 % Yes  
(24) HIGHLINE MEDICAL GROUP

15811 AMBAUM BLVD SW STE 170
BURIEN,WA98166
91-1586438 		MEDICAL SERVICES WA HMC
  		C CORPORATION -6,049,147 5,689,139 100 % Yes  
(25) MEDQUEST

1602 WEST 11TH ST
WILLISTON,ND58801
45-0392137 		SALE OF DME ND MMC WILLISTON
  		C CORPORATION   1,152,715 100 % Yes  
(26) MERCY PARK APARTMENTS LTD

1111 6TH AVE
DES MOINES,IA50314
42-1202422 		HOUSING IA CHI-IA CORP
  		C CORPORATION 273,525 1,937,218 100 % Yes  
(27) MERCY SERVICES CORP

2700 STEWART PARKWAY
ROSEBURG,OR97471
93-0824308 		RETAIL SALES OR MMC
  		C CORPORATION 0 142,337 100 % Yes  
(28) MHI CLINICAL SERVICES

1201 W FRANK AVE
LUFKIN,TX75904
46-1967952 		HEALTHCARE TX MHSET
  		C CORPORATION 0 0 100 % Yes  
(29) MOUNTAIN MANAGEMENT SERVICES INC

6028 SHALLOWFORD RD
CHATTANOOGA,TN37421
62-1570739 		MGMT SVC ORG TN MHCS
  		C CORPORATION 96,044 6,465,179 100 % Yes  
(30) NAZARETH ASSURANCE COMPANY

PO BOX 10073 APO
GEORGETOWN,GRAND CAYMANKY1-1001
CJ
03-0304831 		INSURANCE CJ CHI
  		C CORPORATION 0 0 100 % Yes  
(31) PATIENT TRANSPORT SERVICES INC

1700 EDISON DR
MILFORD,OH45150
31-1100798 		HOME HEALTH OH ANC
  		C CORPORATION -164,340 5,488,275 100 % Yes  
(32) PHYSICIANHEALTH SYSTEM NETWORK

1149 MARKET ST
TACOMA,WA98402
91-1746721 		HEALTH ORG. WA FHS
  		C CORPORATION 0 0 100 % Yes  
(33) PROMINENCE HEALTH PLAN SERVICES INC (FKA COLLABHEALTH PLAN SERVICES INC)

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-1224037 		ADMIN SERVICES CO PHI
  		C CORPORATION -5,339,325 38,272,608 100 % Yes  
(34) PROMINENCE HEALTH INC (FKA COLLABHEALTH MANAGED SOLUTIONS INC)

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-1222808 		HOLDING CO CO CHI
  		C CORPORATION 0 23,806,707 100 % Yes  
(35) QCA HEALTH PLAN INC

12615 CHENAL PARKWAY STE 300
LITTLE ROCK,AR72211
71-0794605 		INSURANCE AR QCHI
  		C CORPORATION 0 0 100 % Yes  
(36) QUALCHOICE HOLDINGS INC

12615 CHENAL PARKWAY STE 300
LITTLE ROCK,AR72211
27-4075520 		HOLDING CO AR PHPS
  		C CORPORATION 0 0 100 % Yes  
(37) QUALCHOICE LIFE AND HEALTH INSURANCE COMPANY INC

12615 CHENAL PARKWAY STE 300
LITTLE ROCK,AR72211
71-0386640 		INSURANCE AR QCH
  		C CORPORATION 0 0 100 % Yes  
(38) RIVERLINK HEALTH

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-4380824 		INSURANCE OH PHPS
  		C CORPORATION 0 0 100 % Yes  
(39) RIVERLINK HEALTH OF KENTUCKY INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-4828332 		INSURANCE KY PHPS
  		C CORPORATION 0 0 100 % Yes  
(40) SAINT CLARE'S PRIMARY CARE INC

66 FORD RD
DENVILLE,NJ07834
22-2441202 		BILLING SERVICES NJ SCCC
  		C CORPORATION -235,604 1,361,242 100 % Yes  
(41) SAMARITAN FAMILY CARE INC

40 W FOURTH ST STE 1700
DAYTON,OH45402
31-1299450 		HEALTHCARE OH SHP
  		C CORPORATION 0 0 100 % Yes  
(42) SJH SERVICES CORPORATION

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
23-2307408 		HEALTHCARE CO FSI
  		C CORPORATION -197,039 3,331,737 100 % Yes  
(43) SJL PHYSICIAN MANAGEMENT SERVICES INC

424 LEWIS HARGETT CR STE 160
LEXINGTON,KY40503
27-0164198 		MGMT KY SJHS
  		C CORPORATION 0 0 100 % Yes  
(44) SLMT PARKING INC

6624 FANNIN STE 800
HOUSTON,TX77030
76-0637140 		PARKING TX SLHS
  		C CORPORATION 1,117,934 13,768,221 100 % Yes  
(45) SOUNDPATH HEALTH INC

32129 WEYERHAEUSER WAY S STE 201
FEDERAL WAY,WA98001
42-1720801 		INSURANCE WA PHPS
  		C CORPORATION -154,741 10,976,973 62.6 % Yes  
(46) ST ANTHONY DEVELOPMENT COMPANY

1415 SOUTHGATE
PENDLETON,OR97801
93-1216943 		ATHLETIC CLUB OR SAH
  		C CORPORATION 114,663 2,936,102 100 % Yes  
(47) ST JOSEPH DEVELOPMENT COMPANY INC

1717 SOUTH J ST
TACOMA,WA98405
91-1480569 		RENTAL WA FSI
  		C CORPORATION 63,164 11,845,439 100 % Yes  
(48) ST JOSEPH OFFICE PARK ASSOCIATION

1401 HARRODSBURG RD BLDG B70
LEXINGTON,KY40504
61-1079899 		MGMT KY SJHS
  		C CORPORATION 0 882,139 85 % Yes  
(49) ST LUKE'S 6620 MAIN CONDOMINIUM ASSOCIATION

6624 FANNIN STE 2505
HOUSTON,TX77030
30-0355517 		CONDO ASSOC TX SLPC
  		C CORPORATION 0 0 100 % Yes  
(50) ST LUKE'S ANESTHESIOLOGY ASSOCIATES

6624 FANNIN STE 1100
HOUSTON,TX77030
46-1517163 		MEDICAL CLINIC TX CHI-SLH
  		C CORPORATION 0 0 100 % Yes  
(51) ST LUKE'S EPISCOPAL HOSPITAL PHYSICIAN HOSPITAL ORGANIZATION INC

6720 BERTNER MC4-262
HOUSTON,TX77030
76-0377932 		PHO TX CHI-SLH
  		C CORPORATION 6 0 60 % Yes  
(52) ST LUKE'S HEALTH SYSTEM HOLDINGS INC (FKA SLEHS HOLDINGS INC)

6624 FANNIN STE 800
HOUSTON,TX77030
76-0637138 		HOLDING CO TX SLHS
  		C CORPORATION 1,425,313 33,114,103 100 % Yes  
(53) ST LUKE'S MEDICAL ARTS CENTER I CONDOMINIUM ASSOCIATION

6624 FANNIN STE 2505
HOUSTON,TX77030
30-0355518 		CONDO ASSOC TX SLPC
  		C CORPORATION 0 0 100 % Yes  
(54) ST LUKE'S MEDICAL TOWER CONDOMINIUM ASSOCIATION

6624 FANNIN STE 2505
HOUSTON,TX77030
76-0298751 		CONDO ASSOC TX SLMTC
  		C CORPORATION 0 0 100 % Yes  
(55) ST VINCENT COMMUNITY HEALTH SERVICES INC

TWO ST VINCENT CIRCLE
LITTLE ROCK,AR72205
71-0710785 		HEALTHCARE AR SVIMC
  		C CORPORATION 2,408,638 15,225,732 100 % Yes  
(56) STABLEVIEW HEALTH INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-4373713 		INSURANCE KY PHPS
  		C CORPORATION 0 0 100 % Yes  
(57) SUGAR LAND DOCTOR GROUP

1317 LAKE POINTE PARKWAY
SUGAR LAND,TX77478
45-4270163 		MEDICAL CLINIC TX SLCDC-SL
  		C CORPORATION 0 0 100 % Yes  
(58) THE TEXAS HEART INSTITUTE AT ST LUKE'S EPISCOPAL HOSPITAL DENTON A COOLEY B
UILDING COMDOMINIUM ASSOCIATION
6624 FANNIN STE 2505
HOUSTON,TX77030
90-0064009 		CONDO ASSOC TX CHI-SLH
  		C CORPORATION 0 0 100 % Yes  
(59) TOWSON MANAGEMENT INC

7601 OSLER DR
TOWSON,MD21204
52-1710750 		MGMT SERVICES MD FSI
  		C CORPORATION 516,457 197,196 100 % Yes  
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
 
No
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
Yes
 
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
Yes
 
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
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
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
Yes
 
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





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


Software ID: 13000248
Software Version: 2013v3.1






TY 2013 AffiliatedGroupSchedule
Name:
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
EIN: 47-0376615
Software ID:13000248
Software Version:2013v3.1
Affiliated Group Business Name:
ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
 
Address. Either US or Foreign Type:
6901 NORTH 72ND STREET


OMAHA,
NE
68154



 
 
EIN:
47-0376615
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
5,497
Total Lobbying Expenditures:
5,497
Other Exempt Purpose Expenditures:
220,544,411
Total Exempt Purpose Expenditures:
220,549,908
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
ALEGENT CREIGHTON HEALTH
 
Address. Either US or Foreign Type:
12809 WEST DODGE ROAD


OMAHA,
NE
68154



 
 
EIN:
47-0757164
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
163,889
Total Lobbying Expenditures:
163,889
Other Exempt Purpose Expenditures:
737,550,348
Total Exempt Purpose Expenditures:
737,714,237
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0