Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions. 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
CHI NATIONAL HOME CARE
Employer identification number
45-1261716
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
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)
(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)
(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
Gross receipts from related activities, etc. (see instructions)
..................
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.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
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
.....................................................
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)
(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.") .
608,852
529,495
197,938
1,336,285
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......
2,776,788
25,663,320
44,883,723
75,588,963
148,912,794
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
0
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
6
Total. Add lines 1 through 5.
0
2,776,788
26,272,172
45,413,218
75,786,901
150,249,079
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
0
0
0
0
0
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.
0
0
0
0
0
0
c
Add lines 7a and 7b..
0
0
0
0
0
0
8
Public support (Subtract line 7c from line 6.)
150,249,079
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
0
2,776,788
26,272,172
45,413,218
75,786,901
150,249,079
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
105
84
0
189
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
0
0
105
84
0
189
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
0
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
0
0
1,744
20,159
21,735
43,638
13
Total support. (Add lines 9, 10c, 11, and 12.)..
0
2,776,788
26,274,021
45,433,461
75,808,636
150,292,906
14
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.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
99.970 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
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
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
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
CHI NATIONAL HOME CARE
Employer identification number
45-1261716
Return Reference
Explanation
FORM 990, PART III, LINE 1, MISSION STATEMENT
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.
FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS
CHI NATIONAL HOME CARE'S SOLE MEMBER IS CATHOLIC HEALTH INITIATIVES, AN IRC SEC. 501(C)(3) ORGANIZATION WITH NON-PRIVATE FOUNDATION STATUS UNDER IRC SEC. 509(A)(2). CATHOLIC HEALTH INITIATIVES ("CHI"), A VALUES-BASED ORGANIZATION, IS THE ULTIMATE PARENT TO A HEALTHCARE SYSTEM COMPRISED OF 92 HOSPITALS; 24 CRITICAL ACCESS FACILITIES AND NUMEROUS LONG-TERM CARE, ASSISTED AND RESIDENTIAL LIVING FACILITIES, COMMUNITY HEALTH SYSTEMS AND HOSPITAL-BASED FOUNDATIONS LOCATED IN 18 STATES. IN THAT ROLE, CHI IS CHARGED WITH DEVELOPMENT OF NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL AND SOCIAL SERVICES; PROMOTING LEADERSHIP DEVELOPMENT AND FORMATION FOR THE MINISTRY THROUGHOUT THE ORGANIZATION; ADVOCATING FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED AND UNDERSERVED; AND STEWARDING RESOURCES BY PROVIDING COORDINATED MANAGEMENT AND STRATEGIC PLANNING SERVICES ALONG WITH CENTRALIZED SHARED SERVICES (E.G. PAYROLL, HUMAN RESOURCES, ACCOUNTS PAYABLE AND PURCHASING) FOR THE CHI HEALTHCARE MINISTRY. THE PURPOSE OF CHI NATIONAL HOME CARE WILL BE TO HOUSE CHI'S TAX-EXEMPT HOME HEALTH ACTIVITIES. AS CHI ACQUIRES FUTURE-TAX EXEMPT NATIONAL HOME CARE BUSINESS LINES, THE PARTNERSHIP OR MEMBERSHIP INTERESTS IN, OR ASSETS OF THOSE BUSINESSES, WOULD BE HELD BY CHI NATIONAL HOME CARE. THE CONSOLIDATION OF THE HOME CARE OPERATIONS WILL REDUCE VARIATION IN CLINICAL OUTCOMES, LOWER THE COST OF ADMINISTRATIVE AND BACK OFFICE SERVICES, ENHANCE GROWTH THROUGH THE STANDARDIZED MARKETING PROGRAM, AND ENHANCE OVERALL CORPORATE COMPLIANCE THROUGH STANDARDIZATION AND REVIEW. CHI HAS BEGUN TRANSITIONING EXISTING TAX-EXEMPT HOME HEALTH OPERATIONS ACROSS THE HEALTH CARE SYSTEM INTO AND UNDER THE COORDINATED MANAGEMENT OF CHI NATIONAL HOME CARE WHEREBY CHI HAS BEEN AVAILED OF EFFICIENCIES THROUGH CENTRALIZED MANAGEMENT AND STANDARDIZATION OF VARIOUS PRACTICE AND SUPPORT METHODOLOGIES. IN THE FUTURE, CHI NATIONAL HOME CARE WILL GRADUALLY TRANSITION MORE EXISTING HOME HEALTH CARE OPERATIONS, AS WELL AS ANY NEW HOME HEALTH OPERATIONS TO CHI NATIONAL HOME CARE, PROVIDED THE OPERATIONS ARE COMPATIBLE WITH THE MISSION, STRUCTURE AND CLINICAL TARGETED GOALS. THIS TRANSITION WILL ALLOW CHI TO ACHIEVE ECONOMIES OF SCALE IN ITS HOME CARE OPERATIONS AND INCREASE THE REACH OF HOME HEALTH OPERATIONS IN AREAS NOT CURRENTLY SERVED.
Form 990, Part VI, Sec A, Line 1a, Delegate broad authority to a committee
PURSUANT TO SECTION 8.6 OF THE BYLAWS OF CHI NATIONAL HOME CARE, THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, THE PRESIDENT AND CEO, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.6 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders
THE ORGANIZATION'S SOLE CORPORATE MEMBER IS CHI NATIONAL SERVICES, A COLORADO NONPROFIT CORPORATION.
Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body
THE CORPORATE MEMBER HAS THE POWER TO APPOINT, REMOVE OR REPLACE THE MEMBERS OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders
THE ORGANIZATION'S SOLE CORPORATE MEMBER IS CHI NATIONAL SERVICES, PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, BOTH CHI NATIONAL SERVICES AND CATHOLIC HEALTH INITIATIVES ("CHI") (CHI NATIONAL SERVICES' SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE CHI GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX, THE FOLLOWING RIGHTS ARE HELD BY CHI NATIONAL SERVICES BOARD: * APPROVE MEMBERS OF CHI NATIONAL HOME CARE BOARD * AMENDMENT OF THE CORPORATE DOCUMENTS OF CHI NATIONAL HOME CARE * APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF CHI NATIONAL HOME CARE * ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR CHI NATIONAL HOME CARE BOARD THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: * SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF CHI NATIONAL HOME CARE * REMOVAL OF A MEMBER OF THE GOVERNING BODY OF CHI NATIONAL HOME CARE * APPROVAL OF ISSUANCE OF DEBT BY CHI NATIONAL HOME CARE * APPROVAL OF PARTICIPATION OF CHI NATIONAL HOME CARE IN A JOINT VENTURE * APPROVAL OF FORMATION OF A NEW CORPORATION BY CHI NATIONAL HOME CARE * APPROVAL OF A MERGER INVOLVING CHI NATIONAL HOME CARE * APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CHI NATIONAL HOME CARE * TO REQUIRE THE TRANSFER OF ASSETS BY CHI NATIONAL HOME CARE TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CHI NATIONAL SERVICES OR CHI MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.
Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body
ONCE THE RETURN IS PREPARED BY THE CHI TAX DEPARTMENT, A COPY OF THE RETURN IS PROVIDED TO EACH MEMBER OF THE GOVERNING BODY. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy
THE ORGANIZATION HAS ADOPTED CHI'S CONFLICT OF INTEREST POLICY. THE FOLLOWING CHI CONFLICT OF INTEREST POLICY APPLIES TO THE OFFICERS AND BOARD MEMBERS OF CHI NATIONAL HOME CARE: EACH TRUSTEE MUST PROMPTLY AND FULLY REPORT TO THE BOARD CHAIR SITUATIONS THAT MAY CREATE A CONFLICT OF INTEREST WHEN HE OR SHE BECOMES AWARE OF SUCH SITUATIONS. IN ANY SITUATION WHEN A TRUSTEE IS IN DOUBT, FULL DISCLOSURE SHOULD BE MADE SO AS TO PERMIT AN IMPARTIAL AND OBJECTIVE DETERMINATION. A WRITTEN RECORD OF THE DISCLOSURE WILL BE MADE. IN ADDITION TO THE ONGOING DISCLOSURE OBLIGATION, CHI'S SENIOR VICE PRESIDENT, LEGAL SERVICES AND GENERAL COUNSEL SHALL ANNUALLY SEND TO ALL TRUSTEES A COPY OF THE COI POLICY AND THE CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE TRUSTEES MUST PROMPTLY COMPLETE, SIGN, AND RETURN THE STATEMENT TO CHI'S SENIOR VICE PRESIDENT LEGAL SERVICES AND GENERAL COUNSEL. THE COMPLETED STATEMENTS WILL BE REVIEWED BY THE GENERAL COUNSEL, WHO WILL REPORT POTENTIAL CONFLICTS TO THE BOARD CHAIR. THE BOARD CHAIR OR DESIGNEE SHALL MAKE SUCH FURTHER INVESTIGATION OF ANY CONFLICT OF INTEREST DISCLOSURES AS HE OR SHE MAY DEEM APPROPRIATE. IF THE CONFLICT INVOLVES THE BOARD CHAIR, THE VICE CHAIR WILL ASSUME THE CHAIR'S ROLE OUTLINED IN THE POLICY. BASED ON REVIEW AND EVALUATION OF THE RELEVANT FACTS AND CIRCUMSTANCES, THE BOARD CHAIR WILL MAKE AN INITIAL DETERMINATION AS TO WHETHER A CONFLICT OF INTEREST EXISTS AND WHETHER, PURSUANT TO THIS POLICY, REVIEW AND APPROVAL OR OTHER ACTION BY THE BOARD OF STEWARDSHIP TRUSTEES IS REQUIRED. A WRITTEN RECORD OF THE BOARD CHAIR'S DETERMINATION, INCLUDING RELEVANT FACTS AND CIRCUMSTANCES, WILL BE MADE. THE BOARD CHAIR SHALL THEN MAKE AN APPROPRIATE REPORT TO THE EXECUTIVE COMMITTEE OF THE BOARD CONCERNING SUCH REVIEW, EVALUATION AND DETERMINATION. IF A DIFFERENCE OF OPINION EXISTS BETWEEN THE BOARD CHAIR AND ANOTHER TRUSTEE AS TO WHETHER BOARD OF STEWARDSHIP TRUSTEES REVIEW AND APPROVAL OR OTHER ACTION IS REQUIRED WITHIN THIS POLICY, THE MATTER SHALL BE SUBMITTED TO THE BOARD'S EXECUTIVE COMMITTEE, WHICH SHALL MAKE A FINAL DETERMINATION AS TO THE MATTER PRESENTED. SUCH DETERMINATION, INCLUDING RELEVANT FACTS AND CIRCUMSTANCES, WILL BE REFLECTED IN THE COMMITTEE MINUTES AND WILL BE REPORTED TO THE BOARD OF STEWARDSHIP TRUSTEES. THE FOLLOWING CONFLICT OF INTEREST POLICY APPLIES TO INDIVIDUALS WHO SERVE AS OFFICERS OR KEY EMPLOYEES: AT THE TIME OF THE EMPLOYEE'S ANNUAL EVALUATION, THE EMPLOYEE'S DIRECT MANAGER OR SUPERVISOR SHALL REVIEW THIS POLICY WITH THE EMPLOYEE. IF THERE ARE CHANGES TO THE EMPLOYEE'S PREVIOUSLY SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT, A NEW DISCLOSURE STATEMENT SHALL BE COMPLETED, SIGNED AND MAINTAINED IN THE EMPLOYEE'S HR FILE. IF THERE ARE NO CHANGES TO THE EMPLOYEE'S PREVIOUSLY SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT, THE MANAGER AND EMPLOYEE WILL NOTE THAT THERE IS NO CHANGE ON THE SPACE PROVIDED ON THE EMPLOYEE'S EVALUATION FORM. ANY QUESTION ABOUT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST SHOULD FIRST BE PRESENTED BY THE EMPLOYEE TO THE EMPLOYEE'S DIRECT MANAGER OR SUPERVISOR FOR REVIEW AND DETERMINATION. IF THE EMPLOYEE DOES NOT IDENTIFY OR RECOGNIZE THE CONFLICT OR THE NEED TO REQUEST A REVIEW, THE MANAGER, WHO BECOMES AWARE OF A SITUATION THAT INVOLVES THE EMPLOYEE AND PRESENTS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, SHOULD MAKE A DETERMINATION AND ADVISE THE EMPLOYEE OF THE SAME. IF THE EMPLOYEE AND THE MANAGER DO NOT AGREE ABOUT THE APPLICABILITY OF THIS POLICY, OR IF THE EMPLOYEE SEEKS AN EXCEPTION OR EXEMPTION FROM THIS POLICY, THE MANAGER SHALL CONSULT WITH THE MANAGER'S VICE PRESIDENT (OR HIGHER IF THE MANAGER IS A VICE PRESIDENT) TO REACH A DETERMINATION. IF THE MATTER REMAINS UNRESOLVED, IT SHALL BE REFERRED TO THE CHI VICE PRESIDENT OF HUMAN RESOURCES AND THE CHI CORPORATE RESPONSIBILITY OFFICER FOR DETERMINATION. IF THE CHI VICE PRESIDENT OF HUMAN RESOURCES AND THE CHI CORPORATE RESPONSIBILITY OFFICER ARE UNABLE TO REACH AGREEMENT, THE MATTER SHALL BE REFERRED TO THE CHI GENERAL COUNSEL, WHOSE DECISION SHALL BE FINAL. EACH DECISION MAKER MAY INVESTIGATE AND CONSIDER THE CIRCUMSTANCES SURROUNDING THE POTENTIAL OR ACTUAL CONFLICT OF INTEREST, INCLUDING INTERVIEWING THE EMPLOYEE, AS THE DECISION MAKER DEEMS NECESSARY OR APPROPRIATE TO MAKE AN INFORMED DECISION.
FORM 990, PART VI, LINE 15A, PROCESS USED TO ESTABLISH COMPENSATION FOR TOP MANAGEMENT OFFICIAL
THE ORGANIZATION'S CEO'S COMPENSATION IS PAID BY CONSOLIDATED HEALTH SERVICES (CHS). THE CHS BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION FOR THE CEO OF CHI NATIONAL HOME CARE. ADDITIONALLY, CHS USES HR ADVANTAGE TO ASSESS EXECUTIVE COMPENSATION PROGRAM AND TO ENSURE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. THE LAST REVIEW OF THE CEO'S COMPENSATION WAS PERFORMED IN 2014.
FORM 990, PART VI, LINE 15B, COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES
DURING THE TAX YEAR ENDED 6/30/2014, NO OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A.
Form 990, Part VI, Sec C, Line 19, Required documents available to the public
THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE COLORADO SECRETARY OF STATE'S WEBSITE. THE ORGANIZATION'S BYLAWS AND CONFLICT OF INTEREST POLICY ARE NOT PUBLICLY AVAILABLE. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.ORG.
Form 990 , Part XI, Line 9, Other changes in net assets or fund balances
OPERATIONAL TRANSFERS - 240850;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.