TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) KURT SCHLEY CEO	50.0 ................. 42.0	X	X	0	464,621	63,141
(2) SR NANCY MILLER OSB PRESIDENT	3.0 ................. 2.0	X	X	0	0	0
(3) JOHN GIESE Chair	3.0 ................. 3.0	X	X	5,550	0	0
(4) SR THOMAS WELDER Vice President	3.0 ................. 2.0	X	X	0	0	0
(5) SR GERARD WALD Secretary (Partial Year)	3.0 ................. 1.0	X	X	0	0	0
(6) SR ROSANNE ZASTOUPIL Treasurer (Partial Year)	3.0 ................. 1.0	X	X	0	0	0
(7) JEFFREY DROP Director	1.0 ................. 62.0	X		0	1,216,002	27,308
(8) MIKE LEFOR Director	1.0 ................. 5.0	X		0	0	0
(9) PATRICK SOGARD Director	1.0 ................. 3.0	X		0	0	0
(10) VERNON DOSCH Director	3.0 ................. 2.0	X		2,775	0	0
(11) ROBERT GAYTON Director (PARTIAL YEAR)	3.0 ................. 1.0	X		3,375	0	0
(12) PAMELA SCHMIDT Director (Partial Year)	3.0 ................. 1.0	X		3,175	0	0
(13) SR JOANN KREBSBACH Director (Partial Year)	3.0 ................. 1.0	X		0	0	0
(14) LESLIE OLIVER Director	3.0 ................. 2.0	X		3,475	0	0
(15) TIMOTHY BOPP MD Director	3.0 ................. 2.0	X		1,300	0	0
(16) Dr Guy Tangedahl Director (Partial Year)	3.0 ................. 1.0	X		1,625	0	0
(17) JOSEPH MESSMER Interim President/CEO (PARTIAL YEAR)	50.0 ................. 51.0		X	0	392,534	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Priscilla Needham CFO (Partial Year)	40.0 .......................0	X				0	186,458	22,057
(19) DEB MOHESKY CFO (Partial Year)	40.0 .......................0	X				0	0	0
(20) Shiraz Hyder VP Medical Affairs	40.0 .......................0		X			622,320	0	31,588
(21) Rosanne Schmidt VP & Chief Nursing Officer	40.0 .......................0		X			283,000	0	30,486
(22) Duwayne Schlittenhard VP Professional Services	40.0 .......................0		X			326,440	0	39,052
(23) Amy Hornbacher VP Corporate Responsibility	40.0 .......................0		X			158,554	0	15,513
(24) Julie Jeske VP Community Services	40.0 .......................0		X			151,092	0	7,879
(25) JEFFREY BEAUCHAMP VP Materials & Facilities Resources	40.0 .......................0		X			168,493	0	18,891
(26) Dr Michael Brown Cardiovascular Surgeon	40.0 .......................1.0			X		739,497	0	33,190
(27) Dr Eric Belanger Neurosurgeon	40.0 .......................0			X		1,955,924	0	45,998
(28) Dr Steven Kraljic Neurosurgeon	40.0 .......................0			X		1,937,573	0	47,098
(29) Dr Allen Booth Cardiovascular & Thoracic Surgeon	40.0 .......................0			X		726,455	0	48,602
(30) Boyd Marts Cardiovascular Surgeon	40.0 .......................0			X		720,897	0	49,057
(31) Susan Sisk Former VP Accounting & Finance	40.0 .......................0				X	292,822	0	39,437
(32) Gary Miller Former President/ CEO	50.0 .......................1.0				X	748,469	0	15,857

(A) Name and business address	(B) Description of services	(C) Compensation
Medical Solutions 1010 N 102nd St Suite 300 Omaha,NE68114	NURSE STAFFING SERVICES	6,607,091
Bismarck Radiology Associates 810 E Rosser Ave Ste 201 Bismarck,ND58501	Radiology Services	5,328,828
Northern Plains Lab PO Box 2036 Bismarck,ND58502	Pathology Services	5,201,400
DMS Health Technologies Inc 2101 N University Dr Fargo,ND58102	Radiology Services	901,688
Northland Nuclear Medicine LLC 2124 E Thayer Ave Bismarck,ND58501	Radiology Services	789,090
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 20

- TIN:

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.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

St Alexius Medical Center

Employer identification number

45-0226711

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.)..
11	Total support. Add lines 7 through 10.

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

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

St Alexius Medical Center

Employer identification number

45-0226711

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization St Alexius Medical Center

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization St Alexius Medical Center		Employer identification number 45-0226711

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization St Alexius Medical Center			Employer identification number 45-0226711
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

St Alexius Medical Center

Employer identification number

45-0226711

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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

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

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

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

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

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

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

Yes

8,927

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

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

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

Yes

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

8,927

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	Line 1f- THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION- $2,719 CATHOLIC HEALTH ASSOCIATION- $1,653 NORTH DAKOTA HOSPITAL ASSOCIATION- $4,555
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	Line 1f- THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION- $2,719 CATHOLIC HEALTH ASSOCIATION- $1,653 NORTH DAKOTA HOSPITAL ASSOCIATION- $4,555

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St Alexius Medical Center

Employer identification number

45-0226711

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

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

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	5,511,626	5,092,887	4,168,921	3,654,924	3,639,568
b	Contributions ...	155,866	1,167,300	1,294,587	958,033	494,559
c	Net investment earnings, gains, and losses	18	148,073	243,129	120,568	137,978
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	623,219	877,031	596,057	548,054	601,477
f	Administrative expenses ....	12,625	19,603	17,693	16,550	15,704
g	End of year balance ......	5,031,666	5,511,626	5,092,887	4,168,921	3,654,924

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

Board designated or quasi-endowment SchDMd Bullet

100 %

Permanent endowment SchDMd Bullet

0 %

Temporarily restricted endowment SchDMd Bullet

0 %

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

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on 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 ...	18,061,206		18,061,206
b	Buildings	63,639,189	14,206,555	49,432,634
c	Leasehold improvements	0	0	0
d	Equipment ...	56,704,365	8,455,091	48,249,274
e	Other ...	4,472,306	138,844	4,333,462
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				120,076,576

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other (A) CHI OIP	18,771,919	F
(B) CANCER CENTER
(C) CANCER CENTER FOUNDATION
(D) CASH & CASH EQUIVALENTS
(E) MANDAN PHARMACY
(F) CENTRAL DAKOTA LAUNDRY
(G) COOP
(H) NCHCA PRIMECARE
(I) NORTHERN PLAINS LAB
(J) SA HEALTH SERVICES INC
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	18,771,919

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) Deposits				52,196
(2) Intercompany Receivables				85,157,858
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				85,210,054

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Other Liabilities	13,005
Unclaimed Property	5,929
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	18,934
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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 (losses) 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' on 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

The endowment is utilized to provide funding to continue to enhance patient care at St. Alexius Medical Center set forth in our mission, "Let all be received as Christ."

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

St. Alexius 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, 2016, 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) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on 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 arrow

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

Information about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
St Alexius Medical Center

Employer identification number

45-0226711

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

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

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

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










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2015

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on 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 Night for the Stars (event type)	(b) Event #2 SAKT (event type)	(c) Other events (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	383,329	54,763		438,092
2	Less: Contributions . . . .	214,983	44,838		259,821
3	Gross income (line 1 minus line 2) . . . . . .	168,346	9,925	0	178,271

4	Cash prizes . . . . .
5	Noncash prizes . . . .		339	339
6	Rent/facility costs . . . .	6,940	344	7,284
7	Food and beverages . . .	28,854	148	29,002
8	Entertainment . . . .	2,800		2,800
9	Other direct expenses . . .	94,062	1,122	95,184
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .			134,609
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .			43,662

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .			24,950	24,950

2	Cash prizes . . . . .
3	Noncash prizes . . . .			23,175	23,175
4	Rent/facility costs . . . .
5	Other direct expenses . . .	94,062	1,122		95,184

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes90 %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities: ND

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2015

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

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

13a

0 %

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

13b

100 %

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

KILEE HARMON

Address

900 E BROADWAY AVE
BISMARCK,ND58501

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

$ 0

Description of services provided right arrow

DEVELOPMENT DIRECTOR

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

$ 32,529

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, Part III, Line 17 Distributions required under state law	STATE=NORTH DAKOTA,MANDATORY DISTRIBUTION AMOUNT=32529;

Schedule G (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St Alexius Medical Center

Employer identification number

45-0226711

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

100% 150% 200% Other %

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

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

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			606,723		606,723	0.19 %
b	Medicaid (from Worksheet 3, column a) . . . . .			12,159,153	9,702,292	2,456,861	0.75 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	12,765,876	9,702,292	3,063,584	0.94 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			139,382		139,382	0.04 %
f	Health professions education (from Worksheet 5) . . .			1,927,124		1,927,124	0.59 %
g	Subsidized health services (from Worksheet 6) . . . .			12,005,513	2,415,665	9,589,848	2.94 %
h	Research (from Worksheet 7) .			286,617	159,832	126,785	0.04 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			91,108		91,108	0.03 %
j	Total. Other Benefits . .	0	0	14,449,744	2,575,497	11,874,247	3.64 %
k	Total. Add lines 7d and 7j .	0	0	27,215,620	12,277,789	14,937,831	4.58 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

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
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	0	0	0	0

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

5,582,964

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. ......

669,956

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

Section B. Medicare

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

87,265,139

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

124,523,891

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

-37,258,752

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1NORTHERN PLAINS LAB	LABORATORY SERVICES	50 %	50 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

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 (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	St Alexius Medical Center 900 East Broadway Bismarck,ND585065510 www.st.alexius.org 5004	X	X	X	X

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	St Alexius Medical Center
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

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 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

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

Yes

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

Hospital facility’s website (list url): https://www.st.alexius.org/about/community-health-assessment

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://www.st.alexius.org/about/community-health-assessment

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	St Alexius Medical Center
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of % and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

https://www.st.alexius.org/visitors/financial-assistance

The FAP application form was widely available on a website (list url):

https://www.st.alexius.org/visitors/financial-assistance

A plain language summary of the FAP was widely available on a website (list url):
https://www.st.alexius.org/visitors/financial-assistance

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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 all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	St Alexius Medical Center
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - St. Alexius Medical Center. Input for CHI St. Alexius Health's Community Health Needs Assessment was derived from several resources including a generalizable survey, non-generalizable survey, stakeholders' meeting, Project Service Connect Survey and Veteran's Stand Down Survey. In March of 2015, CSR conducted a mail survey (generalizable) to a representative sample of community residents of the Bismarck-Mandan metro area via the United States Postal Service. On April 1, members of the community were invited to participate in an online (non-generalizable) survey. The survey instrument was available on each Community Health Collaborative partner's website and was also distributed via e-mail to various agencies. Data collection occurred throughout the month of April 2015 and a total of 502 respondents participated in the online survey. The online survey instrument used was based largely on questions included in the paper survey format. However, some questions in the paper survey were modified for the online version of the survey and therefore are not comparable, particularly those questions relating to Advanced Care Directives and alcohol use and prescription or non-prescription drug abuse. To gain input from persons who represent the broad interests of the communities served by our facilities, including those with special knowledge of or expertise in public health, a community stakeholders meeting was held in June. The Project Service Connect Survey was conducted by Bismarck Burleigh Public Health. Summary of the feedback provided by the community stakeholders was placed in a survey tool and distributed to stakeholders to determine a prioritization of needs for the communities. An additional survey title Veteran's Stand Down, was conducted to reach vulnerable populations in the Burleigh-Morton county area. Vulnerable populations include the economically disadvantaged, racial and ethnic minorities, the uninsured, low-income children, the elderly, the homeless, those with human immunodeficiency virus (HIV), and those with other chronic health conditions, including severe mental illness identified as at-risk for health disparities.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - St. Alexius Medical Center. The 2016 Community Health Needs Assessment identified the following three critical needs in the community: Chronic Diseases/Mental Health/Diabetes with a focus on diabetics The implementation strategy for the Chronic Diseases/Mental Health/Diabetes committee includes recognizing and referring at risk individuals. This will be accomplished through education to providers as well as the general population. Awareness will be created through a series of public service announcements, digital media and printed collateral pieces. Violence Prevention/Violence Against Women Part of the violence prevention strategy is focused on our partnerships with area schools. School programs will be presented to middle school students in an age-appropriate manner to raise awareness and provide information on how gender roles and expectations, as well as our culture, influence dating violence and sexual assault. Students will learn about resources, risk reduction strategies and bystander intervention. The committee will also develop a strategy to involve local law enforcement officers. Obesity/Childhood Obesity Many social and environmental factors have negatively influenced the physical activity and eating behaviors of US children and adolescents. Financial and time pressures force many families to minimize food costs and meal preparation time, resulting in increased consumption of prepackaged convenience foods that are high in calories and fat. To move the needle when it comes to childhood obesity, the committee will add to our Kohl's Care for Kids sponsored activities. Each of these activities is designed to educate children and their parents/guardians about the importance of proper weight, good nutrition and exercise.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - St. Alexius Medical Center. When Catholic Health Initiatives (the ultimate parent organization to St. Alexius Medical Center established its financial assistance policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among urban and rural communities in 18 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines (FPG), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. St. Alexius 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. An individual's income under the HUD guidelines is a significant factor in determining eligibility for financial assistance. However, in determining whether to extend discounted or free care to a patient, the patient's assets may also be taken into consideration. For example, a patient suffering a catastrophic illness may have a reasonable level of income, but a low level of liquid assets such that the payment of medical bills would be seriously detrimental to the patient's basic financial (and ultimately physical) well-being and survival. Such a patient may be extended discounted or free care based upon the facts and circumstances.
Schedule H, Part V, Section B, Line 22 Facility , 1	Facility , 1 - St. ALexius Medical Center. THE ORGANIZATION WILL NOT CHARGE INDIVIDUALS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE MORE THAN AMOUNTS GENERALLY BILLED TO THOSE WHO HAVE INSURANCE

Schedule H (Form 990) 2015

Page 8

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?6
Name and address		Type of Facility (describe)
1	St Alexius Heart & Lung Clinic 310 North 10th Street Bismarck,ND58501	Heart, lung & peripheral vascular disease clinic
2	Great Plains Rehabilitation Services 1212 East Main Bismarck,ND58501	Provide home medical products to general public
3	St Alexius Minot Clinic 2700 8TH ST NW Minot,ND58701	Family medicine clinic
4	St Alexius Mandan Clinic North 2500 Sunset Dr NW Mandan,ND58554	Family medicine clinic
5	St Alexius Mandan Clinic-South 403 Burlington Street SE Mandan,ND58554	Family medicine clinic
6	Mandan Clinic-East 2008 Twin City Drive Mandan,ND58554	Family medicine clinic
7
8
9
10

Schedule H (Form 990) 2015

Page 9

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 I, Line 3c Eligibility criteria for free or discounted care	When Catholic Health Initiatives (the ultimate parent organization to St. Alexius Medical Center established its financial assistance policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among urban and rural communities in 18 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines (FPG), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. St. Alexius 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. An individual's income under the HUD guidelines is a significant factor in determining eligibility for financial assistance. However, in determining whether to extend discounted or free care to a patient, the patient's assets may also be taken into consideration. For example, a patient suffering a catastrophic illness may have a reasonable level of income, but a low level of liquid assets such that the payment of medical bills would be seriously detrimental to the patient's basic financial (and ultimately physical) well-being and survival. Such a patient may be extended discounted or free care based upon the facts and circumstances.
Schedule H, Part I, Line 7g Subsidized Health Services	Subsidized health services does not include any costs attributable to physician clinics.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	5582964
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	The charity care included in Part I, Line 7a is based on the average cost to gross charges calculated from our audited financial. The unreimbursed Medicaid in Part I, Line 7b is based on gross charges and claims from our Accounts Receivable system. The community health services, education and contributions in Part I, Lines 7e, f and i are based on actual expenses. The subsidized health services in Part I, Line 7g are based on estimated costs from the internal cost accounting general ledger systems.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	THE AMOUNT REPORTED AS BAD DEBT EXPENSE REPRESENTS TOTAL CHARGES WRITTEN OFF TO BAD DEBT. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The estimated amount of the organization's bad debt expense that is attributable to patients eligible under the organization's charity care policy is approximately $669,956. This was based off the most recent community needs assessment reported, which indicated that 12% of the population is below the Federal Poverty Guidelines. The 12% was applied to the amount of bad debt expense.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	St. Alexius Medical Center does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in health care coverage, and other collection indicators. Management routinely assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. The provision for bad debts is presented on the consolidated statements of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats all patients without regard to the ability to pay."
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Using essentially the same Medicare cost report principles as to the allocation of general services costs and "apportionment" methods, the "CHI Workbook" calculates a payers' gross allowable costs by service (so as to facilitate a corresponding comparison between gross allowable costs and ultimate payments received). The term "gross allowable costs" means costs before any deductibles or co-insurance are subtracted. St. Alexius Medical Center's ultimate reimbursement will be reduced by any applicable copayment/ deductible. Where Medicare is the secondary insurer, amounts due from the insured's primary payer were not subtracted from Medicare allowable costs because the amounts are typically immaterial. St. Alexius Medical Center believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." Medicare losses are different from Medicaid losses, which are counted in the CHA community benefit framework, because Medicaid reimbursements generally do not receive the level of attention paid to Medicare reimbursement. Medicaid payment is largely driven by what states can afford to pay, and is typically substantially less than what Medicare pays.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	St. Alexius Medical Center's debt collection policy provides that St. Alexius Medical Center will perform a reasonable review of each inpatient account prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment, to assure that the patient and patient guarantor are not eligible for any assistance program (e.g. Medicaid) and do not qualify for coverage through St. Alexius Medical Center's community assistance policy. After having been turned over to a third-party collection agent, any patient account that is subsequently determined to meet the St. Alexius Medical Center community assistance policy is required to be returned immediately by the third-party collection agent to St. Alexius Medical Center for appropriate follow-up. St. Alexius Medical Center requires its third-party collection agents to include a message on all statements indicating that if a patient or patient guarantor meets certain stipulated income requirements, the patient or patient guarantor may be eligible for financial assistance. All of Catholic Health Initiatives' hospitals' contracts with third party collection agencies include the following standards: * Neither CHI hospitals nor their collection agencies will request bench or arrest warrants as a result of non-payment; * Neither CHI hospitals nor their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No Catholic Health Initiatives' collection agency may seek court action without hospital approval. Finally, collection agencies are trained on the Catholic Health Initiatives Mission, Core Values and Standard of Conduct to make sure all patients are treated with dignity and respect.
Schedule H, Part V, Section B, Line 16a FAP website	- St. Alexius Medical Center: Line 16a URL: https://www.st.alexius.org/visitors/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- St. Alexius Medical Center: Line 16b URL: https://www.st.alexius.org/visitors/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- St. Alexius Medical Center: Line 16c URL: https://www.st.alexius.org/visitors/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment	The Organization completed a community health needs assessment during fiscal year 2016.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	St. Alexius Medical Center includes information concerning its financial assistance policy on its website. In addition, St. Alexius Medical Center prominently displays its financial assistance policy in both English and Spanish in obvious locations throughout the hospitals, including the emergency rooms and other patient intake areas, as well as in St. Alexius Medical Center outpatient facilities. In addition, St. Alexius Medical Center registration clerks are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for financial assistance under St. Alexius Medical Center's financial assistance policy. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicare or Medicaid) are provided with a packet of information that addresses the financial assistance policy and procedures including an application for assistance. St. Alexius Medical Center registration clerks read the organization's medical assistance policy to those who appear to be incapable of reading, and provide translators for non-English-speaking individuals. St. Alexius Medical Center's staff will also assist the patient/guarantor with applying for other available coverage (such as Medicaid), if necessary. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies.
Schedule H, Part VI, Line 4 Community information	St. Alexius provides outreach services across its service area of central and western North Dakota. St. Alexius operates the Garrison Memorial Hospital in Garrison, North Dakota and manages the Community Memorial Hospital in Turtle Lake. St. Alexius owns and operates clinics in Mandan, Minot, Garrison, and Washburn. North Dakota's population is 739,482 of which 68,896 reside in the city of Bismarck. The population is 89.1% white, 4.5% Native American, and the remaining 6.4% being African American, Asian, and Hispanic. By the year 2020, 45 of the 53 counties will have more than 22% of their population age 65 or older. From 2000-2005 our state had a 15% decrease in the number of youth and a 13.8% increase in the minority population which was primarily Native American Reservations. North Dakota has 12% of their population living in poverty. The leading causes of death in Burleigh county ranked in order are Diseases of the Heart, Alzheimers, Respiratory Cancer, Accidental, Cerebrovascular Disease, COPD, Diabetes, Breast Cancer, and Colorectal Cancer. Health related behaviors influence cardiovascular diseases such as smoking, physical inactivity, poor nutrition, and unhealthy weight status. Hypertension is a chronic disease associated with aging that has a high risk factor for heart disease and stroke. In North Dakota, 26% adults have high blood pressure. North Dakota adults are a part of the national trend towards increased obesity. 63% of the adults here have an unhealthy weight/BMI. Some of the health screenings that St. Alexius is conducting throughout the service region are vascular, wellness, memory, sleep apnea, and chronic obstructive pulmonary disease. Those individuals that are being screened at no or minimal cost are being alerted of health risks that might go undetected. Through screenings, it is our hope that these individuals seek further treatment and are empowered to make healthier lifestyle choices.
Schedule H, Part VI, Line 5 Promotion of community health	The governing body is comprised of people in the community who are knowledgeable to advise the organization and are compensated for their expertise and time (see Part VII of Form 990). The organization extends medical staff privileges to Primecare physicians. The organization applies surplus funds, if available, to their reinvestment in equipment and facilities to improve patient care. The Hospital provides several services at reduced or no costs. Those included are as follows: 1. INTERACTIVE NETWORK - Consists of twenty five communities located in Montana, South and North Dakota covering 70,000 square miles are serviced by the St. Alexius Medical Center network. INTERACTIVE NETWORK provides electrocardiogram management, interactive cardiac management, remote cardiac monitoring, electroencephalogram monitoring, fetal monitoring, biomedical services, dialysis and infant pneumocardiograms to patients in western and central North Dakota. These services might not be provided if not for the Hospital servicing these areas. 2. OTHER ACTIVITES INCLUDED ON PART 1, LINE 7E: - In keeping with the Hospital's commitment to serve all members of its community St. Alexius Medical Center: -participated in health fairs -provided patient educational materials and classes -provided patient support groups for different diseases -conducted health screenings -sponsored "Wellness" type programs ranging from Lamaze instruction and parenting to babysitting to diet and weight control to social issues. -operated a Hospice Program -has telemedicine capabilities set-up in several rural communities -provides PAC's (radiology) services and radiology reading to many rural communities -tumor registry 3. St. Alexius operates a Telemedicine network, known as The Telecare Network. It is a service St. Alexius Medical Center and affiliated physicians offer in cooperation with 27 healthcare providers throughout the Dakotas. The service features telemedicine consultations between rural physicians and specialists in Bismarck using real time video and audio telepresence equipment. Consultations of both urgent and routine nature are available. 4. St. Alexius provides support to many other rural communities in terms of Critical Access Hospital management, primary care physician coverage, and visiting specialists.
Schedule H, Part VI, Line 6 Affiliated health care system	St. Alexius Medical Center, along with its affiliated outpatient facilities, are part of Catholic Health Initiatives. Catholic Health Initiatives (CHI) is a national faith-based nonprofit health care organization with headquarters in Englewood, Colorado. CHI's exempt purpose is to serve as an integral part of its national system of hospitals and other charitable entities, which are described as market-based organizations, or MBOs. An MBO is a direct provider of care or services within a defined market area that may be an integrated health system and/or a stand-alone hospital or other facility or service provider. CHI serves as the parent corporation of its MBOs which are comprised of 104 hospitals, including four academic medical centers, and 30 critical access facilities; community health service organizations; accredited nursing colleges; home health agencies; and other facilities that span the inpatient and outpatient continuum of care. Together, these facilities provided $1.1 billion in financial assistance and community benefit in the 2016 fiscal year, including services for the poor, free clinics, education and research. CHI provides strategic planning and management services as well as centralized "shared services" for the MBOs. The provision of centralized management and shared services - including areas such as accounting, human resources, payroll and supply chain -- provides economies of scale and purchasing power to the MBOs. The cost savings achieved through CHI's centralization enable MBOs to dedicate additional resources to high-quality health care and community outreach services to the most vulnerable members of our society. St. Alexius Medical Center operates with its wholly owned affiliates and community partners, to serve the health care needs of the North Dakota communities.
Schedule H, Part VI, Line 7 State filing of community benefit report	ND

Schedule H (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on 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

2015

Open to Public
Inspection

Name of the organization
St Alexius Medical Center

Employer identification number
45-0226711

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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 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) Cystic Fibrosis Foundation 921 S 9th St 115 Bismarck,ND585045858	13-1930701	501(c)(3)	16,328	Cysitc Fibrosis clinic
(2) ND Department of Health 600 E Boulevard Ave Bismarck,ND585050200		ND Dept of Health	150,785	Program Support for Multiple Medical Programs
(3) North Dakota Community Foundation PO Box 387 Bismarck,ND58502	45-0336015	501(c)(3)	10,000	COMMUNITY SUPPORT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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) CHARITY CARE	733	1,186,847
(1)
(2)
(3)
(4)
(5)
(6)
(7)

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 Charity Care

St. Alexius 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.

St. Alexius makes donations to entities with charitable missions to ensure that our donations are used for the purposes intended.

Schedule I (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St Alexius Medical Center

Employer identification number

45-0226711

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on 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 ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

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

Cat. No. 50053T

Schedule J (Form 990) 2015

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 on 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 in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Gary Miller Former President/ CEO	(i) (ii)	192,801 ------------- 0	149,127 ------------- 0	406,541 ------------- 0	8,001 ------------- 0	7,856 ------------- 0	764,326 ------------- 0	0 ------------- 0
2KURT SCHLEY CEO	(i) (ii)	0 ------------- 308,346	0 ------------- 75,581	0 ------------- 80,694	0 ------------- 52,675	0 ------------- 10,466	0 ------------- 527,762	0 ------------- 0
3JEFFREY DROP Director	(i) (ii)	0 ------------- 509,375	0 ------------- 472,560	0 ------------- 234,067	0 ------------- 15,428	0 ------------- 11,880	0 ------------- 1,243,310	0 ------------- 42,295
4JOSEPH MESSMER Interim President/CEO (PARTIAL YEAR)	(i) (ii)	0 ------------- 392,534	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 392,534	0 ------------- 0
5Priscilla Needham CFO (Partial Year)	(i) (ii)	0 ------------- 173,571	0 ------------- 12,756	0 ------------- 131	0 ------------- 10,078	0 ------------- 11,979	0 ------------- 208,515	0 ------------- 0
6Susan Sisk Former VP Accounting & Finance	(i) (ii)	93,423 ------------- 0	63,076 ------------- 0	136,323 ------------- 0	25,503 ------------- 0	13,934 ------------- 0	332,259 ------------- 0	0 ------------- 0
7Shiraz Hyder VP Medical Affairs	(i) (ii)	391,222 ------------- 0	226,196 ------------- 0	4,902 ------------- 0	10,600 ------------- 0	20,988 ------------- 0	653,907 ------------- 0	0 ------------- 0
8Rosanne Schmidt VP & Chief Nursing Officer	(i) (ii)	209,740 ------------- 0	68,563 ------------- 0	4,697 ------------- 0	10,600 ------------- 0	19,886 ------------- 0	313,485 ------------- 0	0 ------------- 0
9Duwayne Schlittenhard VP Professional Services	(i) (ii)	252,798 ------------- 0	68,022 ------------- 0	5,619 ------------- 0	28,600 ------------- 0	10,452 ------------- 0	365,492 ------------- 0	0 ------------- 0
10Amy Hornbacher VP Corporate Responsibility	(i) (ii)	133,369 ------------- 0	24,538 ------------- 0	646 ------------- 0	6,435 ------------- 0	9,079 ------------- 0	174,067 ------------- 0	0 ------------- 0
11Julie Jeske VP Community Services	(i) (ii)	113,735 ------------- 0	36,548 ------------- 0	809 ------------- 0	6,030 ------------- 0	1,849 ------------- 0	158,971 ------------- 0	0 ------------- 0
12JEFFREY BEAUCHAMP VP Materials & Facilities Resources	(i) (ii)	124,337 ------------- 0	43,245 ------------- 0	911 ------------- 0	6,794 ------------- 0	12,097 ------------- 0	187,384 ------------- 0	0 ------------- 0
13Dr Michael Brown Cardiovascular Surgeon	(i) (ii)	739,497 ------------- 0	0 ------------- 0	0 ------------- 0	28,150 ------------- 0	5,040 ------------- 0	772,687 ------------- 0	0 ------------- 0
14Dr Eric Belanger Neurosurgeon	(i) (ii)	1,559,922 ------------- 0	394,291 ------------- 0	1,710 ------------- 0	27,500 ------------- 0	18,498 ------------- 0	2,001,922 ------------- 0	0 ------------- 0
15Dr Steven Kraljic Neurosurgeon	(i) (ii)	1,309,192 ------------- 0	627,241 ------------- 0	1,140 ------------- 0	28,600 ------------- 0	18,498 ------------- 0	1,984,671 ------------- 0	0 ------------- 0
16Dr Allen Booth Cardiovascular & Thoracic Surgeon	(i) (ii)	704,591 ------------- 0	14,340 ------------- 0	7,524 ------------- 0	27,604 ------------- 0	20,998 ------------- 0	775,057 ------------- 0	0 ------------- 0
17Boyd Marts Cardiovascular Surgeon	(i) (ii)	720,897 ------------- 0	0 ------------- 0	0 ------------- 0	28,124 ------------- 0	20,933 ------------- 0	769,954 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

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	Compensation for the top management official was established and paid by Catholic Health Initiatives (CHI), a related organization. CHI used the following to establish the top management official's compensation: (1) Compensation Committee; (2) Independent Compensation Consultant; (3) Written Employment Contracts; (4) Compensation Survey or Study; (5) Approval by the Board or Compensation Committee.
Schedule J, Part I, Line 4a Severance or change-of-control payment	The following reportable individuals received severance payments during the 2015 calendar year, and these severance payments were included in the individual's W-2 income and reportable compensation on Schedule J: Gary Miller $367,200 Susan Sisk $108,022
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	During the 2015 calendar year Catholic Health Initiatives (CHI), a related organization, maintained a supplemental non-qualified deferred compensation plan for MBO CEOs/Presidents and other CHI employees at the level of Senior Vice President and above. The following reportable individuals were eligible to participate in that plan: Jeffrey Drop Kurt Schley During 2015 the following contributions were made by CHI to the deferred compensation plan: Kurt Schley- $ 36,900 During 2015 the following distributions were made by CHI from the deferred compensation plan: JEFFREY DROP - $ 42,295 Due to the "super" vesting rules under the CHI deferred compensation plan, participants who have met certain requirements such as age, years of service or more than 5 years of plan participation are eligible to receive their 2015 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 2015, the following contributions that would have been made by CHI to the deferred compensation plan were paid in cash: Jeffrey Drop - $ 79,113
Schedule J, Part I, Line 7 Non-fixed payments	At the beginning of each fiscal year, the Compensation Committee establishes a financial threshold which must be met before any awards are paid and establishes guidelines defining the size of any awards available to participants. At the end of the plan year, the Committee decides whether to make any awards to participants and how large any award shall be, in accordance with the guidelines established at the beginning of the plan year. Incentive compensation is earned as a percent of base salary. Base salary is defined as the annualized rate of pay (summation of monthly base salary for the plan year).

Schedule J (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete 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 image

Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St Alexius Medical Center

Employer identification number

45-0226711

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 .......	X		209,690	Market value
6 Cars and other vehicles ..	X	2	30,974	Market value
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	1	5,019	Market value
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 ...	X	1	102	Market value
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Custom Built Wine Cabinet )	X	1	6,500	Market value
26 Other ( GIft Cards )	X	1	937	Market value
27 Other ( Vacation Package )	X	3	18,430	Market value
28 Other ( American Girl Doll )	X	1	592	Market value

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

Yes

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

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

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) (2015)

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 Explanations of reporting method for number of contributions	Cars and other vehicles - Number of Items Received Food inventory - Number of Contributions Other - Custom Built Wine Cabinet Number of Items Received Other - GIft Cards Number of contributors Other - Vacation Package Number of Contributions Received Other - American Girl Doll Number of items contributed Securities - Publicly traded - Number of contributions

Schedule M (Form 990) (2015)

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ 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

2015

Open to Public
Inspection

Name of the organization

St Alexius Medical Center

Employer identification number

45-0226711

Return Reference	Explanation
Form 990, Part III, Line 1 ORGANIZATION'S MISSION	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 Accomplishment Continuation	We are comprised of an interventional radiologist, cardiologists, heart and vascular surgeons as well as other highly trained support personnel. Specialty Clinics: Our specialty clinics are a unique multi-specialty group practice located mainly inside St. Alexius Medical Center. Over 26 providers in 14 different specialties work together to care for patients. Specialists must complete sever or more years of medical school and post-graduate training and then complete fellowships in their chosen specialties. All physicians are board eligible or board certified in one or more specialties. We provide clinic services in many off site satellite clinics and bring specialty services to the region. The specialty clinics include Medical Plaza Mandan, Medical Plaza Minot, Infectious Disease, Children's Services, Infusion Center, Nephrology, Neurosurgery, Pain, Neurology, Adult Physical Medicine, Rheumatology, and Urology. St. Alexius operates an outpatient family service program called Archway Mental Health Services. This program offers sensitive and responsive services for individual, marital and family problems. This program is keeping with St. Alexius Medical Center's philosophy of being a leader in progressive and quality services to the people of North Dakota. Archway services are also provided in Hazen, Garrison, and Linton, ND. Great Plains Rehabilitation Services is a division of St. Alexius Medical Center that provides Home Medical Equipment, Orthotic & Prosthetic, Home Respiratory Care, ADA Environmental and Rehabilitation Technology services. Great Plains provides needed medical equipment and supplies to help individual lead active and independent lives. Great Plains services all of North Dakota, Center and Eastern Montana, and Northern South Dakota. Other: St. Alexius Medical Center served 10,555 inpatients 126,620 outpatients, 28,965 emergency patients, and 2,364 Home Health Care patients during fiscal year ended June 30, 2016. St. Alexius Medical Center provided community activities and services at reduced or no cost. Those included: 1. Employee Assistance Program (EAP)- St. Alexius services over 200 employer contracts through its EAP with more than 35,000 employees by providing problem assessment, short term counseling and referral to appropriate resources for follow-up care. EAP services are only open to employees of a participating company. The service is free if your employer pays to participate. 2. Employee Activities - In keeping with the Medical center commitment to its employees: a. Actively participated in the United Way fund campaign. b. Journey Beyond Excellence Program - we have several teams that assist with our journey-rewards and recognition, patient satisfaction, physician satisfaction. These teams work together with our leadership to resolve challenges and engage all in our mission. c. The vacation donation program assisted employees who have an illness or an illness in the family allowing other employees to donate vacation hours to allow the affected employee time to heal or time with a family member during their healing process. d. The Employee Emergency Fund is for any St. Alexius employee who experiences a crisis or is directly affected by a crisis involving a family member. The funds are available to employees who are facing personal tragedies or hardships for reason such as a loss of a spouse or child, catastrophic illness, loss of home by fire or flood, or other calamities. 3. Acute Care Facility - St. Alexius is a partner with another acute care facility in Bismarck for the operation of a radiation therapy facility known as the Bismarck Cancer Center. The Bismarck Cancer Center helps to ensure that patients with cancer receive quality care and management of their disease without having to drive a long distance to receive necessary care. 4.Awards and Accomplishments: For the third consecutive year, CHI St. Alexius Health was recognized as The Best Hospital in North Dakota by U.S. News & World Report. The annual U.S. News Best Hospitals rankings, recognize hospitals that excel in treating the most challenging patients. Less than three percent of the nearly 5,000 hospitals that were analyzed for Best Hospitals 2015-16 were nationally ranked in even one specialty. CHI St. Alexius Health ranked high performing in gastroenterology and GI surgery, geriatrics, orthopedics and pulmonology. Cleverley and Associates Community rated CHI St. Alexius Health a Value Five-Star Hospital. Each year, Cleverley and Associates publishes a ranking of the best hospitals in the nation in terms of the value that they provide to their community. The current rankings were recently published in The State of the Hospital Industry - 2015 Edition In September 2015, CHI St. Alexius Health was notified by Women's Choice Award that it was considered a Best Hospital I American for Bariatric Surgery. The recognition is determined as the result of meeting Women's Choice Award's high standards, including current MBSAQIP accreditation, and high patient safety and patient recommendation scores. CHI St. Alexius Health was among a select group of hospitals nationwide and the only hospital in western North Dakota recognized by the U.S. Department of Health and Human Services (HHS) for reaching the gold level of achievement for conducting activities that encouraged enrollment in state organ donor registries. CHI St. Alexius Health was part of a national hospital campaign, sponsored by HHS's Health Resources and Services Administration (HRSA), which added 580,000 donor enrollments to state registries nationwide since 2011, exceeding the goal of 300,000. CHI St. Alexius Health was recognized by Women's Choice Award as one of America's Best Hospitals for Heart Care, based on our cardiac and vascular experience and our record with regard to 30-day mortality and readmission rates for heart attacks, heart failure with additional consideration given for patient satisfaction scores. CHI St. Alexius Health was recognized as The Joint Commission Top Performing Hospital For Key Quality Measures as part of The Joint Commission's 2015 annual report "America's Hospitals: Improving Quality and Safety," for attaining and sustaining excellence in accountability measure performance for heart attack, heart failure, pneumonia, surgical care, stroke and perinatal care. CHI St. Alexius Health is the only hospital in Bismarck and one of only 1,043 hospitals out of more than 3,300 eligible hospitals in the United States to achieve the 2014 Top Performer distinction. In CareChex 2015 Quality Recognition, CHI St. Alexius Health was ranked # 1 in the state for medical excellence - scoring 94.1 in overall hospital care and a 94.1 in overall medical care. CHI St. Alexius Health was also ranked #1 in the state for medical excellence award summary for overall hospital care, overall medical care, cancer care, gastrointestinal hemorrhage, neurological care, pulmonary care and women's health. Women's Choice Award ranked CHI St. Alexius Health the Best Hospital for Cancer Care based on our advanced cancer program accreditation as well as additional cancer services, clinical performance and patient recommendations. CHI St. Alexius Health received The Joint Commission's Certification of Distinction for advanced certification as a primary stroke center. Comparion Medical Analytics ranked CHI St. Alexius Health #1 in state for Overall Hospital Care - Patient Safety; #1 in Overall Medical Care - Patient Safety. The 2016 Quality Recognition for Medical Excellence in one or more clinical categories based on Comparion's CareChex Hospital Quality Ratings. CHI St. Alexius Health was recognized as a Blue Cross Blue Shield Distinction Center+ for Maternity Care. CHI St. Alexius Health was designated as one of the first hospitals to receive the Blue Distinction Center+ for Maternity Care designation, a new designation under the Blue Distinction Specialty Care program. The Leapfrog Group gave CHI St. Alexius Health the highest rating possible - Hospital Safety Score "A" Grade. CHI St. Alexius Health was one of only two hospitals in ND to receive this score. And the only hospital in central and western North Dakota. CHI St. Alexius Health received Comparion Medical Analytics 2016 CareChex Quality Award and was ranked #1 in the State of Overall Hospital Care as well as its 2016 Quality Recognition for being Ranked #1 in the State for Medical Excellence in one or more clinical categories based on Comparion's CareChex Hospital Quality Ratings. CHI St. Alexius Health was ranked #1 in the state for Overall Hospital Care and Overall Medical Care. CHI St. Alexius Health was rated the Best Hospital in North Dakota by HealthGrove. Our top rating is based on several attributes including US and World Report Best Hospital, Truven Health Analytics, Medicare Performance Score and others.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	PURSUANT TO SECTION 8.6 OF THE BYLAWS OF ST. ALEXIUS MEDICAL CENTER, THE EXECUTIVE COMMITTEE IS COMPOSED OF ONLY DIRECTORS OF THE CORPORATION AND SHALL BE COMPOSED OF THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON OF THE BOARD, AND THE PRESIDENT, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE (1) YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. 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, Line 6 Classes of members or stockholders	ACCORDING TO THE BYLAWS OF St. Alexius Medical Center, THE ENTITY'S SOLE MEMBER IS CATHOLIC HEALTH INITIATIVES, A COLORADO NONPROFIT CORPORATION.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	The organization's corporate member is Catholic Health Initiatives. Pursuant to Section 5.4 of the organization's bylaws, Catholic Health Initiatives shall have the specific rights set forth in the governance matrix. Pursuant to the governance matrix the following rights are reserved to the CHI Board directly or through powers delegated to the CHI Chief Executive Officer: * Approve members of the organization's board * Amendment of the corporate documents of the organization * Adoption of long range and strategic plans for the organization * Substantial change in the mission or philosophy of the organization * Removal of a member of the governing body of the organization * Approval of issuance of debt by organization * Approval of participation of organization in a joint venture * Approval of formation of a new corporation by organization * Approval of a merger involving the organization * Approval of the sale of all or substantially all of the assets of the organization * To require the transfer of assets by the organization to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. Pursuant to Section 5.5 of the organization's bylaws, 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, Line 11b Review of form 990 by governing body	Once the return is prepared, the return is reviewed by the Chief Financial Officer. The Chief Financial Officer sends an electronic copy of the return to each board member by email for their review
Form 990, Part VI, Line 12c Conflict of interest policy	Catholic Health Initiatives ("CHI") has a Conflicts of Interest ("COI") policy in place to maintain the integrity of all of its activities. The policy applies to CHI Board of Stewardship Trustees and members of its committees; all board and board committee members of CHI Entities; all CHI employees; all CHI physicians (both employed and non-employed) and all physician administrators and leaders; advanced practice clinicians (both employed and non-employed); and all CHI research personnel (both employed and non-employed). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure process. Each person has a general ongoing obligation to promptly and fully report to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must report the actual or potential conflict as soon as she/he becomes aware of it. In any situation where the person may be in doubt, a full disclosure should be made to permit an impartial and objective determination. In addition to the general ongoing obligation, there are initial disclosure obligations. The board, board committee members, and new employees are required to make disclosures at the time of their initial hiring/appointment. All non-employed, credentialed or contracted physicians are required to make disclosures at the time of their credentialing and during any subsequent reappointment or recredentialing. All researchers are required to make disclosures upon consideration of affiliation with a research sponsor. In addition to the general ongoing and initial disclosure obligations, there is an annual disclosure obligation. All corporate officers, board and board committee members, employees at the level of manager and above, researchers, supply chain employees, employed physicians, physician administrators and leaders, and employed advanced practice clinicians must complete a new conflict of interest disclosure annually. Disclosures of perceived, potential or actual conflicts involving financial interests are forwarded to the Conflicts of Interest Review Committee ("C-CIRC") or Legal Services Group for review depending on the position of the person involved. The C-CIRC reviews COI questionnaires containing disclosures of perceived or possible conflicts for employees at a level of manager or above, supply chain employees, researchers and physicians, physician administrators and leaders, and advanced practice clinicians (both employed and non-employed). In the determination of a conflict, a COI management plan will be developed for that person. With respect to those audiences for which the C-CIRC has review responsibility, the C-CIRC will facilitate development of any such conflict of interest management plan in collaboration with local CRP staff. A designated CHI Entity staff will be responsible for monitoring the COI management plan and for documenting monitoring activities. At its sole discretion, a CHI Entity may reject a Person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential COI. If the C-CIRC determines that there is a potential or actual conflict of interest that does not currently have appropriate controls to address the conflict of interest, it may recommend that the disclosing person be allowed to participate in the activity or transaction subject to restrictions as outlined in the COI management plan. If a Person does not agree with a determination made by the C-CIRC, its interpretation of the Policy or Addenda, or seeks an exemption or exception, the following steps should be followed. The Employee disputing the review decision, interpretation of the Policy, or seeking exemption or exception must present the matter to the Employee's immediate direct manager or supervisor for review and determination. If the Employee and the manager do not agree with the review decision, interpretation of the Policy, or seek exemption or exception, 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. If they are unable to reach agreement, the matter shall be referred to the CHI General Counsel, whose decision shall be final. Reviews and determinations involving board and board committee members and corporate officers will be the responsibility of the board, board executive committee, or board chair, with guidance from the Legal Services Group (LSG). Annual COI disclosures of all trustee and corporate officers will be reviewed by the CHI Senior Vice President, Legal Services, and General Counsel or his or her designee who will report potential conflicts to the applicable 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. Based on review and evaluation of the relevant facts and circumstances, the Board Chair will make an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI Policy, review and approval or other action by the Board 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 the facts and circumstances of a given situation constitute a conflict of interest or whether Board review and approval or other action is required within the COI 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 Executive Committee minutes and will be reported to the Board. When any conflict of interest is considered by the board, the trustee or corporate officer, as appropriate, must disclose all of the material facts to the Board. The trustee shall not vote and the trustee or corporate officer shall not use his or her personal influence on the matter. The trustee or corporate officer shall be excused from the meeting during discussion and vote on the conflict of interest. In reviewing such transactions between CHI or CHI Entities and vendors or other contractors who are, or are affiliated with, Trustees or Corporate Officers, the Board will act as it would in reviewing transactions with unrelated third parties. The transaction is not be approved unless the Board determines that the transaction is fair to CHI or the CHI Entity. The Board must approve the transaction by a majority of the Trustees on the Board, without counting the vote of any individual who has an interest in the transaction. All determinations of conflicts of interest are reported as required by law, regulations, and CHI policy.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	Compensation is reviewed annually by an independent group using comparability data and recommendations are presented to the President/CEO and/or Board of Directors for approval.
Form 990, Part VI, Line 19 Required documents available to the public	The organization's financial statements, conflict of interest policy and governing documents are available to the public upon request. The organization's financial statements are included in Catholic Health Initiatives' consolidated audited financial statements that are available at http://www.catholichealthinitiatives.org/ or at www.DACBOND.org.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Other Miscellaneous Revenue - Total Revenue: 1741314, Related or Exempt Function Revenue: , Unrelated Business Revenue: 1741314, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	Other Fees for Services - Total Expense: 33502887, Program Service Expense: 12906223, Management and General Expenses: 20596664, Fundraising Expenses: ; Physician Fees - Total Expense: 31153623, Program Service Expense: 30918434, Management and General Expenses: 235189, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Net Asset Transfer - 21082930; Capital Resource Pool Contribution - -916734;

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St Alexius Medical Center

Employer identification number

45-0226711

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) St Alexius Heart & Lung Clinic LLC 900 East Broadway Avenue Bismarck,ND58501 86-1123162	Speciality Clinic-Cardiology, etc.	ND	39,188,366	14,194	St Alexius Medical Center

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ALEGENT CREIGHTON CLINIC 12809 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)BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS,TX77384 27-4499340	PHYSICIANS	TX	501(c)(3	9	SLCHS	Yes
(12)BELLEVILLE ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 27-4005511	HEALTHCARE	TX	501(c)(3	3	SHSC	Yes
(13)BISHOP DRUMM RETIREMENT CENTER 1111 6TH AVE DES MOINES,IA50314 42-0725196	LTERM CARE	IA	501(c)(3	9	CHI-IA CORP	Yes
(14)BORNEMANN HEALTHCARE CORPORATION 2500 BERNVILLE RD PO BOX 316 READING,PA19603 23-2187242	HEALTHCARE	PA	501(c)(3	Type I	CHI	Yes
(15)BRAZOSPORT HEALTH FOUNDATION INC 129 CIRCLE WAY STE 102 LAKE JACKSON,TX77566 76-0080110	FUNDRAISING	TX	501(c)(3	Type I	BRHS	Yes
(16)BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON,TX77566 80-0240261	HEALTHCARE	TX	501(c)(3	3	BRHS	Yes
(17)BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2759890	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(18)BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2913931	HEALTHCARE	TX	501(c)(3	9	SJSC	Yes
(19)CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON,ND58421 45-0227311	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(20)CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 47-0617373	HEALTHCARE	CO	501(c)(3	Type I	NA	Yes
(21)CATHOLIC HEALTH INITIATIVES - COLORADO 188 INVERNESS DRIVE WEST STE 500 ENGLEWOOD,CO80112 84-0405257	HEALTHCARE	CO	501(c)(3	3	CHI	Yes
(22)CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES,IA50314 42-0680448	HEALTHCARE	IA	501(c)(3	3	CHI	Yes
(23)CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 6385 CORPORATE DR STE 301 COLORADO SPRINGS,CO80919 84-0902211	FUNDRAISING	CO	501(c)(3	7	CHIC	Yes
(24)CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 6385 CORPORATE DR COLORADO SPRINGS,CO80919 27-0930004	FUNDRAISING	CO	501(c)(3	Type I	CHI	Yes
(25)CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-0992796	HEALTHCARE	CO	501(c)(3	Type I	CHINS	Yes
(26)CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG,OR97471 26-3946191	PHYSICIANS	OR	501(c)(3	9	MMC	Yes
(27)CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND,KS67530 48-0543724	SURGERY CENTER	KS	501(c)(3	3	CHI	Yes
(28)CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO,ND58104 27-1966847	HEALTHCARE	MN	501(c)(3	9	CHI	Yes
(29)CHI INSTITUTE FOR RESEARCH AND INNOVATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 27-1050565	HEALTHCARE	CO	501(c)(3	Type I	CHI	Yes
(30)CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER,KY41018 20-2741651	HEALTHCARE	KY	501(c)(3	Type I	CHI	Yes
(31)CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 45-1261716	HEALTHCARE	CO	501(c)(3	9	CHI NS	Yes
(32)CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 45-2532084	HEALTHCARE	CO	501(c)(3	Type I	CHI	Yes
(33)CHI NEBRASKA 6940 O ST STE 200 LINCOLN,NE68510 36-3233121	HEALTHCARE	NE	501(c)(3	Type I	CHI	Yes
(34)CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER,PA17602 23-2342997	HEALTHCARE	PA	501(c)(3	Type I	CHI	Yes
(35)CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE,NM87102 71-0897107	COMMUNITY	NM	501(c)(3	Type I	CHI	Yes
(36)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
(37)CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS,AR71913 71-0236913	HEALTHCARE	AR	501(c)(3	3	CHISVHS	Yes
(38)CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS,AR71913 26-1125064	HOLDING CO	AR	501(c)(3	Type II	SVIMC	Yes
(39)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
(40)COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK ST ACCOUNTING-3 W CINCINNATI,OH45206 23-7419853	HOLDING CO	OH	501(c)(2		GSH	Yes
(41)COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION 631 N 8TH ST MISSOURI VALLEY,IA51555 42-1294399	FUNDRAISING	IA	501(c)(3	Type I	AH-CMHMV	Yes
(42)CONTINUING CARE HOSPITAL 150 NORTH EAGLE CREEK DR LEXINGTON,KY40509 61-1400619	LT ACH	KY	501(c)(3	3	SJHS	Yes
(43)COVENANT HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 23-2028429	HOME HEALTH	PA	501(c)(3	Type II	CHI NHC	Yes
(44)ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1450 BATTERSBY AVE ENUMCLAW,WA98022 91-0715805	HEALTHCARE	WA	501(c)(3	3	FHS	Yes
(45)FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN,KY40004 61-1345363	HEALTHCARE	KY	501(c)(3	3	KOH	Yes
(46)FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN,KY40004 56-2351341	FUNDRAISING	KY	501(c)(3	Type I	FH	Yes
(47)FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO,OH43623 34-1931806	HEALTHCARE	OH	501(c)(3	9	FLC	Yes
(48)FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA,WA98405 91-1145592	FUNDRAISING	WA	501(c)(3	9	FHS	Yes
(49)FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA,WA98405 91-0564491	HEALTHCARE	WA	501(c)(3	3	CHI	Yes
(50)FRANCISCAN HEALTH VENTURES FKA SJMGROUP TACOMA FNC CTR BLDG 1145 BROADWAY TACOMA,WA98402 43-1882377	PHYSICIANS	MO	501(c)(3	9	CHI	Yes
(51)FRANCISCAN LIVING COMMUNITIES 5942 RENAISSANCE PLACE STE A TOLEDO,OH43623 34-1892096	HEALTHCARE	OH	501(c)(3	Type I	SFH	Yes
(52)FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA,WA98402 91-1939739	HEALTHCARE	WA	501(c)(3	9	FHS	Yes
(53)FRANCISCAN VILLA OF SOUTH MILWAUKEE INC 3601 S CHICAGO AVE SOUTH MILWAUKEE,WI53172 39-1093829	HEALTHCARE	WI	501(c)(3	9	CHI	Yes
(54)GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON,ND58540 45-0227752	HEALTHCARE	ND	501(c)(3	3	SAMC	Yes
(55)GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 20-1536108	MINISTRIES	CO	501(c)(3	Type I	CHI	Yes
(56)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
(57)GOOD SAMARITAN FOUNDATION OF CINCINNATI INC 619 OAK ST ACCOUNTING-3 W CINCINNATI,OH45206 31-1206047	FUNDRAISING	OH	501(c)(3	Type I	GSH	Yes
(58)GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY,NE68848 47-0379755	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(59)GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY,NE68847 47-0659443	FUNDRAISING	NE	501(c)(3	7	GSH	Yes
(60)GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON 110 N MAIN ST STE 500 DAYTON,OH45402 23-7296923	FUNDRAISING	OH	501(c)(3	7	SHP	Yes
(61)HARRISON MEDICAL CENTER 2520 CHERRY AVE BREMERTON,WA98310 91-0565546	HEALTHCARE	WA	501(c)(3	3	FHS	Yes
(62)HARRISON MEDICAL CENTER FOUNDATION 2520 CHERRY AVE BREMERTON,WA98310 91-1197626	FUNDRAISING	WA	501(c)(3	7	HMC	Yes
(63)HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 76-0761782	FUNDRAISING	MN	501(c)(3	Type I	SFMC	Yes
(64)HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN,WA98166 91-0712166	HEALTHCARE	WA	501(c)(3	3	FHS	Yes
(65)HOUSE OF MERCY 1111 6TH AVE DES MOINES,IA50314 42-1323808	SHELTER	IA	501(c)(3	7	CHI-IA CORP	Yes
(66)JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 61-1029768	HEALTHCARE	KY	501(c)(3	3	KOH	Yes
(67)KENTUCKYONE HEALTH MEDICAL GROUP INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 61-1352729	HEALTHCARE	KY	501(c)(3	9	JHSMH	Yes
(68)KENTUCKYONE HEALTH INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 61-1029769	HEALTHCARE	KY	501(c)(3	9	CHI	Yes
(69)LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE,MN56623 41-0758434	HEALTHCARE	MN	501(c)(3	3	CHI	Yes
(70)LAKEWOOD REGIONAL HEALTHCARE FOUNDATION 600 MAIN AVE S BAUDETTE,MN56623 41-1893795	FUNDRAISING	ND	501(c)(3	7	LHC	Yes
(71)LINUS OAKES INC 2700 STEWART PKWY ROSEBURG,OR97471 93-0821381	SENIOR LIVING	OR	501(c)(3	9	MMC	Yes
(72)LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON,ND58054 82-0558836	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(73)LUFKIN VISION ACQUISITIONS PO BOX 1447 LUFKIN,TX75901 82-0563768	PROPERTY MGMT	TX	501(c)(3	Type III-FI	MHSET	Yes
(74)MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2761145	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(75)MADONNA MANOR INC 2344 AMSTERDAM ROAD VILLA HILLS,KY51017 61-0654635	LIVING ASSIST	KY	501(c)(3	1	FLC	Yes
(76)MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC 2525 DE SALES AVE CHATTANOOGA,TN37404 62-1839548	FUNDRAISING	TN	501(c)(3	7	MHCS	Yes
(77)MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVE CHATTANOOGA,TN37404 62-0532345	HEALTHCARE	TN	501(c)(3	3	CHI	Yes
(78)MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD RD STE 500 CHATTANOOGA,TN37411 03-0417049	HEALTHCARE	TN	501(c)(3	9	MHCS	Yes
(79)MEMORIAL HEALTH SYSTEM OF EAST TEXAS PO BOX 1447 LUFKIN,TX75902 75-0755367	HEALTHCARE	TX	501(c)(3	3	CHI	Yes
(80)MEMORIAL MEDICAL CENTER - LIVINGSTON PO BOX 1447 LUFKIN,TX75902 76-0436439	HEALTHCARE	TX	501(c)(3	3	MHSET	Yes
(81)MEMORIAL MEDICAL CENTER - SAN AUGUSTINE PO BOX 1447 LUFKIN,TX75902 75-2663904	HEALTHCARE	TX	501(c)(3	3	MHSET	Yes
(82)MEMORIAL MULTISPECIALTY ASSOCIATES 1201 FRANK AVE LUFKIN,TX95904 75-2721155	PHYSICIANS	TX	501(c)(3	Type III-FI	MHSET	Yes
(83)MEMORIAL SPECIALTY HOSPITAL PO BOX 1447 LUFKIN,TX95902 75-2492741	HEALTHCARE	TX	501(c)(3	3	MHSET	Yes
(84)MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVE DES MOINES,IA50314 42-6076069	AUXILIARY	IA	501(c)(3	Type I	MF-DM IA	Yes
(85)MERCY CLINICS INC 1111 6TH AVE DES MOINES,IA50314 42-1193699	PHYSICIANS	IA	501(c)(3	9	CHI-IA CORP	Yes
(86)MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVE DES MOINES,IA50314 42-1511682	EDUCATION	IA	501(c)(3	2	CHI-IA CORP	Yes
(87)MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVE DES MOINES,IA50314 23-7358794	FUNDRAISING	IA	501(c)(3	7	CHI-IA CORP	Yes
(88)MERCY FOUNDATION INC 2700 STEWART PKWY ROSEBURG,OR97471 93-6088946	FUNDRAISING	OR	501(c)(3	7	MMC	Yes
(89)MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING,IA50841 42-1461064	FUNDRAISING	IA	501(c)(3	Type I	AHMH-Corning	Yes
(90)MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BLVD VALLEY CITY,ND58072 45-0435338	FUNDRAISING	ND	501(c)(3	Type I	MHVC	Yes
(91)MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DR COUNCIL BLUFFS,IA51503 42-1178204	FUNDRAISING	IA	501(c)(3	Type I	AHBMHS	Yes
(92)MERCY HOSPITAL OF DEVILS LAKE 1031 7TH ST NE DEVILS LAKE,ND58301 45-0227012	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(93)MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 7TH ST NE DEVILS LAKE,ND58301 35-2367360	FUNDRAISING	ND	501(c)(3	7	MHDL	Yes
(94)MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BLVD VALLEY CITY,ND58072 45-0226553	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(95)MERCY MEDICAL CENTER 1301 15TH AVE WEST WILLISTON,ND58801 45-0231183	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(96)MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE,IA52544 42-0680308	HEALTHCARE	IA	501(c)(3	3	CHI-IA CORP	Yes
(97)MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER 1111 6TH AVE DES MOINES,IA50314 42-1470935	PHYSICIANS	IA	501(c)(3	9	CHI-IA CORP	Yes
(98)MERCY MEDICAL CENTER INC 2700 STEWART PKWY ROSEBURG,OR97471 93-0386868	HEALTHCARE	OR	501(c)(3	3	CHI	Yes
(99)MERCY MEDICAL FOUNDATION 1301 15TH AVE WEST WILLISTON,ND58801 45-0381803	FUNDRAISING	ND	501(c)(3	Type I	MMC	Yes
(100)NEBRASKA HEART HOSPITAL 7500 S 91ST ST LINCOLN,NE68526 39-2031968	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(101)North Central Health Care Alliance dba PrimeCare Health Group 401 N 9th St BISMARCK,ND585014507 45-0439894	HEALTHCARE	ND	501(c)(3	9	NHCA	Yes
(102)OAKES COMMUNITY HOSPITAL 1200 N 7TH ST OAKES,ND58474 45-0231675	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(103)OAKES COMMUNITY HOSPITAL FOUNDATION 1200 N 7TH ST OAKES,ND58474 71-0966606	FUNDRAISING	ND	501(c)(3	Type I	OCH	Yes
(104)PINEYWOODS MEDICAL DEVELOPMENT CORP PO BOX 1447 LUFKIN,TX75902 75-2493116	PROPERTY MGMT	TX	501(c)(3	Type III-FI	MHSET	Yes
(105)PROVIDENCE CARE CENTER 2025 HAYES AVENUE SANDUSKY,OH44870 34-1658625	HEALTHCARE	OH	501(c)(3	9	FLC	Yes
(106)PROVIDENCE CARE CENTERS 2025 HAYES AVENUE SANDUSKY,OH44870 34-1826099	HOLDING CO	OH	501(c)(3	Type II	FLC	Yes
(107)PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION 5055 PROVIDENCE DRIVE SANDUSKY,OH44870 34-1896807	LIVING COMM	OH	501(c)(3	9	FLC	Yes
(108)PUEBLO STEPUP 1925 E ORMAN AVE STE G52 PUEBLO,CO81004 84-1234295	COMMUNITY	CO	501(c)(3	7	CHIC	Yes
(109)REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE 12844 MILITARY RD S TUKWILA,WA98168 91-1170040	HEALTHCARE	WA	501(c)(3	3	FHS	Yes
(110)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
(111)SAINT CLARE'S COMMUNITY CARE INC 25 POCONO RD DENVILLE,NJ07834 22-2876836	HEALTHCARE	NJ	501(c)(3	Type II	SCHS	Yes
(112)SAINT CLARE'S FOUNDATION INC 25 POCONO RD DENVILLE,NJ07834 22-2502997	FUNDRAISING	NJ	501(c)(3	7	SCHS	Yes
(113)SAINT CLARE'S HEALTH SERVICES INC 25 POCONO RD DENVILLE,NJ07834 22-3639733	MANAGEMENT	NJ	501(c)(3	Type II	CHI	Yes
(114)SAINT CLARE'S HOSPITAL INC 25 POCONO RD DENVILLE,NJ07834 22-3319886	HEALTHCARE	NJ	501(c)(3	3	SCHS	Yes
(115)SAINT ELIZABETH FOUNDATION 555 S 70TH ST LINCOLN,NE68510 47-0625523	FUNDRAISING	NE	501(c)(3	7	SERMC	Yes
(116)SAINT ELIZABETH HEALTH SERVICES 555 S 70TH ST LINCOLN,NE68510 36-3233120	HEALTHCARE	NE	501(c)(3	3	SERMC	Yes
(117)SAINT ELIZABETH REGIONAL MEDICAL CENTER 555 S 70TH ST LINCOLN,NE68510 47-0379836	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(118)SAINT FRANCIS MEDICAL CENTER 2620 W FAIDLEY GRAND ISLAND,NE68803 47-0376601	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(119)SAINT FRANCIS MEDICAL CENTER FOUNDATION PO BOX 9804 GRAND ISLAND,NE68802 47-0630267	FUNDRAISING	NE	501(c)(3	7	SFMC	Yes
(120)SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC 305 ESTILL ST BEREA,KY40403 26-0152877	FUNDRAISING	KY	501(c)(3	7	SJHS	Yes
(121)SAINT JOSEPH HEALTH SYSTEM INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 61-1334601	HEALTHCARE	KY	501(c)(3	3	KOH	Yes
(122)SAINT JOSEPH HOSPITAL FOUNDATION INC ONE SAINT JOSEPH DRIVE LEXINGTON,KY40504 61-1159649	FUNDRAISING	KY	501(c)(3	Type I	SJHS	Yes
(123)SAINT JOSEPH LONDON FOUNDATION INC 1001 SAINT JOSEPH LANE LONDON,KY40741 26-0438748	FUNDRAISING	KY	501(c)(3	7	SJHS	Yes
(124)SAINT JOSEPH MOUNT STERLING FOUNDATION INC 225 FALCON DR MOUNT STERLING,KY40353 27-2884584	FUNDRAISING	KY	501(c)(3	7	SJHS	Yes
(125)SAINT JOSEPH'S HOSPITAL FOUNDATION 30 WEST 7TH ST DICKINSON,ND58601 36-3418207	FUNDRAISING	ND	501(c)(3	Type I	SJHHC	Yes
(126)SAMARITAN BEHAVIORAL HEALTH INC 601 S EDWIN C MOSES BLVD DAYTON,OH45417 02-0633634	HEALTHCARE	OH	501(c)(3	7	SHP	Yes
(127)SAMARITAN HEALTH PARTNERS 110 N MAIN ST STE 500 DAYTON,OH45402 31-1107411	HEALTHCARE	OH	501(c)(3	Type I	CHI	Yes
(128)SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC 104 W 17TH ST SCHUYLER,NE68661 36-3630014	FUNDRAISING	NE	501(c)(3	Type I	AHMHS	Yes
(129)SJRMC JOPLIN MISSOURI 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 44-0545809	HEALTHCARE	MO	501(c)(3	3	CHI	Yes
(130)SL AUGUSTA CORP PO BOX 20269 HOUSTON,TX77225 76-0226623	TITLE HOLDING	TX	501(c)(2		SLPC	Yes
(131)ST ALEXIUS MEDICAL CENTER 900 EAST BROADWAY AVENUE BISMARCK,ND58501 45-0226711	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(132)ST ANTHONY HOSPITAL 1601 SE COURT AVE PENDLETON,OR97801 93-0391614	HEALTHCARE	OR	501(c)(3	3	CHI	Yes
(133)ST ANTHONY HOSPITAL FOUNDATION 1601 SE COURT AVE PENDLETON,OR97801 93-0992727	FUNDRAISING	OR	501(c)(3	Type I	SAH	Yes
(134)ST ANTHONY'S HOSPITAL ASSOCIATION FOUR HOSPITAL DR MORRILTON,AR72110 71-0245507	HEALTHCARE	AR	501(c)(3	3	SVIMC	Yes
(135)ST CATHERINE HOSPITAL 401 EAST SPRUCE ST GARDEN CITY,KS67846 48-0543721	HEALTHCARE	KS	501(c)(3	3	CHI	Yes
(136)ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION 401 EAST SPRUCE ST GARDEN CITY,KS67846 20-0598702	FUNDRAISING	KS	501(c)(3	Type I	SCH	Yes
(137)ST CLARE COMMONS 5942 RENAISSANCE PLACE STE A TOLEDO,OH43623 27-0163752	LIVING COMM	OH	501(c)(3	9	FLC	Yes
(138)ST DOMINIC OF ONTARIO OREGON 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 93-0433692	HEALTHCARE	OR	501(c)(4		CHI	Yes
(139)ST FRANCIS HOME 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 41-0729978	LTERM CARE	MN	501(c)(3	9	CHI	Yes
(140)ST FRANCIS LIFE CARE CORPORATION 19 POCONO RD DENVILLE,NJ07834 22-2536017	ELDERLY CARE	NJ	501(c)(3	9	SCHS	Yes
(141)ST FRANCIS MEDICAL CENTER 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 41-0695598	HEALTHCARE	MN	501(c)(3	3	CHI	Yes
(142)ST FRANCIS OF BAKER CITY 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 93-0412495	HEALTHCARE	OR	501(c)(3	3	CHI	Yes
(143)ST JOSEPH FOUNDATION OF BRYAN TEXAS 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2351158	FUNDRAISING	TX	501(c)(3	Type I	SJSC	Yes
(144)ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2847594	HEALTHCARE	TX	501(c)(3	9	SJSC	Yes
(145)ST JOSEPH MEDICAL CENTER INC 201 INTERNATIONAL CIRCLE STE 212 HUNT VALLEY,MD21030 52-0591461	HEALTHCARE	MD	501(c)(3	3	CHI	Yes
(146)ST JOSEPH PHYSICIAN ASSOCIATES 2801 FRANCISCAN DRIVE BRYAN,TX77802 20-3159302	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(147)ST JOSEPH PHYSICIAN ENTERPRISE INC 201 INTERNATIONAL CIRCLE STE 212 HUNT VALLEY,MD21030 52-1311775	PHYSICIANS	MD	501(c)(3	Type I	SJMC	Yes
(148)ST JOSEPH REGIONAL HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-1282696	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(149)ST JOSEPH REGIONAL HEALTH PARTNERS 2801 FRANCISCAN DRIVE BRYAN,TX77802 45-4088170	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(150)ST JOSEPH REGIONAL HEALTH PARTNERS ACO 2801 FRANCISCAN DRIVE BRYAN,TX77802 46-3265423	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(151)ST JOSEPH SERVICES CORPORATION 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2455161	MANAGEMENT	TX	501(c)(3	Type I	SFH	Yes
(152)ST JOSEPH'S AREA HEALTH SERVICES 600 PLEASANT AVE PARK RAPIDS,MN56470 41-0695603	HEALTHCARE	MN	501(c)(3	3	CHI	Yes
(153)ST JOSEPH'S HOSPITAL AND HEALTH CENTER 30 WEST 7TH ST DICKINSON,ND58601 45-0226429	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(154)ST LEONARD 8100 CLYO ROAD CENTERVILLE,OH45458 34-1940863	LIVING COMM	OH	501(c)(3	9	FLC	Yes
(155)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-0274448	MANAGEMENT	TX	501(c)(3	Type I	SLHS	Yes
(156)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC 6624 FANNIN ST STE 2505 HOUSTON,TX77030 27-3733278	HEALTHCARE	TX	501(c)(3	3	SLCDC	Yes
(157)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
(158)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
(159)ST LUKE'S COMMUNITY HEALTH SERVICES 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0536234	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes
(160)ST LUKE'S FOUNDATION 1213 HERMANN DRIVE STE 855 HOUSTON,TX77004 45-3811485	FUNDRAISING	TX	501(c)(3	7	SLHS	Yes
(161)ST LUKE'S HEALTH SYSTEM CORPORATION 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0536232	MANAGEMENT	TX	501(c)(3	Type I	CHI	Yes
(162)ST LUKE'S HOSPITAL AT THE VINTAGE 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-3734606	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes
(163)ST LUKE'S MEDICAL GROUP 6624 FANNIN ST HOUSTON,TX77030 76-0458535	PHYSICIANS	TX	501(c)(3	3	SLHS	Yes
(164)ST LUKE'S MEDICAL TOWER CORPORATION 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0531713	PROPERTY MGMT	TX	501(c)(3	Type I	CHI-SLH	Yes
(165)ST LUKE'S PROPERTIES CORPORATION 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0531716	PROPERTY MGMT	TX	501(c)(3	Type I	SLHS	Yes
(166)ST LUKE'S SUGAR LAND PROPERTIES CORPORATION 6624 FANNIN ST STE 2505 HOUSTON,TX77030 45-4120549	PROPERTY MGMT	TX	501(c)(3	Type I	SLCDC-SL	Yes
(167)ST MARY'S COMMUNITY HOSPITAL 1314 3RD AVE NEBRASKA CITY,NE68410 47-0443636	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(168)ST MARY'S HOSPITAL FOUNDATION 1314 3RD AVE NEBRASKA CITY,NE68410 47-0707604	FUNDRAISING	NE	501(c)(3	7	SMCH	Yes
(169)ST VINCENT FOUNDATION TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 51-0169537	FUNDRAISING	AR	501(c)(3	Type I	SVIMC	Yes
(170)ST VINCENT INFIRMARY MEDICAL CENTER TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0236917	HEALTHCARE	AR	501(c)(3	3	CHI	Yes
(171)ST VINCENT MEDICAL GROUP TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0830696	HEALTHCARE	AR	501(c)(3	9	SVIMC	Yes
(172)SYLVANIA FRANCISCAN HEALTH 1715 INDIAN WOOD CIR 200 MAUMEE,OH43537 34-1412964	HEALTHCARE	OH	501(c)(3	Type I	CHI	Yes
(173)SYLVANIA FRANCISCAN HEALTH FOUNDATION 1715 INDIAN WOOD CIR 200 MAUMEE,OH43537 45-5357161	FUNDRAISING	OH	501(c)(3	Type I	FLC	Yes
(174)THE COMMONS OF PROVIDENCE 5000 PROVIDENCE DRIVE SANDUSKY,OH44870 34-1826097	ASSIST LIVING	OH	501(c)(3	9	FLC	Yes
(175)THE COMMUNITY HOSPITAL OF BRAZOSPORT 100 MEDICAL DRIVE LAKE JACKSON,TX77566 74-1385192	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes
(176)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
(177)THE PHYSICIAN NETWORK 2000 Q ST STE 500 LINCOLN,NE68503 47-0780857	PHYSICIANS	NE	501(c)(3	Type I	CHI NEBRASKA	Yes
(178)TOTAL HEALTHCARE 188 INVERNESS DRIVE WEST STE 500 ENGLEWOOD,CO80112 84-0927232	HEALTHCARE	CO	501(c)(3	3	CHIC	Yes
(179)TRINITY HEALTH FOUNDATION 380 SUMMIT AVENUE STEUBENVILLE,OH43952 31-1329423	FUNDRAISING	OH	501(c)(3	Type I	THS	Yes
(180)TRINITY HEALTH SYSTEM 380 SUMMIT AVENUE STEUBENVILLE,OH43952 34-1818681	HEALTHCARE	OH	501(c)(3	Type I	SFH	Yes
(181)TRINITY HEALTH SYSTEM GROUP 380 SUMMIT AVENUE STEUBENVILLE,OH43952 30-0752920	HEALTHCARE	OH	501(c)(3	3	THS	Yes
(182)TRINITY HOSPITAL HOLDING COMPANY 380 SUMMIT AVENUE STEUBENVILLE,OH43952 34-1842025	HEALTHCARE	OH	501(c)(3	3	THS	Yes
(183)TRINITY HOSPITAL TWIN CITY 819 NORTH FIRST STREET DENNISON,OH44621 27-5401105	HEALTHCARE	OH	501(c)(3	3	CHI	Yes
(184)TRI-STATE HEALTH SERVICES INC ONE ROSS PARK BLVD STEUBENVILLE,OH43952 34-1522484	ASSIST LIVING	OH	501(c)(3		THS	Yes
(185)UNITY FAMILY HEALTHCARE 815 SE 2ND ST LITTLE FALLS,MN56345 41-0721642	HEALTHCARE	MN	501(c)(3	3	CHI	Yes
(186)VILLA NAZARETH INC 801 PAGE DR FARGO,ND58103 45-0226714	LTERM CARE	ND	501(c)(3	9	CHI	Yes
(187)VISITING NURSE ASSOCIATION OF ST CLARE'S INC 191 WOODPORT RD SPARTA,NJ07871 22-1768334	HOME HEALTH	NJ	501(c)(3	9	SCHS	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Alegent Health Northwest Imaging Center LLC 3606 N 156th St OMAHA,NE68116 06-1786985	OP Diagnostics	NE	ACH	Related	-7,263	485,853		No	0	Yes
(2) Audubon Land Company LLC 5390 N Academy Blvd STE 300 COLORADO SPRINGS,CO80918 84-1513085	Real Estate	CO	CHIC	Related	250,214	23,193,712		No	0		No
(3) AVON EMERGENCY AND URGENT CARE CENTER LLC 188 INVERNESS DRIVE WEST 500 ENGLEWOOD,CO80112 81-1727282	HEALTHCARE SRVC	CO	CHIC	Related	0	0		No	0	Yes
(4) BAYLOR CHI ST LUKES HEALTH SERVICES LLC 6624 Fannin St Ste 1100 HOUSTON,TX77030 47-2079184	HEALTHCARE SRVC	TX	SLHS	Related	0	0		No	0	Yes
(5) BERGAN MERCY SURGERY CENTER LLC 7710 Mercy Rd Ste 200 OMAHA,NE68124 20-8671994	AMBUL SURG CTR	NE	ACH	Related	709,407	1,953,385		No	0		No
(6) BERYWOOD OFFICE PROPERTIES LLC 400 BERYWOOD TRAIL CLEVELAND,TN37312 62-1875199	PHYS OFFICE	TN	MHCS	Related	127,778	958,445		No	0	Yes
(7) BLUEGRASS REGIONAL IMAGING CENTER 1218 SOUTH BROADWAY STE 310 LEXINGTON,KY40504 61-1386736	DIAGNOSTIC IMAGING	KY	SJHS	Related	312,944	3,261,145		No	0		No
(8) CATHOLIC HEALTH INITIATIVES PHYSICIAN SERVICES LLC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-2945938	PRACTICE MGMT SRVC	DE	CHI	Related	-572,758	28,961,482		No	0	Yes
(9) CENTRAL NEBRASKA HOME CARE SERVICES PO BOX 1146 4502 N SECOND AVE KEARNEY,NE68848 47-0692112	HEALTHCARE SRVC	NE	na	Related	-33,398	156,208		No	0	Yes
(10) CENTRAL NEBRASKA REHABILITATION SERVICES LLC 3004 W FAIDLEY AVENUE GRAND ISLAND,NE68803 81-0653461	Physical Therapy	NE	SFMC	Related	2,441,607	3,412,341		No	0		No
(11) CENTURA-SCA HOLDINGS LLC 569 BROOK VILLAGE STE 901 BIRMINGHAM,AL35209 47-4823023	OP SURGERY CENTER	AL	CHIC	Related	525,814	1,305,299		No	0	Yes
(12) CHI OPERATING INVESTMENT PROGRAM LP 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 47-0727942	INVESTMENTS	CO	CHI	Unrelated	332,023,271	6,703,637,716		No	515,470	Yes
(13) CHI ST LUKE'S HEALTH EMERGENCY CENTER LLC 6624 Fannin St Ste 1100 HOUSTON,TX77030 81-0743412	URGENT CARE	TX	SLHS	Related	0	0		No	0	Yes
(14) CHICAMSURG Surgery Centers LLC 188 INVERNESS DRIVE WEST 500 ENGLEWOOD,CO80112 46-5683027	SURGERY CENTER	CO	CHIC	Related	0	0		No	0		No
(15) CHICLARKIN VENTURES LLC 188 INVERNESS DRIVE WEST 500 ENGLEWOOD,CO80112 47-4210888	URGENT CARE	CO	CHIC	Related	0	0		No	0	Yes
(16) Colorado Springs CK Leasing LLC 8770 W Bryn Mawr Ste 1370 CHICAGO,IL60631 26-2982714	REAL ESTATE	CO	CHIC	Related	599,151	425,148		No	0	Yes
(17) HC SL VINTAGE I LLC 18000 W SARAH LANE STE 250 BROOKFIELD,WI53045 27-0453767	PROPERTY HOLDING	WI	SL HOSP-VINTAGE	Related	1,365,254	375,590,761		No	0		No
(18) HEALTHCARE SUPPORT SERVICES LLC PO BOX 9804 GRAND ISLAND,NE68802 72-1546196	LAUNDRY	NE	na	Related	256,166	3,371,484		No	0		No
(19) Heartland Oncology LLC 2337 E Crawford St SALINA,KS67401 46-4265403	ONCOLOGY	KS	SCH	Related	-457,809	1,985,911		No	0		No
(20) HIGHLINE IMAGING LLC PO BOX 184 BRUSH PRAIRIE,WA98606 20-0460005	DIAGNOSTIC IMAGING	WA	HMC	Related	65,074	1,408,012		No	0		No
(21) LAKESIDE AMBULATORY SURGICAL CENTER LLC 17031 LAKESIDE HILLS DR OMAHA,NE68130 20-4267902	AMBUL SURG CTR	NE	ACH	Related	4,111,597	2,474,455		No	0		No
(22) LAKESIDE ENDOSCOPY CENTER LLC 17001 LAKESIDE HILLS PLZ STE 201 OMAHA,NE68130 20-5544496	ENDOSCOPY SRVC	NE	ACH	Related	670,348	721,021		No	0		No
(23) LINCOLN CK LEASING LLC 6003 Old Cheney Rd Lincoln,NE68516 26-2496856	Real Estate	NE	SERMC	Related	488,450	230,998		No	0		No
(24) NEBRASKA SPINE HOSPITAL LLC 6901 N 72ND ST OMAHA,NE68122 27-0263191	SPINE HOSPITAL	NE	ACH	Related	10,386,143	19,795,974		No	0		No
(25) NORTH RIVER SURGERY CENTER LLC 2209 WILDWOOD AVE SHERWOOD,AR72120 71-0799771	AMBUL SURG CTR	AR	SVIMC	Related	163,900	1,280,229		No	0		No
(26) ORTHOCOLORADO LLC 11650 WEST 2ND PLACE LAKEWOOD,CO80255 37-1577105	ORTHO HOSPITAL	CO	THC	Related	9,902,290	2,561,198		No	0		No
(27) PENINSULA RADIATION ONCOLOGY LLC 314 MLK JR WAY STE 11 TACOMA,WA98405 87-0808610	HEALTHCARE SRVC	WA	FHS	Related	343,465	2,173,284		No	0		No
(28) Penrad Imaging 1390 Kelly Johnson Blvd COLORADO SPRINGS,CO80920 84-1072619	Medical Imaging	CO	CHIC	Related	1,160,221	2,168,695		No	0		No
(29) PMC HOSPITAL LLC 3100 MAIN ST STE 500 HOUSTON,TX77002 27-3280598	HOSPITAL	TX	SL CDC-PMC	Related	5,287,747	67,411,280		No	0	Yes
(30) PRAIRIE HEALTH VENTURES LLC 421 S 9TH ST STE 102 LINCOLN,NE68508 20-4962103	TECH SRVC	NE	AH-IMC	Related	1,126,606	2,905,862		No	0	Yes
(31) Pueblo Ambulatory Surgery Center LLC 188 INVERNESS DRIVE WEST 500 ENGLEWOOD,CO80112 62-1488737	SURGERY CENTER	CO	CHIC	Related	-155,230	107,312		No	0		No
(32) Saint JOSEPH - PAML LLC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 45-2116736	MGMT SVCS	KY	SJHS	Related	57,681	589,808		No	0	Yes
(33) SAINT JOSEPH - SCA HOLDINGS LLC 1451 Harrodsburg RD LEXINGTON,KY40503 45-3801157	OP SURGERY	DE	SJHS	Related	0	0		No	0	Yes
(34) SAINT JOSEPH-ANC HOME CARE SERVICES 1700 EDISON DR MILFORD,OH45150 26-3330545	HOME HEALTH	KY	JHSMH	Related	5,517,685	7,112,135		No	0		No
(35) SCA Premier Surgery Center of Louisville LLC 200 Abraham Flexner Way LOUISVILLE,KY40202 72-1386840	SURGERY CENTER	KY	JHSMH	Related	-177,796	2,205,015		No	0		No
(36) ST FRANCIS LAND COMPANY 5390 N ACADEMY BLVD STE 300 COLORADO SPRINGS,CO80918 26-3134100	REAL ESTATE	CO	CHIC	Related	-82,977	14,572,659		No	0		No
(37) ST FRANCIS MEDICAL CENTER ASSOCIATES 1717 SOUTH J ST TACOMA,WA98405 91-1352698	MED OFFICE	WA	FHS	Related	265,442	1,984,098		No	0		No
(38) ST LUKE'S DIAGNOSTIC CATH LAB LLP 6624 FANNIN ST STE 800 HOUSTON,TX77030 71-0959365	DIAGNOSTICS	TX	SLHS HOLDINGS	Related	611,532	1,117,217		No	0		No
(39) ST LUKE'S LAKESIDE HOSPITAL LLC 6624 FANNIN STE 2505 HOUSTON,TX77030 30-0427437	HOSPITAL	TX	SL CDC-W	Related	277,867	42,485,184		No	0	Yes
(40) ST LUKE'S THE WOODLANDS SLEEP CENTER LLC 6624 FANNIN STE 800 HOUSTON,TX77030 46-2795726	DIAGNOSTICS	TX	SLHSH	Related	-76,879	1,171,971		No	0	Yes
(41) Superior Medical Imaging LLC 5000 North 26th ST LINCOLN,NE68521 26-2884555	OP Diagnostics	NE	SERMC	Related	9,528	402,804		No	0	Yes
(42) SURGERY CENTER OF LEXINGTON LLC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 62-1179539	SURGERY CENTER	KY	SJHS	Related	187,315	2,777,419		No	0	Yes
(43) SURGERY CENTER OF LOUISVILLE LLC 200 Abraham Flexner Way LOUISVILLE,KY40202 62-1179537	SURGERY CENTER	KY	JHSMH	Related	11,207	803,899		No	0	Yes

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) Alegent HealthCreighton St Joseph Managed Care Services Inc 12809 West Dodge Rd Omaha,NE68154 47-0802396	Managed Care	NE	CHI Nebraska	C Corporation	8,129,445	5,108,822	100 %	Yes
(2) All Saints Insurance Company SPC Ltd PO BOX 10073 APO Georgetown,GRAND CAYMANKY11001 CJ 98-0556913	Insurance	CJ	CHI	C Corporation	0	0	100 %	Yes
(3) ALLIANCE HEALTH PROVIDERS OF BRAZOS Valley Inc 2801 FRACNISCAN DRIVE BRYAN,TX77802 74-2466914	Healthcare	TX	SJSC	C Corporation	204,115	535,165	100 %	Yes
(4) Alternative Insurance Management Service Inc 3900 OLYMPIC BLVD STE 400 Erlanger,KY41018 84-1112049	Management Services	CO	CHI	C Corporation	0	6,056,338	100 %	Yes
(5) AMERICAN NURSING CARE Inc 1700 EDISON DR MILFORD,OH45150 31-1085414	HOME HEALTH	OH	CHS	C Corporation	91,903,143	55,758,044	100 %	Yes
(6) AMERIMED INC 1700 EDISON DR MILFORD,OH45150 31-1158699	HOME HEALTH	OH	ANC	C Corporation	21,464,273	12,744,198	100 %	Yes
(7) BC HOLDING COMPANY INC 1850 BLUEGRASS AVE LOUISVILLE,KY40215 31-1542851	Fitness Club	KY	JHSMH	C Corporation	0	0	100 %	Yes
(8) BrazoSport Health Alliance 1 WEST WAY COURT LAKE JACKSON,TX77566 76-0518376	Health Care	TX	BRHS	C Corporation	0	0	100 %	Yes
(9) Caduceus Medical Associates INC 5600 Brainerd Road Ste 500 Chattanooga,TN37411 62-1570736	Healthcare	TN	MHCS	C Corporation	0	1,008	100 %	Yes
(10) Captive Management Initiatives Ltd PO BOX 10073 APO Georgetown,GRAND CAYMANKY11001 CJ 98-0663022	Captive Management	CJ	CHI	C Corporation	29,750	112,461	100 %	Yes
(11) 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
(12) Catholic Health Initiatives Center for Translational Research 198 INVERNESS DRIVE WEST Englewood,CO80112 27-2269511	Research	CO	CIRI	C Corporation	510,763	3,054,989	100 %	Yes
(13) CHI St Luke's Health Baylor College of Medicine Medical Center Condominium Assoc 6624 Fannin STE 1100 Houston,TX77030 46-5079545	Condo Assoc	TX	CHI-SLHBCM	C Corporation	0	0	100 %	Yes
(14) ClearRiver Health 198 INVERNESS DRIVE WEST Englewood,CO80112 46-4495960	Insurance	TN	PHPSI	C Corporation	-186,666	6,973,984	100 %	Yes
(15) Comcare Services Inc 5570 DTC Parkway Englewood,CO80111 84-0904813	Inactive	CO	CHIC	C Corporation	0	0	100 %	Yes
(16) CONSOLIDATED HEALTH SERVICES 1700 EDISON DR MILFORD,OH45150 31-1378212	HOME HEALTH	OH	CHI	C Corporation	247,400	51,845,030	100 %	Yes
(17) Des Moines Medical Center Inc 1111 6TH AVE Des Moines,IA50314 42-0837382	Real Estate	IA	CHI-IA Corp	C Corporation	71,628	1,151,078	93 %	Yes
(18) Diversified Health Resources Inc 100 MEDICAL DRIVE LAKE JACKSON,TX77566 76-0222679	Health Care	TX	BRHS	C Corporation	0	0	100 %	Yes
(19) East Texas Clinical Services Inc 2801 Via Fortuna 500 Austin,TX78746 45-4736213	Healthcare	TX	MHSET	C Corporation	0	16,782	100 %	Yes
(20) First Initiatives Insurance LTD PO BOX 10073 APO Georgetown,GRAND CAYMANKY11001 CJ 98-0203038	Insurance	CJ	CHI	C Corporation	0	0	100 %	Yes
(21) Franciscan Services Inc 198 INVERNESS DRIVE WEST Englewood,CO80112 23-2487967	Healthcare	CO	CHI	C Corporation	318,497	11,891,645	100 %	Yes
(22) Good Samaritan Outreach Services PO Box 1990 Kearney,NE68848 47-0659440	Medical Clinic	NE	CHI Nebraska	C Corporation	0	0	100 %	Yes
(23) HarvestPlains Health of Iowa 32129 Weyerhaeuser Way S STE 201 FEDERAL WAY,WA98001 47-3451750	Insurance	WA	QCHPS	C Corporation	2,182	3,002,182	100 %	Yes
(24) Health Systems Enterprises Inc 1700 EDISON DR MILFORD,OH45150 47-0664558	MGMT	NE	GSH	C Corporation	84,269	1,115,210	100 %	Yes
(25) Healthcare MGMT Services Organization INC 1149 MARKET ST Tacoma,WA98402 91-1865474	Health Org.	WA	FHS	C Corporation	0	0	100 %	Yes
(26) HeartlandPlains Health 198 INVERNESS DRIVE WEST Englewood,CO80112 46-4368223	Insurance	NE	PHPSI	C Corporation	1,755,860	3,679,133	100 %	Yes
(27) Highline Medical Group 15811 AMBUAN Blvd SW STE A Burien,WA98166 91-1407026	Medical Services	WA	HMC	C Corporation	0	0	100 %	Yes
(28) Medquest 1301 15TH AVENUE WEST Williston,ND58801 45-0392137	Sale of DME	ND	MMC Williston	C Corporation	677,839	1,583,325	100 %	Yes
(29) Memorial CV Service Line Management Company LLC 1201 W Frank Ave Lufkin,TX75904 46-3622849	Heath Care	TX	MHSET	C Corporation	0	0	100 %	Yes
(30) Mercy Park Apartments LTD 1111 6th AVE Des Moines,IA50314 42-1202422	Housing	IA	CHI-IA Corp	C Corporation	1,888,173	2,376,812	100 %	Yes
(31) Mercy Services Corp 2700 STEWART PARKWAY Roseburg,OR97471 93-0824308	Retail Sales	OR	MMC	C Corporation	2,502,051	1,446,108	100 %	Yes
(32) MHI Clinical Services 1201 W Frank Ave Lufkin,TX75904 46-1967952	Healthcare	TX	MHSET	C Corporation	10,063,699	1,339,619	100 %	Yes
(33) Mountain Management Services Inc 6028 Shallowford Rd Chattanooga,TN37421 62-1570739	MGMT SVC ORG	TN	MHCS	C Corporation	31,344,101	6,237,932	100 %	Yes
(34) Nazareth Assurance Company PO BOX 10073 APO Georgetown,GRAND CAYMANKY11001 CJ 03-0304831	Insurance	CJ	CHI	C Corporation	0	0	100 %	Yes
(35) PATIENT TRANSPORT SERVICES INC 1700 EDISON DR MILFORD,OH45150 31-1100798	HOME HEALTH	OH	ANC	C Corporation	9,010,987	6,688,783	100 %	Yes
(36) PhysicianHealth System Network 1149 MARKET ST Tacoma,WA98402 91-1746721	Health Org.	WA	FHS	C Corporation	0	0	100 %	Yes
(37) QCA Health Plan Inc 12615 Chenal Parkway STE 300 Little Rock,AR72211 71-0794605	Insurance	AR	QCHI	C Corporation	104,106,960	86,204,029	100 %	Yes
(38) QualChoice Advantage 32129 WEYERHAEUSER WAY S STE 201 FEDERAL WAY,WA98001 47-3433912	Insurance	WA	QCPS	C Corporation	2,767	3,502,767	100 %	Yes
(39) QualChoice Health Plan Services Inc (fka CollabHealth Plan Services Inc) 198 INVERNESS DRIVE WEST Englewood,CO80112 46-1224037	Admin Services	CO	QCHI	C Corporation	17,917,443	64,152,898	100 %	Yes
(40) QualChoice Health Inc (fka CollabHealth Managed Solutions Inc) 198 INVERNESS DRIVE WEST Englewood,CO80112 46-1222808	Holding Co	CO	CHI	C Corporation	2,010,400	-2,237,656	100 %	Yes
(41) QualChoice Holdings Inc 12615 Chenal Parkway STE 300 Little Rock,AR72211 27-4075520	Holding Co	AR	PHPS	C Corporation	0	10,190	100 %	Yes
(42) QualChoice Life and Health Insurance Company Inc 12615 Chenal Parkway STE 300 Little Rock,AR72211 71-0386640	Insurance	AR	QCH	C Corporation	19,949,469	19,444,633	100 %	Yes
(43) QualChoice of Nebraska 2401 S 73rd St Omaha,NE68124 81-0738827	Insurance	NE	QCH	C Corporation	0	0	100 %	Yes
(44) RiverLink Health 198 INVERNESS DRIVE WEST Englewood,CO80112 46-4380824	Insurance	OH	PHPS	C Corporation	2,069,874	3,679,879	100 %	Yes
(45) RiverLink Health of Kentucky Inc 198 INVERNESS DRIVE WEST Englewood,CO80112 46-4828332	Insurance	KY	PHPS	C Corporation	1,590,037	5,958,786	100 %	Yes
(46) Ross Park Pharmacy Inc 380 SUMMIT AVE STEUBENVILLE,OH43952 34-1832654	Pharmacy	OH	THS	C Corporation	1,104,611	2,024,431	100 %	Yes
(47) Saint Clare's Primary Care Inc 66 FORD RD Denville,NJ07834 22-2441202	Billing Services	NJ	SCCC	C Corporation	499,042	1,183,247	100 %	Yes
(48) SAMARITAN FAMILY CARE INC 40 W FOURTH ST STE 1700 Dayton,OH45402 31-1299450	Healthcare	OH	SHP	C Corporation	0	0	100 %	Yes
(49) SJH Services Corporation 198 INVERNESS DRIVE WEST Englewood,CO80112 23-2307408	Healthcare	CO	FSI	C Corporation	2,007,370	2,441,286	100 %	Yes
(50) SJL PHYSICIAN MANAGEMENT SERVICES INC 424 LEWIS HARGETT CR STE 160 Lexington,KY40503 27-0164198	Mgmt	KY	SJHS	C Corporation	41	0	100 %	Yes
(51) SLMT Parking Inc 6624 Fannin STE 800 Houston,TX77030 76-0637140	Parking	TX	SLHS	C Corporation	3,345,698	205,200	100 %	Yes
(52) SoundPath Health Inc 32129 Weyerhaeuser Way S STE 201 Federal Way,WA98001 42-1720801	Insurance	WA	PHPS	C Corporation	138,106,211	32,840,909	100 %	Yes
(53) St Alexius Health Services Inc 900 East Broadway Avenue Bismarck,ND58501 45-0402812	Healthcare	ND	SAMC	C Corporation	0	0	100 %	Yes
(54) St Anthony Development Company 1415 Southgate Pendleton,OR97801 93-1216943	Athletic Club	OR	SAH	C Corporation	1,541,465	2,192,287	100 %	Yes
(55) St Joseph Development Company Inc 1717 SOUTH J ST Tacoma,WA98405 91-1480569	Rental	WA	FSI	C Corporation	3,758,845	12,828,493	100 %	Yes
(56) ST JOSEPH OFFICE PARK ASSOCIATION 1401 HARRODSBURG RD BLDG B70 Lexington,KY40504 61-1079899	Mgmt	KY	SJHS	C Corporation	200,108	1,137,660	85 %	Yes
(57) St Luke's 6620 Main Condominium Association 6624 Fannin STE 1100 Houston,TX77030 30-0355517	Condo Assoc	TX	SLPC	C Corporation	0	0	100 %	Yes
(58) St Luke's Anesthesiology Associates 6624 Fannin STE 1100 Houston,TX77030 46-1517163	Medical Clinic	TX	CHI-SLH	C Corporation	0	0	100 %	Yes
(59) St Luke's Episcopal Hospital Physician Hospital Organization Inc 6720 Bertner MC4-262 Houston,TX77030 76-0377932	PHO	TX	CHI-SLH	C Corporation	0	0	60 %	Yes
(60) St Luke's Health System Holdings Inc 6624 Fannin STE 800 Houston,TX77030 76-0637138	Holding Co	TX	SLHS	C Corporation	2,163,924	4,389,084	100 %	Yes
(61) St Luke's Medical Arts Center I Condominium Association 6624 Fannin STE 1100 Houston,TX77030 30-0355518	Condo Assoc	TX	SLPC	C Corporation	0	0	100 %	Yes
(62) St Luke's Medical Tower Condominium Association 6624 Fannin STE 1100 Houston,TX77030 76-0298751	Condo Assoc	TX	SLMTC	C Corporation	0	0	100 %	Yes
(63) St Vincent Community Health Services Inc TWO ST VINCENT CIRCLE Little Rock,AR72205 71-0710785	Healthcare	AR	SVIMC	C Corporation	4,033,444	16,764,150	100 %	Yes
(64) StableView Health Inc 198 INVERNESS DRIVE WEST Englewood,CO80112 46-4373713	Insurance	KY	PHPS	C Corporation	301,615	5,787,296	100 %	Yes
(65) Sugar Land Doctor Group 1317 Lake Point Parkway Sugar Land,TX77478 45-4270163	Medical Clinic	TX	SLCDC-SL	C Corporation	0	0	100 %	Yes
(66) The Texas Heart Institute at St Luke's Episcopal Hospital Denton A Cooley B uilding Comdominium Association 6624 Fannin STE 1100 Houston,TX77030 90-0064009	Condo Assoc	TX	CHI-SLH	C Corporation	0	0	100 %	Yes
(67) Towson Management Inc 7601 OSLER DR Towson,MD21204 52-1710750	Mgmt Services	MD	FSI	C Corporation	0	0	100 %	Yes
(68) TRINITY MANAGEMENT SERVICES ORGANIZATION 380 SUMMIT AVE STEUBENVILLE,OH43952 34-1471026	Mgmt Services	OH	THS	C Corporation	-76,969	259,991	100 %	Yes
(69) Vintage Doctor Group 6624 Fannin STE 1100 Houston,TX77030	Medical Clinic	TX	CHI-SLH	C Corporation	0	0	100 %	Yes

Schedule R (Form 990) 2015

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

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Yes

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

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

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

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

Yes

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) 2015

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

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) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

1	Briefly describe the organization’s mission or most significant activities: PROVIDING HEALTHCARE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	10
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 2015 (Part V, line 2a) ......	5	2,901
6	Total number of volunteers (estimate if necessary) .............	6	184
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	4,581,938
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	681,920

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	845,158	867,878
9	Program service revenue (Part VIII, line 2g) .........	308,363,471	313,602,656
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,150,687	-2,442,183
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	9,952,440	11,159,671
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	322,311,756	323,188,022
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	3,026,486	1,367,116
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	132,064,299	129,117,209
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 251,993
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	179,889,655	202,805,926
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	314,980,440	333,290,251
19	Revenue less expenses. Subtract line 18 from line 12.......	7,331,316	-10,102,229
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	288,258,761	299,127,589
21	Total liabilities (Part X, line 26).............	126,317,270	126,276,107
22	Net assets or fund balances. Subtract line 21 from line 20.....	161,941,491	172,851,482

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 278,262,801 including grants of $ 1,367,116 ) (Revenue $ 319,166,297 )
	St. Alexius Medical Center began as a 20-bed hospital 130 years ago. Over the years it has evolved into a 306-bed, full-service, certified Level II Trauma Acute Care Center that provides advanced healthcare services. St. Alexius served 10,555 inpatients during the fiscal year ended June 30th 2016. With 1,570 births in FY 2016, mothers in the region choose to have their baby at St. Alexius Medical Center. Our family-focused care provides a wide range of services for mother and baby, and our specially trained nurses and physicians are prepared to handle every birthing experience with care. St. Alexius' 4-bed Level III NICU has served the region for more than 26 years, which is staffed by neonatal nurses, therapists, board-certified neonatologists, a pediatric neurologist and the region's only pediatric cardiologist. St. Alexius' Heart & Vascular Center provides comprehensive care to patients with cardiovascular, lung, and peripheral artery disease.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses278,262,801

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,852,810	2,259,615	535,154

1a	Federated campaigns..		1a	0
b	Membership dues..		1b	0
c	Fundraising events..		1c	259,821
d	Related organizations		1d	0
e	Government grants (contributions)		1e	150,785

f	All other contributions, gifts, grants, and similar amounts not included above		1f	457,272

g	Noncash contributions included in lines 1a-1f:$ 272,244
h Total.Add lines 1a-1f.......		867,878

		Business Code
2a	Patient Services	900099	312,305,672	312,305,672	0	0
b	Cafeteria	722100	1,078,593	1,078,593	0	0
c	Tuition	611600	218,391	218,391		0
d			0	0	0	0
e			0	0	0	0
f	All other program service revenue.			0	0	0	0
g Total.Add lines 2a–2f.....			313,602,656

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			486,519	0	-1,023	487,542
4 Income from investment of tax-exempt bond proceeds			0	0	0	0
5 Royalties...........			0	0	0	0
		(ii) Personal	(i) Real
6a	Gross rents	0	1,096,888
b	Less: rental expenses	0	189,299
c	Rental income or (loss)	0	907,589
d	Net rental income or (loss)......			907,589	0	-60,293	967,882
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses	1,799,865	1,128,837
c	Gain or (loss)	-1,799,865	-1,128,837
d	Net gain or (loss).....			-2,928,702	0	0	-2,928,702
8a	Gross income from fundraising events (not including $ 259,821of contributions reported on line 1c). See Part IV, line 18 ....
	a		178,271
b	Less: direct expenses ...b		134,609
c	Net income or (loss) from fundraising events..			43,662		0	43,662
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		24,950
b	Less: direct expenses ...b		23,425
c	Net income or (loss) from gaming activities..			1,525	0	0	1,525
10a	Gross sales of inventory, less returns and allowances ..
	a		0
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			0	0	0	0
Business Code			Miscellaneous Revenue
11a	Pharmacy Services		446110	6,457,545	5,483,019	974,526	0
b	Laboratory Services		621500	1,247,437	80,622	1,166,815	0
c	Services Sold		900099	760,599	0	760,599	0
d	All other revenue ....			1,741,314	0	1,741,314	0
e	Total. Add lines 11a–11d ......			10,206,895
12	Total revenue. See Instructions......			323,188,022	319,166,297	4,581,938	-1,428,091

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	180,269	180,269
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	1,186,847	1,186,847
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	1,689,567	0	1,689,567	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	14,976		14,976
7	Other salaries and wages	102,062,558	90,125,945	11,794,934	141,679
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,902,929	3,487,407	410,525	4,997
9	Other employee benefits .......	12,948,141	11,366,473	1,564,340	17,328
10	Payroll taxes ...........	8,499,038	7,447,278	1,041,843	9,917
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	564,749		564,749
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	64,656,510	43,824,657	20,831,853	0
12	Advertising and promotion ....	2,235,688	1,117,844	1,117,844
13	Office expenses .......	4,825,378	3,356,791	1,391,894	76,693
14	Information technology ......	5,014,164	2,507,082	2,507,082
15	Royalties ..
16	Occupancy ...........	4,474,912	3,918,165	556,747
17	Travel ............	2,507,723	2,197,524	308,820	1,379
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	2,644	1,322	1,322
20	Interest ...........	4,217,967	4,217,967
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	14,035,603	13,995,192	40,411
23	Insurance ...	316,397	313,782	2,615
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical Supplies	61,780,087	61,780,087
b	Purchased Services	6,472,000	6,472,000
c	Bad debts	5,582,964	5,582,964
d	Repairs and maintenance	4,247,271	4,247,271
e	All other expenses	21,871,869	10,935,934	10,935,935	0
25	Total functional expenses. Add lines 1 through 24e	333,290,251	278,262,801	54,775,457	251,993
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1	0
2	Savings and temporary cash investments .........			26,381,796	2	-2,279,147
3	Pledges and grants receivable, net ......				3	0
4	Accounts receivable, net .............			39,505,664	4	55,872,393
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				3,452,358	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net ....				7	340,438
8	Inventories for sale or use ........			9,464,611	8	10,523,677
9	Prepaid expenses and deferred charges ......			947,673	9	991,699
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	142,877,066
b	Less: accumulated depreciation	10b	22,800,490	135,740,263	10c	120,076,576
11	Investments—publicly traded securities .			9,971,110	11	9,619,980
12	Investments—other securities. See Part IV, line 11 .....			61,023,862	12	18,771,919
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14	0
15	Other assets. See Part IV, line 11 ...........			1,771,424	15	85,210,054
16	Total assets. Add lines 1 through 15 (must equal line 34)...			288,258,761	16	299,127,589

17	Accounts payable and accrued expenses .....	28,055,590	17	17,101,196
18	Grants payable ...		18
19	Deferred revenue .........		19	22,710,237
20	Tax-exempt bond liabilities .........	91,071,113	20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	6,530,119	23	86,445,740
24	Unsecured notes and loans payable to unrelated third parties ..		24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	660,448	25	18,934
26	Total liabilities. Add lines 17 through 25..	126,317,270	26	126,276,107

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	159,017,746	27	170,022,378
28	Temporarily restricted net assets ...........	2,527,780	28	1,552,004
29	Permanently restricted net assets	395,965	29	1,277,100
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	161,941,491	33	172,851,482
34	Total liabilities and net assets/fund balances ........	288,258,761	34	299,127,589