Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 07-01-2015 , and ending 06-30-2016
BCheck if applicable:
CName of organization
Catholic Health Initiatives Colorado
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
9100 EAST MINERAL CIRCLE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CENTENNIAL, CO80112
D Employer identification number

84-0405257
E Telephone number

G Gross receipts $ 2,000,890,339
F Name and address of principal officer:
GARY CAMPBELL
9100 EAST MINERAL CIRCLE
CENTENNIAL,CO80112
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.centura.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:  
L Year of formation: 1968
M State of legal domicile: CO
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: CATHOLIC HEALTH INITIATIVES-COLORADO IS A FAITH BASED ORGANIZATION THAT INVESTS IN CHARITY CARE, COMMUNITY PROGRAMS, AND SPONSORSHIPS DESIGNED TO NURTURE THE HEALTH OF THE PEOPLE OF COLORADO.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 3
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 1
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 14,278
6 Total number of volunteers (estimate if necessary) ............. 6 1,375
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 7,688,110
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 22,191,854 13,738,454
9 Program service revenue (Part VIII, line 2g) ......... 1,672,394,856 1,950,928,414
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 21,902,297 16,676,886
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 18,976,309 18,852,683
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,735,465,316 2,000,196,437
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 7,220,296 109,897,318
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 634,291,888 678,153,657
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 992,804,309 1,086,149,998
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,634,316,493 1,874,200,973
19 Revenue less expenses. Subtract line 18 from line 12....... 101,148,823 125,995,464
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,863,697,328 1,949,183,357
21 Total liabilities (Part X, line 26)............. 460,818,593 460,561,482
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,402,878,735 1,488,621,875
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: WE EXTEND THE HEALING MINISTRY OF CHRIST BY CARING FOR THOSE WHO ARE ILL AND BY NURTURING THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,602,629,377 including grants of $ 109,897,318 ) (Revenue $ 1,953,332,212 )
SEE SCHEDULE H
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 expensesMediumBullet1,602,629,377
Form 990 (2015)
Form 990 (2015)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III .............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII .................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I ...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II ................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV
........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II ...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I ........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
14,278
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2015)
Form 990 (2015)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
3
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
1
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletCAROL TRAVIS9100 EAST MINERAL CIRCLE   CENTENNIAL,CO80112 (303) 673-8108
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) GARY CAMPBELL
 
PRESIDENT
1.0
.................
0.0
X   X       0 0 0
(2) MICHAEL ROWAN FACHE
 
CHAIR
1.0
.................
59.0
X   X       0 3,895,913 57,577
(3) DEAN SWINDLE CPA
 
VICE CHAIR
1.0
.................
59.0
X   X       0 2,912,490 321,807
(4) KRIS ORDELHEIDE
 
SECRETARY
1.0
.................
0.0
    X       0 0 0
(5) Dan Enderson
 
Treasurer
1.0
.................
0.0
    X       0 0 0
(6) MARGARET SABIN
 
GROUP CEO & CEO - PENROSE ST FRANCIS HEALTH SERVICES
40.0
.................
0.0
    X       1,194,135 0 245,053
(7) DANIEL REEVES
 
Group CFO & CFO - Penrose St Francis Health Services
40.0
.................
0.0
    X       382,438 0 37,693
(8) DAVID THOMPSON
 
Group CFO & CFO - St. Anthony's Hospital
40.0
.................
1.0
    X       446,451 0 43,096
(9) Jeffrey Brickman
 
Group CEO & CEO - St. Anthony's Hospital
40.0
.................
0.0
    X       1,120,380 0 136,731
(10) Thomas Gessel
 
CEO Mercy Regional Medical Center
40.0
.................
0.0
      X     612,307 0 46,644
(11) Jane Strobel
 
CFO Mercy Regional Medical Center
40.0
.................
0.0
      X     242,634 0 25,568
(12) Brian Moore
 
CEO St. Mary-Corwin Medical Center
40.0
.................
0.0
      X     439,720 0 43,977
(13) Vanessa Kochevar
 
CFO St. Mary-Corwin Medical Center
40.0
.................
0.0
      X     290,413 0 40,644
(14) A STEWART LEVY
 
PHYSICIAN
40.0
.................
0
        X   834,466 0 53,613
(15) Mark ROBINSON
 
Physician
50.0
.................
0
        X   948,968 0 31,526
(16) Camille Azar
 
Physician
40.0
.................
0
        X   835,863 0 37,682
(17) Shawn Nakamura
 
Physician
40.0
.................
0
        X   828,667 0 42,806
Form 990 (2015)
Form 990 (2015)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Brandon Green
 
Physician
40.0
.......................0
        X   753,891 0 34,161
(19) Janiece MCNichols
 
FORMER KE - CFO - St. Anthony North
50.0
.......................0
          X 254,703 0 11,346






















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 9,185,036 6,808,403 1,209,924
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet502
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
VASCULAR CENTER OF COLORADO

2222 N Nevada Ave
Ste 3000
COLORADO SPRINGS,CO80907
MEDICAL SERVICES 23,801,310
COLORADO SPRINGS CARDIOLOGISTS

2222 N NEVADA AVE SUITE 4000
COLORADO SPRINGS,CO80907
MEDICAL SERVICES 10,981,557
FRONT RANGE ORTHOPEDICS

1610 Dry Creek Drive
LONGMONT,CO80503
MEDICAL SERVICES 4,773,411
CARDIAC & THORACIC SURGERY ASSOCIATION

2222 N NEVADA AVE
SUITE 5011
COLORADO SPRINGS,CO80907
MEDICAL SERVICES 4,678,911
SOUND HOSPITALISTS OF CENTURA PC

2525 S Downing Street
DENVER,CO80210
MEDICAL SERVICES 4,136,788
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet156
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a 0
b Membership dues..1b 0
c Fundraising events..1c 0
d Related organizations1d 6,482,720
e Government grants (contributions)1e 30,317
f All other contributions, gifts, grants, and similar amounts not included above1f 7,225,417
g Noncash contributions included in lines 1a-1f:$ 0
h Total.Add lines 1a-1f.......MediumBullet 13,738,454
 Program Service RevenueAmt Business Code
2a Patient Services 900099 1,909,313,342 1,909,313,342 0 0
b Equity changes of unconsolidated orgs 900099 33,769,971 33,769,971 0 0
c Rental Income 900099 7,542,268 7,542,268   0
d Education 611710 302,833 302,833 0 0
e     0 0 0 0
f All other program service revenue. 0 0 0 0
g Total.Add lines 2a–2f.....MediumBullet 1,950,928,414
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 8,792,637 0 393 8,792,244
4 Income from investment of tax-exempt bond proceedsMediumBullet 0 0 0 0
5 Royalties...........MediumBullet 0 0 0 0
(ii) Personal (i) Real
6a Gross rents 0 27,010
b Less: rental expenses 0 0
c Rental income or (loss) 0 27,010
d Net rental income or (loss)......MediumBullet 27,010 0 0 27,010
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 3,548,964 4,335,285
b Less: cost or other basis and sales expenses 0 0
c Gain or (loss) 3,548,964 4,335,285
d Net gain or (loss).....MediumBullet 7,884,249 0 0 7,884,249
8a Gross income from fundraising events (not including $ 0of contributions reported on line 1c). See Part IV, line 18 ....
a 0
b Less: direct expenses ...b 0
c Net income or (loss) from fundraising events..MediumBullet 0 0 0
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 0
b Less: direct expenses ...b 0
c Net income or (loss) from gaming activities..MediumBullet 0 0 0 0
10a Gross sales of inventory, less
returns and allowances ..
a 997,949
b Less: cost of goods sold ..b 693,902
c Net income or (loss) from sales of inventory..MediumBullet 304,047 0 0 304,047
Business Code Miscellaneous Revenue
11a Cafeteria 722100 6,045,445 0 0 6,045,445
b Pharmacy Services 446110 9,829,629 2,403,798 7,425,831 0
c Child Care 624410 576,879 0 0 576,879
d All other revenue .... 2,069,673 0 261,886 1,807,787
e Total. Add lines 11a–11d ...... MediumBullet 18,521,626
12 Total revenue. See Instructions......MediumBullet 2,000,196,437 1,953,332,212 7,688,110 25,437,661
Form 990 (2015)
Form 990 (2015)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 11,070,241 11,070,241
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 98,827,077 98,827,077
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 0 0
5 Compensation of current officers, directors, trustees, and key employees ....        
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 554,102,327 450,485,191 103,617,136  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 25,446,274 20,687,821 4,758,453  
9 Other employee benefits ....... 59,878,510 48,681,228 11,197,282  
10 Payroll taxes ........... 38,726,546 31,484,682 7,241,864  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 50,798   50,798  
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) 439,231,705 338,148,805 101,082,900 0
12 Advertising and promotion .... 6,848,756 5,568,039 1,280,717  
13 Office expenses ....... 26,762,954 21,758,282 5,004,672  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 43,357,363 35,249,536 8,107,827  
17 Travel ............ 2,652,761 2,156,695 496,066  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 1,060,123 861,879 198,244  
20 Interest ........... 11,254,791 9,150,145 2,104,646  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 89,025,281 72,377,554 16,647,727  
23 Insurance ... 10,589,236 8,609,048 1,980,188  
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 Bad debts 56,578,297 56,578,297    
b State Provider Tax 108,044,546 108,044,546    
c Repairs and maintenance 33,973,622 33,973,622    
d Medical Supplies 248,916,689 248,916,689    
e All other expenses 7,803,076 0 7,803,076 0
25 Total functional expenses. Add lines 1 through 24e 1,874,200,973 1,602,629,377 271,571,596 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 8,336,409 1 3,960,232
2 Savings and temporary cash investments ......... 36,766,653 2 59,923,284
3 Pledges and grants receivable, net ......   3 0
4 Accounts receivable, net ............. 258,124,317 4 297,072,664
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
  5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6 0
7 Notes and loans receivable, net .... 2,046,623 7 2,464,814
8 Inventories for sale or use ........ 33,131,058 8 34,776,494
9 Prepaid expenses and deferred charges ...... 9,137,443 9 12,342,138
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,990,220,344
b Less: accumulated depreciation 10b 838,175,404 1,168,006,877 10c 1,152,044,940
11 Investments—publicly traded securities .   11 0
12 Investments—other securities. See Part IV, line 11 ..... 92,870,970 12 61,725,220
13 Investments—program-related. See Part IV, line 11 .. 0 13  
14 Intangible assets ............... 15,306,397 14 18,794,052
15 Other assets. See Part IV, line 11 ........... 239,970,581 15 306,079,519
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,863,697,328 16 1,949,183,357
Liabilities 17 Accounts payable and accrued expenses ..... 220,734,660 17 221,200,030
18 Grants payable ...   18 0
19 Deferred revenue ......... 18,577,036 19 23,170,268
20 Tax-exempt bond liabilities .........   20 0
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 ..   23 0
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 221,506,897 25 216,191,184
26 Total liabilities. Add lines 17 through 25.. 460,818,593 26 460,561,482
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 1,402,858,514 27 1,488,601,654
28 Temporarily restricted net assets ........... 10,221 28 10,221
29 Permanently restricted net assets 10,000 29 10,000
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 1,402,878,735 33 1,488,621,875
34 Total liabilities and net assets/fund balances ........ 1,863,697,328 34 1,949,183,357
Form 990 (2015)
Form 990 (2015)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
2,000,196,437
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,874,200,973
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
125,995,464
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
1,402,878,735
5
Net unrealized gains (losses) on investments ...............
5
-6,194,767
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
1,011
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-34,058,567
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
1,488,621,875
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2015)
Form 990 (2015)
Additional Data


Software ID: 15000238
Software Version: 2015v3.0
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow 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
Catholic Health Initiatives Colorado
 
Employer identification number

84-0405257
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4


5
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations ..............  

g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
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

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) right arrow (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) right arrow (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.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2015

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) right arrow (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) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2015

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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990 or 990-EZ) 2015

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
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Name of the organization
Catholic Health Initiatives Colorado
 
Employer identification number

84-0405257
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
Catholic Health Initiatives Colorado
 
Employer identification number
84-0405257
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


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
Catholic Health Initiatives Colorado
 
Employer identification number

84-0405257
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
Catholic Health Initiatives Colorado
 
Employer identification number

84-0405257
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data


Software ID: 15000238
Software Version: 2015v3.0
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 BulletInformation 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
Catholic Health Initiatives Colorado
 
Employer identification number

84-0405257
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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

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

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the 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


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)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
28,914
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
 
No
 
j
Total. Add lines 1c through 1i ....................................................................................................
28,914
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, 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 Centura paid annual dues to Colorado Health Association, a portion of which is allocated to lobbying. The amount that represents this entity's share of the allocated lobbying expenses is as follows: Colorado Health Association $28,914
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Centura paid annual dues to Colorado Health Association, a portion of which is allocated to lobbying. The amount that represents this entity's share of the allocated lobbying expenses is as follows: Colorado Health Association $28,914
Schedule C (Form 990 or 990EZ) 2015


Additional Data


Software ID: 15000238
Software Version: 2015v3.0

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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
Catholic Health Initiatives Colorado
 
Employer identification number

84-0405257
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 ....    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" 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 ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
 
(ii) related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' 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 ...   76,070,421 76,070,421
b Buildings   1,259,891,427 389,722,221 870,169,206
c Leasehold improvements   0   0
d Equipment ...   571,668,658 432,792,818 138,875,840
e Other ...   82,589,838 15,660,365 66,929,473
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 1,152,044,940
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other 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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' 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.)Small Bullet  
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) Investment in Unconsolidated Orgs 151,951,755
(2) OCH Capital Lease 51,153,283
(3) Parking Garage Easement 5,395,000
(4) Intercompany Receivables 87,966,402
(5) Medical Records 127,000
(6) Property Held for Investment 9,486,079
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 306,079,519
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  
Environmental Remediation 3,194,700
Intercompany Debt 211,619,552
Deferred Rent  
Workers Compensation 314,584
Postretirement 100,352
Other Long Term Debt 961,996
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 216,191,184
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

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 X, Line 2 FIN 48 (ASC 740) footnote Catholic Health Initiatives-Colorado's (CHIC) 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




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
Catholic Health Initiatives Colorado
 
Employer identification number

84-0405257
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the 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.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    2,703,868   2,703,868 0.15 %
b Medicaid (from Worksheet 3, column a) . . . . .     143,528,721   143,528,721 7.90 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     8,545,182   8,545,182 0.47 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 154,777,771 0 154,777,771 8.52 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     5,779,010   5,779,010 0.32 %
f Health professions education (from Worksheet 5) . . .     4,408,466   4,408,466 0.24 %
g Subsidized health services (from Worksheet 6) . . . .     2,763,627   2,763,627 0.15 %
h Research (from Worksheet 7) .     88,693   88,693 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     345,859   345,859 0.02 %
j Total. Other Benefits . . 0 0 13,385,655 0 13,385,655 0.74 %
k Total. Add lines 7d and 7j . 0 0 168,163,426 0 168,163,426 9.25 %
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
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing         0 0 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members
        0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 0 0 0 0 0 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
56,044,000
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
421,623,389
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
611,523,374
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-189,899,985
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1ORTHOCOLORADO LLC
 
HOSPITAL 60 % 0 % 40 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2015
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?9
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)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 PENROSE-ST FRANCIS HEALTH SERVICES
2222 N NEVADA AVE
COLORADO SPRINGS,CO80907
www.penrosestfrancis.org
010543
X X   X X X X   ICU & CCU, CANCER CENTER, IP REHAB A
2 ST ANTHONY HOSPITAL
11600 WEST 2ND PLACE
LAKEWOOD,CO80228
www.stanthonyhosp.org
010429
X X   X     X     A
3 MERCY REGIONAL MEDICAL CENTER
1010 THREE SPRINGS BLVD
DURANGO,CO81301
www.mercydurango.org
011213
X X         X     A
4 ST MARY-CORWIN MEDICAL CENTER
1008 MINNEQUA AVE
PUEBLO,CO81004
www.stmarycorwin.org
010650
X X   X     X     A
5 ST FRANCIS MEDICAL CENTER
6001 E WOODMAN RD
COLORADO SPRINGS,CO80923
www.penrosestfrancis.org
01H523
X X         X   BIRTH CENTER, NICU - IIIA, ICU A
6 ST ANTHONY NORTH HOSPITAL
2551 W 84TH AVE
WESTMINSTER,CO80031
www.stanthonynorth.org
010402
X X   X     X     A
7 ST ANTHONY SUMMIT MEDICAL CENTER
340 PEAK ONE DRIVE
FRISCO,CO80443
www.summitmedicalcenter.org
011155
X X         X     A
8 ST THOMAS MORE HOSPITAL
1338 PHAY AVENUE
CANON CITY,CO81212
www.stmhospital.org
010623
X X         X     A
9 OrthoColorado Hospital
11650 West 2nd Place
Lakewood,CO80255
www.orthocolorado.org
01U246
X X         X     A
Schedule H (Form 990) 2015
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)
A
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 No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE STATEMENT
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE STATEMENT
b
SEE STATEMENT
c
d
e
f
g
h
i
Billing and Collections
17 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?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

A
Name of hospital facility or letter of facility reporting group  
Yes No
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
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 A, 1 Facility A, 1 - ALL FACILITIES. In order to assess the needs of our community, we created a hospital subcommittee to solicit and take into account input from individuals representing the broad interest of our community. Our hospital subcommittee was made up of key stakeholder and individuals who represented the broader interests of our community. Public Health representatives attended every meeting and provided input into the process of narrowing the selection of health issues. Once health needs were prioritized, we determined groups and individuals appropriate for focus groups, being sure to solicit input from underserved or minority groups within the communities we serve. These focus groups helped identify particularly important needs as seen by our communities, help us identify gaps in knowledge, and understand current external efforts around health needs that could be improved by healthcare participation.
Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - PENROSE-ST FRANCIS. (1) PENROSE HOSPITAL AND (2) ST FRANCIS MEDICAL CENTER
Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - ALL FACILITIES. SEE ATTACHED IMPLEMENTATION STRATEGIES
Schedule H, Part V, Section B, Line 22 Facility A, 1 Facility A, 1 - ALL FACILITIES. NO INDIVIDUAL ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE CHARGED MORE THAN AMOUNTS GENERALLY BILLED TO THOSE WHO HAVE INSURANCE COVERING SUCH CARE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
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?0
Name and address Type of Facility (describe)
1 Synergy Orthopedics
8510 Bryant St Suite 320
Westminster,CO80031
Physician clinic
2 VILLAS AT SUNNY ACRES
2501 EAST 104TH AVE
THORNTON,CO80233
SKILLED NURSING ASSISTED LIVING INDEPENDENT LIVING
3 SMC GASTROENTEROLOGY
1925 E ORMAN
PUEBLO,CO81004
GASTROENTEROLOGY PRACTICE
4 WOMEN'S HEALTH SPECIALISTS
13691 Colorado Blvd Suite 106
thornton,CO80602
WOMEN'S CARE CLINIC
5 DURANGO URGENT CARE AT DMR
1 SKIER PLACE
DURANGO,CO81301
URGENT CARE
6 PSF Primary Care Health Care Services
2960 N Circle Dr Suite 100
Colorado Springs,CO80909
Physcian office
7 GARDENS AT ST ELIZABETH
2835 WEST 32ND AVE
DENVER,CO80211
ASSISTED LIVING INDEPENDENT LIVING
8 North Metro Internal Medicine
8300 Alcott St Suite 302
Westminster,CO80031
outpatient clinic
9 SUMMIT CARDIOLOGY
360 PEAK ONE DR Suite 390
FRISCO,CO80443
CARDIOLOGY PRACTICE
10 PENROSE HOME CARE
7015 TALL OAKS DRIVE
COLORADO SPRINGS,CO80919
HOME HOSPICE
11 SMC SURGICAL PHYSICIANS
1925 E ORMAN
PUEBLO,CO81004
GENERAL SURGERY
12 Dimension Pain Management
400 W 144th Suite 240
Westminster,CO80031
Physician Practice
13 PENROSE COMMUNITY HOSPITAL
3205 N CASCADE AVE
COLORADO SPRINGS,CO80917
OP CLINIC URGENT CARE NO IP SERVICES
14 SURGERY SERVICES & THE MEDICAL HOME
1339 PHAY AVE
CANON CITY,CO81212
SURGERY PRACTICE FAMILY PRACTICE
15 Vascular & Endovascular Specialist of Colorado
11700 W 2nd Place Suite 210
Lakewood,CO80228
SPECIALTY SURGERY
16 SMC Physician Partners-Rehab
1925 E ORMAN
PUEBLO,CO81004
REHAB PHYSICIAN
17 BRECKENRIDGE MEDICAL CLINIC
555 S PARK AVE PLAZA II PO BOX 6909
BRECKENRIDGE,CO80424
PRIMARY CARE/URGENT CARE/ER
18 TOUCHSTONE PUEBLO WEST CLINIC
141 S PURCELL BLVD SuiTE 106
PUEBLO WEST,CO81007
FAMILY PRACTICE
19 PSYCHIATRIC SERVICES
11600 W 2nd Place
Lakewood,CO80228
OUTPATIENT CLINIC
20 MEDALION RETIREMENT COMMUNITY
1719 EAST BIJOU ST
COLORADO SPRINGS,CO80909
SKILLED NURSING ASSISTED LIVING INDEPENDENT LIVING
21 ST ANTHONY HEALTH CENTER EVERGREEN
1520 EVERGREEN PKWY
EVERGREEN,CO80439
PHYSICIAN PRACTICE
22 MERCY HEALTH SERVICES CLINIC
1800 E THIRD AVE
DURANGO,CO81301
HEALTH SERVICES
23 Centura Health Urgent Care Canon City
3245 E US Hwy 50
Canon City,CO81212
urgent care clinic
24 Rocky Mountain Sports and Family Medicine
1315 Fortino Blvd W
Pueblo,CO81008
physician clinic
25 AZTEC DIAGNOSTIC LAB
604 S RIO GRANDE
AZTEC,NM87410
MDS SERVICES
26 MERCY HOME HEALTH
ONE MERCADO STREET suite 270
DURANGO,CO81301
HOMECARE
27 SENIOR HEALTH CENTER WEST
11700 W 2nd Place
Lakewood,CO80228
PRIMARY CARE GERIATRICS
28 Endocrinology Diabetes & Thyroid Specialists of Colorado
11700 W 2nd Place Suite 210
Lakewood,CO80228
physician clinic
29 PHYSICIAN PARTNERS ORTHOPAEDIC SURGERY
4112 OUTLOOK BLVD
PUEBLO,CO81008
ORTHOPAEDIC SURGERY
30 ASSOCIATED SURGEONS
11700 W 2nd Place Suite 210
Lakewood,CO80228
GENERAL SURGERY
31 Southern Colorado Gynocology Oncology
2222 N Nevada Ave Suite 2025
Colorado Springs,CO80907
physician office
32 PENROSE URGENT CARE AT CRIPPLE CREEK
1101 TELLER COUNTY ROAD 1
CRIPPLE CREEK,CO80813
URGENT CARE
33 MERCY DIAGNOSTIC LAB
2577 N MAIN AVE
DURANGO,CO81301
MDS SERVICES
34 CENTURA HOME OXYGEN-PUEBLO
4025 CLUB MANOR DRIVE
PUEBLO,CO81008
HOME MEDICAL EQUIP.
35 PSF Primary Care Health Care Services
6011 E Woodmen Suite 100
Colorado Springs,CO80923
Physician office
36 Southern Colorado Breast Care Specialists
2312 N Nevada Ave Suite 235
Colorado Springs,CO80907
physician office
37 PROGRESSIVE CARE CENTER
1338 PHAY AVE
CANON CITY,CO81212
SKILLED NURSING RESPITE CARE
38 ST ANTHONY HOSPICE
1391 SPEER BLVD Suite 600
DENVER,CO80204
HOME HOSPICE
39 NAMASTE ALZHEIMER CENTER
2 PENROSE BOULEVARD
COLORADO SPRINGS,CO80906
ALZHEIMER'S CARE ADULT DAY CARE
40 SENIOR HEALTH CENTER NORTH
8510 BRYANT ST SUITE 250
WESTMINSTER,CO80031
PRIMARY CARE GERIATRICS
41 VILLA PUEBLO SENIOR LIVING COMMUNITY
1111 BONFORTE BLVD
PUEBLO,CO81001
SKILLED NURSING ASSISTED LIVING INDEPENDENT LIVING
42 Cardiac and Thoracic Surgery Associates PC
2222 N Nevada Ave Suite 5011
Colorado Springs,CO80907
Physicians
43 CHAMBERS SPECIALTY SURGICAL CARE
11700 W 2nd Place Suite 210
Lakewood,CO80228
GENERAL SURGERY
44 ST ANTHONY KEYSTONE MEDICAL CLINIC
1252 COUNTY ROAD 8
KEYSTONE,CO80435
PRIMARY CARE/URGENT CARE/ER
45 NORTH RIDGE MEDICAL PRACTICE
13691 COLORADO BLVD SUITE 106
THORNTON,CO80602
PRIMARY CARE
46 CENTURA HOME OXYGEN-COLORADO SPRINGS
4260 BUCKINGHAM DR suite 100
COLORADO SPRINGS,CO80907
HOME MEDICAL EQUIP.
47 TOUCHSTONE
1925 E ORMAN
PUEBLO,CO81004
FAMILY PRACTICE
48 INTERNAL MEDICINE
614 YALE
CANON CITY,CO81212
INTERNAL MEDICINE
49 Southern Colorado Vascular Surgery
2222 N Nevada Ave Suite 5011
Colorado Springs,CO80907
Physician office
50 INTERMOUNTAIN NEURO PHYSICIANS
11750 W 2nd Place Suite 255
Lakewood,CO80228
OUTPATIENT NEURO
51 REHABILITATIONCCOM
1338 PHAY AVE
CANON CITY,CO81212
REHAB CLINIC ORTHOPAEDIC CLINIC CCOM
52 FAMILY MEDICINE CLINIC NORTH
8510 BRYANT ST SUITE 210
WESTMINSTER,CO80031
PRIMARY CARE CLINIC RESIDENCY FACILITY
53 Centura Family Care Center
916 Indiana Ave
Pueblo,CO81004
Physician clinic
54 PENROSE MOUNTAIN URGENT CARE CLINIC
41 STATE HIGHWAY 67
WOODLAND PARK,CO80863
URGENT CARE OP REHAB
55 Advanced Care in Endocrinology and Diabetes
3207 North Academy Blvd Suite 1300
Colorado Springs,CO80917
Physician Practice
56 SOUTHERN COLORADO FAMILY MEDICINE
1008 MINNEQUA AVE
PUEBLO,CO81004
FAMILY PRACTICE
57 HOSPICE OF MERCY
ONE MERCADO STREET suite 270
DURANGO,CO81301
HOMECARE
58 Mercy Cardiology Associates
1 Mercado Street
Durango,CO81301
outpatient care clinic
59 CHPG Westminster Internal & Family Medicine
400 W 144th Suite 260A
Westminster,CO80023
PHYSICIAN PRACTICE
60 Aspen Ridge ENT
11700 2nd Place Suite 210
Lakewood,CO80228
outpatient clinic
61 ST MARY CORWIN HOME SERVICES
4025 CLUB MANOR DRIVE
PUEBLO,CO81003
HOMECARE
62 PRIMARY CARE SERVICES
4231 W 16TH AVE
DENVER,CO80204
PRIMARY CARE CLINIC
63 CENTURA HOME OXYGEN-DENVER
2590 W 2ND AVE SUITE 5
DENVER,CO80219
HOME MEDICAL EQUIP.
64 ST ANTHONY COPPER MOUNTAIN CLINIC
860 COPPER RD
COPPER MOUNTAIN,CO80443
PRIMARY CARE URGENT CARE
65 Urgent Care of Golden
1030 Johnson Rd Suite 200
Golden,CO80401
OP Urgent care
66 OBGYN SERVICES
1335 PHAY AVE SUITE B
CANON CITY,CO81212
OB/GYN
67 SASMC AMBULATORY SURGERY CENTER
340 PEAK ONE DRIVE
FRISCO,CO80443
AMBULATORY SURGERY CENTER
68 Durango Cancer Center
1 Mercado Street Suite 100
Durango,CO81301
radiation and follow up care for cancer patients
Schedule H (Form 990) 2015
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 CHI COLORADO HAS AN ESTABLISHED CHARITY CARE POLICY BASED ON THE FEDERAL POVERTY LEVEL. CHARITY IS PROVIDED TO PATIENTS BASED ON A SLIDING SCALE THAT CONSIDERS THE PATIENT'S FAMILY SIZE AND INCOME LEVEL. THE CHARITY PROVIDED RANGES FROM 100% OF THE PATIENT'S BILL FOR INDIVIDUALS WHOSE HOUSEHOLD INCOME IS AT 100% OR LESS OF THE FEDERAL POVERTY LEVEL, TO A 60% DEDUCTION FOR INDIVIDUALS WHOSE INCOME IS AT 400% OF THE FEDERAL POVERTY LEVEL. CHI COLORADO TAKES INTO ACCOUNT SPECIFIC FACTS AND CIRCUMSTANCES IN GRANTING CHARITY IN SITUATIONS SUCH AS A CATASTROPHIC ILLNESS WHERE THE PATIENT DOES NOT HAVE LIQUID ASSETS.
Schedule H, Part V, Section B, Line 7 CHNA WEBSITE LINKS https://www.penrosestfrancis.org/PSF/Community/Community-Benefit/ http://www.stanthonyhosp.org/SAH/Community/Community-Benefit/Community-Benefit/ http://www.mercydurango.org/MDU/Community/Community-Benefit/ http://www.stmarycorwin.org/STC/Community/Community-Benefit/ https://www.stanthonynorthhealthcampus.org/SHC/Community/Community-Benefit/ http://www.summitmedicalcenter.org/SMC/Community/Community-Benefit/ http://www.stmhospital.org/STM/Community/Community-Benefit/ http://www.orthocolorado.org/OCO/Community/Community-Benefit/
Schedule H, Part V, Section B, Line 10 IMPLEMENTATION STRATEGY WEBSITE LINKS https://www.penrosestfrancis.org/PSF/Community/Community-Benefit/ http://www.stanthonyhosp.org/SAH/Community/Community-Benefit/Community-Benefit/ http://www.mercydurango.org/MDU/Community/Community-Benefit/ http://www.stmarycorwin.org/STC/Community/Community-Benefit/ https://www.stanthonynorthhealthcampus.org/SHC/Community/Community-Benefit/ http://www.summitmedicalcenter.org/SMC/Community/Community-Benefit/ http://www.stmhospital.org/STM/Community/Community-Benefit/ http://www.orthocolorado.org/OCO/Community/Community-Benefit/
Schedule H, Part V, Section B, Line 16a FAP WEBSITE LINKS http://www.stanthonyhosp.org/SAH/For-Patients-and-Families/Billing-and-Financial-Services/Financial-Help/ http://www.mercydurango.org/Financial-Help/ http://www.stmarycorwin.org/Financial-Help/ https://www.penrosestfrancis.org/Financial-Help/ https://www.stanthonynorthhealthcampus.org/Financial-Help/ http://www.summitmedicalcenter.org/Financial-Help/ http://www.stmhospital.org/Financial-Help/ http://www.orthocolorado.org/Financial-Help/
Schedule H, Part V, Section B, Line 16b FAP APPLICATION WEBSITE LINKS http://www.stanthonyhosp.org/SAH/For-Patients-and-Families/Billing-and-Financial-Services/Financial-Help/ http://www.mercydurango.org/Financial-Help/ http://www.stmarycorwin.org/Financial-Help/ https://www.penrosestfrancis.org/Financial-Help/ https://www.stanthonynorthhealthcampus.org/Financial-Help/ http://www.summitmedicalcenter.org/Financial-Help/ http://www.stmhospital.org/Financial-Help/ http://www.orthocolorado.org/Financial-Help/
Schedule H, Part V, Section B, Line 16c FAP PLAIN LANGUAGE SUMMARY WEBSITE LINKS http://www.stanthonyhosp.org/SAH/For-Patients-and-Families/Billing-and-Financial-Services/Financial-Help/ http://www.mercydurango.org/Financial-Help/ http://www.stmarycorwin.org/Financial-Help/ https://www.penrosestfrancis.org/Financial-Help/ https://www.stanthonynorthhealthcampus.org/Financial-Help/ http://www.summitmedicalcenter.org/Financial-Help/ http://www.stmhospital.org/Financial-Help/ http://www.orthocolorado.org/Financial-Help/
Schedule H, Part VI, Line 4 COMMUNITY INFORMATION (CONTINUED) ST. ANTHONY SUMMIT MEDICAL CENTER To define our community for the CHNA and to analyze demographic and health indicator data, we used the STARK-Law service areas. The STARK-Law service area is defined as the lowest number of contiguous ZIP codes that account for 75% of a hospital's inpatient admissions. These ZIP codes have a combined population of 43,982: Race: White 89.6%; Black 1.2%; Asian 0.9%; Native American/Alaskan Native 1.0%; Native Hawaiian/Pacific Islander 0.2%; some other race 6.1%; Multiple races 1.1%. Ethnicity: 16.11% of the population in our service area reports as Hispanic or Latino. Education Level: In our community, 49.0% of the population has an Associate's Degree or higher; CO average is 44.7%. Unemployment Rate: 2.9%; CO average is 4.0%. Population with Limited English Proficiency: 7.1%; CO average is 6.7%. High School Graduation Rate: 82.6%; CO average is 77.6%. Population Living in Households with Income Below 200% of Federal Poverty level: 30.0%; CO average is 29.6%. ST. THOMAS MORE HOSPITAL To define our community for the CHNA and to analyze demographic and health indicator data, we used the STARK-Law service areas. The STARK-Law service area is defined as the lowest number of contiguous ZIP codes that account for 75% of a hospital's inpatient admissions. These ZIP codes have a combined population of 43,982: Race: 85.6% White, 5.8% Black, 1% Asian, 1.9% Native American/Alaska Native, 0.1% Native Hawaiian/Pacific Islander, 3.9% some other race, and 1.7% multiple races. Ethnicity: 12.3% Hispanic/Latino, Non-Hispanic: 87.7% Education Level: In our community, 23.1% of the population has an Associate's Degree or higher. CO average is 44.7% Unemployment Rate: 5.5%, CO average is 4.0% Population with Limited English Proficiency: 5.6%, CO average is 6.7% High School Graduation Rate: 74.8%, CO average is 77.6% Population Living in Households with Income Below 200% of Federal Poverty level: 36.5%, CO average is 29.6%. ORTHOCOLORADO HOSPITAL To define our community for the CHNA and to analyze demographic and health indicator data, we used the STARK-Law service areas. The STARK-Law service area is defined as the lowest number of contiguous ZIP codes that accounts for 75% of a hospital's inpatient admissions. These ZIP codes have a combined population of 1,143,793: Race and Ethnicity: The population is 85.3% white, 1.38% black, 3.11% Asian, 0.99% Native American/Alaskan Native, 0.06% native Hawaiian/Pacific Islander, 6.17% some other race, and 2.99% multiple races. Additionally, 33.1% are Hispanic or Latino. Education Level: In our communities, 48.5% of the population has an Associate's Degree or higher. CO average is 44.7% Unemployment Rate: 3.8%, CO average is 4.0% Population with Limited English Proficiency: 8.3%, CO average is 6.7% High School Graduation Rate: 67.6%, CO average is 77.6% Population Living in Households with Income Below 200% of Federal Poverty level: 28.2%, CO average is 29.6%.
Schedule H, Part I, Line 6a Community benefit report prepared by related organization Centura Health Corporation
Schedule H, Part I, Line 7g Subsidized Health Services THERE ARE NO PHYSICIAN CLINICS INCLUDED IN SUBSIDIZED HEALTH SERVICES.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 56578297
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance CATHOLIC HEALTH INITIATIVES COLORADO DOES NOT USE A COST ACCOUNTING SYSTEM TO DETERMINE THE COST OF CHARITY CARE PROVIDED. THE ESTIMATED COST OF CARE IS CALCULATED BY APPLYING THE RATIO OF EACH FACILITY'S TOTAL EXPENSES TO TOTAL GROSS REVENUE. WORKSHEET 2 WAS NOT USED TO DEVELOP THE COST TO CHARGE RATIO.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Catholic Health Initiatives Colorado uses the overall cost to gross charge ratio applicable to each facility to determine the costs in Part III, Lines 2 and 3. Catholic Health Initiatives Colorado automatically discounts all self-pay patient accounts by 30% and also offers a prompt pay discount. This allowance is not included in the calculation of the cost of bad debts in instances where a patient does not pay his or her bill.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology Catholic Health Initiatives Colorado does not include any portion of bad debt as community benefit.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Catholic Health Initiatives Colorado (CHIC) does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives (CHI). 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 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 substantially all patients without regard to the ability to pay."
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Cost for each hospital's cost report is pulled from year end trial balances. The cost is then evaluated and all non-allowable cost is removed via adjustments. The remaining allowable cost is then allocated to appropriate patient care and non-patient care cost centers based on Medicare allocation principles. Catholic Health Initiatives Colorado (CHIC) does not treat Medicare shortfalls as community benefit. CHIC's position is consistent with that of Catholic Health Initiatives (CHI), its Sponsor. Medicare is not a differentiating feature of tax-exempt health care organizations; for-profit hospitals treat and attempt to attract Medicare beneficiaries.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Catholic Health Initiatives Colorado's debt collection policy provides for the performance of a reasonable review of each patient's account prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment. The review of patient accounts is done to assure that the patient or their guarantor is not eligible for assistance through Catholic Health Initiatives Colorado's charity care policy, uninsured discount policy, or another financial assistance program (i.e. Medicaid). Catholic Health Initiatives Colorado requires the following of its third-party collection agencies: * Neither Catholic Health Initiatives Colorado hospitals or their collection agencies will request bench or arrest warrants as a result of non-payment; * Neither Catholic Health Initiatives Colorado hospitals or their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No Catholic Health Initiatives Colorado collection agency may seek court action without hospital approval.
Schedule H, Part V, Section B, Line 16a FAP website A - PENROSE-ST FRANCIS HEALTH SERVICES: Line 16a URL: SEE STATEMENT; A - ST. ANTHONY HOSPITAL: Line 16a URL: http://www.stanthonyhosp.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Policy-Apr-2017-en.pdf; A - MERCY REGIONAL MEDICAL CENTER: Line 16a URL: http://www.mercydurango.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Policy-Apr-2017-en.pdf; A - ST. MARY-CORWIN MEDICAL CENTER: Line 16a URL: http://www.stmarycorwin.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Policy-Apr-2017-en.pdf; A - ST. FRANCIS MEDICAL CENTER: Line 16a URL: https://www.penrosestfrancis.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Policy-Apr-2017-en.pdf; A - ST. ANTHONY NORTH HOSPITAL: Line 16a URL: http://www.stanthonynorthhealthcampus.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Policy-Apr-2017-en.pdf; A - ST. ANTHONY SUMMIT MEDICAL CENTER: Line 16a URL: https://www.summitmedicalcenter.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Policy-Apr-2017-en.pdf; A - ST. THOMAS MORE HOSPITAL: Line 16a URL: http://www.stmhospital.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Policy-Apr-2017-en.pdf; A - OrthoColorado Hospital: Line 16a URL: http://www.orthocolorado.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Policy-Apr-2017-en.pdf;
Schedule H, Part V, Section B, Line 16b FAP Application website A - PENROSE-ST FRANCIS HEALTH SERVICES: Line 16b URL: SEE STATEMENT; A - ST. ANTHONY HOSPITAL: Line 16b URL: http://www.stanthonyhosp.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Health-Charity-Application-Jul-2016-en.pdf; A - MERCY REGIONAL MEDICAL CENTER: Line 16b URL: http://www.mercydurango.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Health-Charity-Application-Jul-2016-en.pdf; A - ST. MARY-CORWIN MEDICAL CENTER: Line 16b URL: http://www.stmarycorwin.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Health-Charity-Application-Jul-2016-en.pdf; A - ST. FRANCIS MEDICAL CENTER: Line 16b URL: https://www.penrosestfrancis.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Health-Charity-Application-Jul-2016-en.pdf; A - ST. ANTHONY NORTH HOSPITAL: Line 16b URL: http://www.stanthonynorthhealthcampus.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Health-Charity-Application-Jul-2016-en.pdf; A - ST. ANTHONY SUMMIT MEDICAL CENTER: Line 16b URL: https://www.summitmedicalcenter.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Health-Charity-Application-Jul-2016-en.pdf; A - ST. THOMAS MORE HOSPITAL: Line 16b URL: http://www.stmhospital.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Health-Charity-Application-Jul-2016-en.pdf; A - OrthoColorado Hospital: Line 16b URL: http://www.orthocolorado.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Health-Charity-Application-Jul-2016-en.pdf;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - PENROSE-ST FRANCIS HEALTH SERVICES: Line 16c URL: SEE STATEMENT; A - ST. ANTHONY HOSPITAL: Line 16c URL: http://www.stanthonyhosp.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Plain-Language-Summary-Oct-2016.pdf; A - MERCY REGIONAL MEDICAL CENTER: Line 16c URL: http://www.mercydurango.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Plain-Language-Summary-Oct-2016.pdf; A - ST. MARY-CORWIN MEDICAL CENTER: Line 16c URL: http://www.stmarycorwin.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Plain-Language-Summary-Oct-2016.pdf; A - ST. FRANCIS MEDICAL CENTER: Line 16c URL: https://www.penrosestfrancis.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Plain-Language-Summary-Oct-2016.pdf; A - ST. ANTHONY NORTH HOSPITAL: Line 16c URL: http://www.stanthonynorthhealthcampus.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Plain-Language-Summary-Oct-2016.pdf; A - ST. ANTHONY SUMMIT MEDICAL CENTER: Line 16c URL: https://www.summitmedicalcenter.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Plain-Language-Summary-Oct-2016.pdf; A - ST. THOMAS MORE HOSPITAL: Line 16c URL: http://www.stmhospital.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Plain-Language-Summary-Oct-2016.pdf; A - OrthoColorado Hospital: Line 16c URL: http://www.orthocolorado.org/uploadedFiles/Centura/Content/For_Patients_and_Families/Billing_and_Financial_Services/Financial_Assistance_Charity_Care_and_Payment_Plans/Centura-Financial-Assist-Plain-Language-Summary-Oct-2016.pdf;
Schedule H, Part VI, Line 2 Needs assessment The Catholic Health Initiatives Colorado related hospitals provide several services and resources to the communities it serves beyond the prioritized needs specifically identified in the Community Health Needs Assessment. They sponsor wellness events such as breast feeding education, asthma screenings, and financially supports wellness initiatives of cities and public schools. They also provides transportation for low income patients and housing at no cost or very low cost for the families of low income patients of the hospital that are far from their residence. They also supports, financially and through volunteerism, initiatives such as soup kitchens and meals on wheels to provide food and nutrition education to address hunger issues. Hospital staff also volunteer to serve as preceptors for students of local health professional programs and serve on boards of local community organizations that provide social services to populations in need.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Catholic Health Initiatives Colorado (CHIC) is operated as part of Centura Health Corporation (Centura). Information concerning financial assistance is included on Centura's website. The website not only lists phone numbers for patients to call to discuss financial assistance, but also includes Centura's policy for charity care and its policies related to uninsured patients. In addition, at the time of registration, uninsured patients are screened to determine if the patients qualify for any Federal, State or County programs. Uninsured patients are also sent a letter requesting that the patient call to determine eligibility for various assistance programs, including charity.
Schedule H, Part VI, Line 4 Community information PENROSE-ST. FRANCIS HEALTH SERVICES To define our community for the CHNA and to analyze demographic and health indicator data, we used the STARK-Law service areas. The STARK-Law service area is defined as the lowest number of contiguous ZIP codes that accounts for 75% of a hospital's inpatient admissions. These ZIP codes have a combined population of 527,449: Race and Ethnicity: Native American/Alaskan Native .77%; Asian 5.54%; Black 6.34%; Hispanic or Latino 15.07%; White 81.11%; Native Hawaiian/Pacific Islander .32%; Some other race 4.99%; Multiple Races 5.18%. Education Level: The percentage of the population in the Pikes Peak region with an Associate degree or higher is 45.5%. This is comparable to the Colorado state average of 44.7%. Unemployment Rate: The 5.1% unemployment rate in our area is higher than the state average of 4.0%. Population with Limited English Proficiency: El Paso County has a lower level of residents with a limited English proficiency than the state average. Our service area is at 4.2% and the state average of 6.7% High School Graduation Rate: 78.4% of adolescents are graduating from high school which is a slightly higher rate than the Colorado state average of 77.6%. Population Living in Households with Income Below 200% of Federal Poverty level: 29% of our overall population is living at or below this poverty level, which is consistent with the state average of 29.5%. One of the zip-codes in our area has a poverty level of 50% and is targeted with community initiatives included in the PSF CHIP. ST. ANTHONY HOSPITAL To define our community for the CHNA and to analyze demographic and health indicator data, we used the STARK-Law service areas. The STARK-Law service area is defined as the lowest number of contiguous ZIP codes that accounts for 75% of a hospital's inpatient admissions. These ZIP codes have a combined population of 1,143,793: Race and Ethnicity: The population is 85.3% white, 1.38% black, 3.11% Asian, 0.99% Native American/Alaskan Native, 0.06% native Hawaiian/Pacific Islander, 6.17% some other race, and 2.99% multiple races. Additionally, 33.1% are Hispanic or Latino. Education Level: In our communities, 48.5% of the population has an Associate's Degree or higher. CO average is 44.7% Unemployment Rate: 3.8%, CO average is 4.0% Population with Limited English Proficiency: 8.3%, CO average is 6.7% High School Graduation Rate: 67.6%, CO average is 77.6% Population Living in Households with Income Below 200% of Federal Poverty level: 28.2%, CO average is 29.6%. MERCY REGIONAL MEDICAL CENTER To define our community for the CHNA and to analyze demographic and health indicator data, we used the STARK-Law service areas. The STARK-Law service area is defined as the lowest number of contiguous ZIP codes that accounts for 75% of a hospital's inpatient admissions. These ZIP codes have a combined population of 197,281: Race and Ethnicity: Native American/Alaskan Native 15.68%; Asian .61%; Black .6%; Hispanic or Latino 13.02%; White 75.63%; Native Hawaiian/Pacific Islander .1%; Some other race 4.26%; Multiple Races 3.03%. Education Level: Population with associate's degree or higher: 47.6% Unemployment Rate: 4.0% Population with Limited English Proficiency: 3.7% High School Graduation Rate: 75.6% Population Living in Households with Income Below 200% of Federal Poverty level: 34.1%. ST. MARY-CORWIN MEDICAL CENTER To define our community for the Community Health Needs Assessment and to analyze demographic and health indicator data, we used the STARK-Law service areas. The STARK-Law service area is defined as the lowest number of contiguous ZIP codes that accounts for 75% of a hospital's inpatient admissions. These ZIP codes have a combined population of 188,587: Race: 82.85% White; 2.67% Black; 0.7% Asian; 1.87% Native American Ethnicity: 36.84% Hispanic/Latino, Non-Hispanic: 63.16% Education Level: In our community, 30.5% of the population has an Associate's Degree or higher. CO average is 44.7% Unemployment Rate: 5.6%, CO average is 4.0% Population with Limited English Proficiency: 4.5%, CO average is 6.7% High School Graduation Rate: 71.4%, CO average is 77.6% Population Living in Households with Income Below 200% of Federal Poverty level: 40.2%, CO average is 29.6%. ST. FRANCIS MEDICAL CENTER To define our community for the CHNA and to analyze demographic and health indicator data, we used the STARK-Law service areas. The STARK-Law service area is defined as the lowest number of contiguous ZIP codes that accounts for 75% of a hospital's inpatient admissions. These ZIP codes have a combined population of 527,449: Race and Ethnicity: Native American/Alaskan Native .77%; Asian 5.54%; Black 6.34%; Hispanic or Latino 15.07%; White 81.11%; Native Hawaiian/Pacific Islander .32%; Some other race 4.99%; Multiple Races 5.18%. Education Level: The percentage of the population in the Pikes Peak region with an Associate degree or higher is 45.5%. This is comparable to the Colorado state average of 44.7%. Unemployment Rate: The 5.1% unemployment rate in our area is higher than the state average of 4.0%. Population with Limited English Proficiency: El Paso County has a lower level of residents with a limited English proficiency than the state average. Our service area is at 4.2% and the state average of 6.7% High School Graduation Rate: 78.4% of adolescents are graduating from high school which is a slightly higher rate than the Colorado state average of 77.6%. Population Living in Households with Income Below 200% of Federal Poverty level: 29% of our overall population is living at or below this poverty level, which is consistent with the state average of 29.5%. One of the zip-codes in our area has a poverty level of 50% and is targeted with community initiatives included in the PSF CHIP. ST. ANTHONY NORTH HOSPITAL To define our community for the CHNA and to analyze demographic and health indicator data, we used the STARK-Law service areas. The STARK-Law service area is defined as the lowest number of contiguous ZIP codes that accounts for 75% of a hospital's inpatient admissions. These ZIP codes have a combined population of 218,151: Race and Ethnicity: White=85.8%; Black=1.4%; Asian=5.3%; Native American/Alaskan Native=0.5%; Native Hawaiian/Pacific Islander=<0.1%; some other race=3.2%; Multiple races=3.7% 16.9% of our community identifies as Hispanic or Latino Education Level: Population with Associates Level Degree or Higher=46.4%, CO average is 44.7% Unemployment Rate: 6.7%, CO average is 4.0% Population with Limited English Proficiency: 5.2%, CO average is 6.7% High School Graduation Rate: 72.7%, CO average is 77.6% Population Living in Households with Income Below 200% of Federal Poverty level: 18.3%, CO average is 29.6%.
Schedule H, Part VI, Line 5 Promotion of community health Catholic Health Initiatives Colorado hospitals implements a number of efforts and initiatives to promote the health of the community. It provides financial and volunteer support to clinics that provide care to low income patients. Staff volunteer on the boards of community based organizations that provide essential services to disadvantaged patients. Furthermore, the hospitals provides donations to the initiatives of community based organizations, cities and public schools to support events that promote health and wellness.
Schedule H, Part VI, Line 6 Affiliated health care system Catholic Health Initiatives Colorado (CHIC) is operated as part of Centura Health Corporation (Centura). Centura and its affiliated organizations are dedicated to extending the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities. Specifically, Centura has launched a system-wide strategic plan to improve the quality, consistency, availability, and affordability of healthcare to communities throughout Colorado. The three main components of this strategy are (1) to continue investing in technology advancements that improve the quality, costs, and coordination of care including the establishment of electronic health records linking our physicians, clinics, hospitals, long-term facilities and home care services; (2) providing wellness care, thereby potentially reducing health care costs by helping patients to maintain good health, growing the level of support and outreach provided to rural communities, and increasing access, affordability and quality of health care; and (3) coordinate and develop systems of care, looking to each facility and entity in Centura to share best practices and improve overall efficiency and communication system-wide from birth to home care.
Schedule H, Part VI, Line 7 State filing of community benefit report CO, KS
Schedule H (Form 990) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v3.0
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
Catholic Health Initiatives Colorado
 
Employer identification number
84-0405257
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to 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) AMERICAN CANCER SOCIETY
2255 S ONEIDA ST
DENVER,CO80224
84-1316555 501(C)(3) 5,000       Operational support
(2) AMERICAN HEART ASSOCIATION
PIKES PEAK DIVISION
415 N TEJON STE 201
COLORADO SPRINGS,CO80903
13-5613797 501(C)(3) 21,250       Operational support
(3) ASSISTANCE LEAGUE OF PUEBLO
515 CHESTER AVE
PUEBLO,CO81003
23-7127355 501(C)(3) 10,000       Operational support
(4) CATHOLIC CHARITIES OF DIO PUEB
429 W 10TH ST STE 101
PUEBLO,CO81003
84-0471001 501(C)(3) 5,000       Operational support
(5) CENTER FOR AMERICAN VALUES
101 S MAIN ST 100
PUEBLO,CO81003
27-2779073 501(C)(3) 5,000       Operational support
(6) CHI COLORADO FOUNDATION
1150 KELLY JOHNSON BLVD 204
COLORADO SPRINGS,CO80920
52-3663965 501(C)(3) 224,759       Operational support
(7) COLORADO SPRINGS BUSINESS JOURNAL
235 S NEVADA AVE
COLORADO SPRINGS,CO80903
45-5267177   7,000       Operational support
(8) COLORADO SPRINGS CHILDRENS CHORALE
PO BOX 7841
COLORADO SPRINGS,CO80933
84-0999238 501(C)(3) 8,000       Operational support
(9) COLORADO SPRINGS FINE ARTS CTR
30 WEST DALE STREET
COLORADO SPRINGS,CO80903
84-0406947 501(C)(3) 16,000       Operational support
(10) COLORADO SPRINGS PIONEER MUSEU
215 S TEJON ST
COLORADO SPRINGS,CO80903
27-4151466 501(C)(3) 5,000       Operational support
(11) COLORADO STATE UNIVERSITY
2200 BONFORTE BLVD 187
PUEBLO,CO81001
84-0517947 501(C)(3) 22,770       Operational support
(12) CREATE CANON CITY
402 VALLEY RD
CANON CITY,CO81212
45-4476362 501(C)(3) 30,000       Operational support
(13) CROSSROADS MANAGED CARE
509 E 13TH ST
PUEBLO,CO81001
84-0810723 501(C)(3) 24,000       Operational support
(14) DIOCESE OF COLORADO
29 WEST KIOWA
COLORADO SPRINGS,CO80903
84-0936629 501(C)(3) 10,000       Operational support
(15) FRANCISCAN CENTER
MOUNT ST FRANCIS
7665 ASSISI HEIGHTS
COLORADO SPRINGS,CO80919
84-0405261 501(C)(3) 8,941       Operational support
(16) GIRLS ON THE RUN OF
202 NORTH AVENUE 284
GRAND JUNCTION,CO81501
20-1667120 501(C)(3) 5,000       Operational support
(17) GREATER PUEBLO CHAMBER
302 N SANTA FE
PUEBLO,CO81003
84-0296940 501(C)(3) 6,300       Operational support
(18) GRECCIO HOUSING UNLIMITED INC
1808 W COLORADO AVE
COLORADO SPRINGS,CO80904
84-1158819 501(C)(3) 5,000       Operational support
(19) HARP FOUNDATION
125 RIVERWALK PL
PUEBLO,CO81003
84-1461043 501(C)(3) 10,000       Operational support
(20) HOME FRONT CARES
PO BOX 38516
COLORADO SPRINGS,CO80927
20-0564493 501(C)(3) 7,700       Operational support
(21) HUMANE SOCIETY THE
610 ABBOTT LANE
COLORADO SPRINGS,CO80905
84-0410111 501(C)(3) 8,500       Operational support
(22) LONGMONT UNITED HOSPITAL
1950 W MOUNTAIN VIE AVE
LONGMONT,CO80501
84-0460697 501(C)(3) 10,000,000       Operational support
(23) MARCH OF DIMES BIRTH DEFECTS
PO BOX 932852
ATLANTA,GA31193
13-1846366 501(C)(3) 8,500       Operational support
(24) NEWBORN HOPE INC
310 HIDDEN CREEK DRIVE
COLORADO SPRINGS,CO80906
84-1093905 501(C)(3) 8,000       Operational support
(25) PEAK VISTA COMMUNITY HEALTH CE
3205 N ACADEMY BLVD STE 130
COLORADO SPRINGS,CO80917
84-0617567 501(C)(3) 5,000       Operational support
(26) PIKES PEAK HOSPICE & FOUNDATN
825 E PIKES PEAK AVE STE 600
COLORADO SPRINGS,CO80903
36-4095186 501(C)(3) 5,000       Operational support
(27) Pikes Peak or Bust Rodeo
104 S CASCADE AVE STE 200B
COLORADO SPRINGS,CO80903
84-0473034 501(C)(3) 12,615       Operational support
(28) POLICE FOUNDATION OF
10 LAKE CIRCLE
COLORADO SPRINGS,CO80906
27-0926740 501(C)(3) 10,000       Operational support
(29) ROCKY MOUNTAIN WOMEN'S
421 S TEJON ST 333
COLORADO SPRINGS,CO80903
84-1097818 501(C)(3) 10,000       Operational support
(30) RONALD MCDONALD HOUSE OF SOUTH
311 N LOGAN
COLORADO SPRINGS,CO80909
84-1013843 501(C)(3) 11,000       Operational support
(31) SILVER KEY SENIOR SE
1625 SOUTH MURRAY BLVD
COLORADO SPRINGS,CO80916
23-7109922 501(C)(3) 5,000       Operational support
(32) SPREE RACING
738 E CACHE LA POUDRE
COLORADO SPRINGS,CO80903
45-5525583 501(C)(3) 20,000       Operational support
(33) SUSAN G KOMEN BREAST CANCER FO
411 LAKEWOOD CR B 107
COLORADO SPRINGS,CO80910
75-2844654 501(C)(3) 9,000       Operational support
(34) YMCA OF THE PIKES PEAK REGION
17250 JACKSON CREEK PKWY
MONUMENT,CO80133
84-0404266 501(C)(3) 14,400       Operational support
(35) YWCA OF PUEBLO
801 N SANTA FE AVE
PUEBLO,CO81003
84-0402720 501(C)(3) 6,500       Operational support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
34
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015

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 23455   98,827,077 Book Financial Assistance
(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 I, Line 2 Procedures for monitoring use of grant funds. GRANTS ARE GIVEN AT THE DISCRETION OF THE CATHOLIC HEALTH INITIATIVES COLORADO CEO. THE CEO MAKES REQUESTS FOR FUNDING, WHICH IS PAID OUT IN THE FORM OF A DONATION TO THE ENTITY OR USED TO REIMBURSE AN INVOICE SUBMITTED FOR AN EXPENSE FOR A SPECIFIC PURPOSE. THE MAJORITY OF THE DONEES ARE 501(C)(3) ORGANIZATIONS THAT ASSUME RESPONSIBILITY FOR ENSURING THAT THE FUNDS ARE USED IN FURTHERANCE OF THE PURPOSE OF THE GRANT.
Schedule I (Form 990) 2015



Additional Data


Software ID: 15000238
Software Version: 2015v3.0


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
Catholic Health Initiatives Colorado
 
Employer identification number

84-0405257
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization?
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization?
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 .............................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2015

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1MICHAEL ROWAN FACHE
  CHAIR
(i)

(ii)
0
-------------
1,273,340
0
-------------
1,763,164
0
-------------
859,409
0
-------------
15,775
0
-------------
41,802
0
-------------
3,953,490
0
-------------
242,516
2DEAN SWINDLE CPA
  VICE CHAIR
(i)

(ii)
0
-------------
1,160,179
0
-------------
1,519,534
0
-------------
232,777
0
-------------
303,959
0
-------------
17,848
0
-------------
3,234,297
0
-------------
145,738
3MARGARET SABIN
  GROUP CEO & CEO - PENROSE ST FRANCIS HEALTH SERVICES
(i)

(ii)
631,113
-------------
0
319,946
-------------
0
243,076
-------------
0
153,003
-------------
0
92,050
-------------
0
1,439,188
-------------
0
133,860
-------------
0
4DANIEL REEVES
  Group CFO & CFO - Penrose St Francis Health Services
(i)

(ii)
283,673
-------------
0
89,378
-------------
0
9,387
-------------
0
24,000
-------------
0
13,693
-------------
0
420,131
-------------
0
0
-------------
0
5DAVID THOMPSON
  Group CFO & CFO - St. Anthony's Hospital
(i)

(ii)
330,678
-------------
0
98,946
-------------
0
16,827
-------------
0
24,000
-------------
0
19,096
-------------
0
489,547
-------------
0
0
-------------
0
6Jeffrey Brickman
  Group CEO & CEO - St. Anthony's Hospital
(i)

(ii)
631,114
-------------
0
305,772
-------------
0
183,494
-------------
0
134,160
-------------
0
2,571
-------------
0
1,257,111
-------------
0
149,218
-------------
0
7Janiece MCNichols
  FORMER KE - CFO - St. Anthony North
(i)

(ii)
180,960
-------------
0
52,545
-------------
0
21,198
-------------
0
4,192
-------------
0
7,154
-------------
0
266,049
-------------
0
0
-------------
0
8Thomas Gessel
  CEO Mercy Regional Medical Center
(i)

(ii)
338,701
-------------
0
168,098
-------------
0
105,508
-------------
0
24,000
-------------
0
22,644
-------------
0
658,951
-------------
0
0
-------------
0
9Jane Strobel
  CFO Mercy Regional Medical Center
(i)

(ii)
170,032
-------------
0
52,849
-------------
0
19,753
-------------
0
24,000
-------------
0
1,568
-------------
0
268,202
-------------
0
0
-------------
0
10Brian Moore
  CEO St. Mary-Corwin Medical Center
(i)

(ii)
298,662
-------------
0
105,232
-------------
0
35,826
-------------
0
18,000
-------------
0
25,977
-------------
0
483,697
-------------
0
0
-------------
0
11Vanessa Kochevar
  CFO St. Mary-Corwin Medical Center
(i)

(ii)
224,107
-------------
0
65,801
-------------
0
505
-------------
0
18,000
-------------
0
22,644
-------------
0
331,057
-------------
0
0
-------------
0
12A STEWART LEVY
  PHYSICIAN
(i)

(ii)
830,392
-------------
0
1,866
-------------
0
2,208
-------------
0
24,000
-------------
0
29,613
-------------
0
888,079
-------------
0
0
-------------
0
13Mark ROBINSON
  Physician
(i)

(ii)
843,399
-------------
0
104,336
-------------
0
1,233
-------------
0
18,000
-------------
0
13,526
-------------
0
980,494
-------------
0
0
-------------
0
14Camille Azar
  Physician
(i)

(ii)
674,787
-------------
0
157,108
-------------
0
3,968
-------------
0
24,000
-------------
0
13,682
-------------
0
873,545
-------------
0
0
-------------
0
15Shawn Nakamura
  Physician
(i)

(ii)
644,113
-------------
0
181,114
-------------
0
3,440
-------------
0
36,000
-------------
0
6,806
-------------
0
871,473
-------------
0
0
-------------
0
16Brandon Green
  Physician
(i)

(ii)
575,511
-------------
0
177,467
-------------
0
913
-------------
0
18,000
-------------
0
16,161
-------------
0
788,052
-------------
0
0
-------------
0
Schedule J (Form 990) 2015

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 II REPORTABLE INDIVIDUALS COMPENSATED BY UNRELATED ORGANIZATIONS ALL KEY EMPLOYEES AND HOSPITAL CEOS ARE COMPENSATED BY CENTURA HEALTH CORPORATION, WHO MANAGES THE DAILY ACTIVITIES OF THE CATHOLIC HEALTH INITIATIVES-COLORADO (CHIC) HOSPITALS UNDER A JOINT OPERATING AGREEMENT DATED DECEMBER 8, 1995 BETWEEN THE ADVENTIST HEALTHCARE SYSTEM AND CATHOLIC HEALTH INITIATIVES. AS SUCH, THEIR SALARIES ARE PAID TO THEM BY CENTURA, AN UNRELATED ORGANIZATION, FOR SERVICES RENDERED IN THEIR CAPACITY AS KEY EMPLOYEES OR OFFICERS OF CHIC. ALL OF THEIR REPORTABLE COMPENSATION IS DISCLOSED ON FORM 990, SCHEDULE J, PART II, ROW (I) AND 990, PART VII, COLUMN (D) AS REPORTING ORGANIZATION COMPENSATION. IN ADDITION, THE CEO AND CFO OF CHIC WERE APPOINTED AS SUCH BY THE CHIC BOARD OF DIRECTORS. WHILE THEY ARE OFFICERS OF THESE ENTITIES, A VERY SMALL PORTION OF THEIR TIME IS DIRECTLY RELATED TO THE OPERATIONS OF CHIC. THEY ARE COMPENSATED BY CENTURA, WHICH IS CHARGED WITH MANAGING THE FACILITIES. THEIR RESPECTIVE COMPENSATION IS NOT REPORTED ON THE FILING ORGANIZATION'S 990 BUT IN FACT IS REPORTED IN FULL ON PART VII AND SCHEDULE J OF CENTURA HEALTH CORPORATION'S FORM 990.
Schedule J, Part I, Line 3 METHODS USED TO ESTABLISH CEO COMPENSATION CATHOLIC HEALTH INITIATIVES-COLORADO'S CEO IS PAID BY CENTURA HEALTH CORPORATION (CENTURA). OUTSIDE CONSULTANTS ARE ENGAGED TO PROVIDE RECOMMENDATIONS TO CENTURA'S COMPENSATION COMMITTEE REGARDING THE COMPENSATION OF FACILITY CEOS. THE CONSULTANT'S RECOMMENDATIONS ARE THEN PRESENTED TO AND APPROVED BY THE COMPENSATION COMMITTEE.
Schedule J, Part I, Line 1a Travel for companions SENIOR VICE PRESIDENTS AND HOSPITAL CEOS ARE PAID THROUGH CENTURA HEALTH CORPORATION AND ARE ELIGIBLE FOR THE FOLLOWING BENEFITS: TRAVEL FOR COMPANIONS, HEALTH OR SOCIAL CLUB DUES, AND REIMBURSEMENT UP TO $10,000 FOR PERSONAL SERVICES SUCH AS TAX, FINANCIAL, AND ESTATE PLANNING SERVICES, ALONG WITH TAX GROSS-UP PAYMENTS FOR ANY REIMBURSEMENTS INCLUDED IN TAXABLE COMPENSATION. ALL BENEFITS ARE PROVIDED PURSUANT TO A WRITTEN POLICY GOVERNING PAYMENT AND REIMBURSEMENT, SUBSTANTIATION IS REQUIRED FOR ALL EXPENSES SUBMITTED FOR REIMBURSEMENT, AND REIMBURSEMENTS ARE INCLUDED IN TAXABLE COMPENSATION WHERE APPROPRIATE.
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments See Schedule J, Part I, Line 1a - Travel for Companions Disclosure
Schedule J, Part I, Line 1a Personal services See Schedule J, Part I, Line 1a - Travel for Companions Disclosure
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 AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: MICHAEL ROWAN, JAMES SWINDLE, AND JOHN DICOLA. DURING 2015, THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: JAMES SWINDLE $288,009 John Dicola $144,319 DURING 2015, THE FOLLOWING DISTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: MICHAEL ROWAN $242,516 JAMES SWINDLE $145,738 JOHN DICOLA $411,817 DUE TO THE "SUPER" VESTING RULES UNDER THE CHI DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS TERMINATION, AGE, OR YEARS OF SERVICE 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: MICHAEL ROWAN $313,628 IN ADDITION, CENTURA OFFERS A NON-QUALIFIED RETIREMENT PLAN IN WHICH SENIOR EXECUTIVES (SENIOR VP'S AND ABOVE) ARE PROVIDED A 10% OF SALARY ALLOWANCE TO PURCHASE INSURANCE PRODUCTS OR CONTRIBUTE INTO THE DEFERRED COMPENSATION PLAN. IN ADDITION, A PENSION RESTORATION BENEFIT IS PROVIDED WHICH CREDITS PARTICIPANTS WITH A BENEFIT WHICH IS CALCULATED BASED ON THE EXCESS OF THE PARTICIPANT'S COMPENSATION OVER THE MAXIMUM ALLOWED FOR PENSION CONTRIBUTIONS. AMOUNTS DEFERRED ARE NOT REPORTED AS TAXABLE INCOME UNTIL/UNLESS A TRIGGERING EVENT OCCURS. THIS DEFERRED COMPENSATION PLAN HAS A SUBSTANTIAL RISK OF FORFEITURE PROVISION AND AN ELECTED VESTING SCHEDULE. THE FOLLOWING INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN AND RECEIVED CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN DURING THE CALENDAR YEAR 2015: MARGARET SABIN $154,314 JEFFREY BRICKMAN $167,792 DURING THE CALENDAR YEAR 2015 THE FOLLOWING DISTRIBUTIONS WERE MADE BY CENTURA FROM THE DEFERRED COMPENSATION PLAN: JEFFREY BRICKMAN $110,160 MARGARET SABIN $129,003
Schedule J, Part I, Line 7 Non-fixed payments PARTICIPANTS IN CENTURA'S INCENTIVE COMPENSATION PLANS INCLUDE DIRECTORS AND ABOVE. PAYOUTS ARE BASED ON METRICS ESTABLISHED AND APPROVED BY CENTURA'S COMPENSATION COMMITTEE. THE METRICS INCLUDE QUANTIFIABLE MEASURES PERTAINING TO FINANCIAL PERFORMANCE, SAFETY AND QUALITY AND ASSOCIATE SATISFACTION WITH EACH METRIC WEIGHTED IN DETERMINING THE OVERALL SCORE. THE INCENTIVE COMPENSATION PAYOUT IS CALCULATED BASED ON THE CUMULATIVE SCORE FOR ALL METRICS AND THE PAYOUT IS BASED ON A COMBINATION OF THE SCORE, THE INDIVIDUAL'S BASE COMPENSATION AMOUNT AND POSITION (E.G. DIRECTOR, VICE PRESIDENT).
Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - MARGARET SABIN, COMPENSATION FROM UNRELATED ORGANIZATION - 1439188.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS
Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - DANIEL REEVES, COMPENSATION FROM UNRELATED ORGANIZATION - 420131.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS
Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - DAVID THOMPSON, COMPENSATION FROM UNRELATED ORGANIZATION - 489547.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - SALARIES AND WAGES
Schedule J (Form 990) 2015
Additional Data


Software ID: 15000238
Software Version: 2015v3.0
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
Catholic Health Initiatives Colorado
 
Employer identification number

84-0405257
Return Reference Explanation
Form 990, Part VI, Line 16b EVAL OF PARTICIPATION IN JV ARRANGEMENTS CATHOLIC HEALTH INITIATIVES-COLORADO HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER, CATHOLIC HEALTH INITIATIVES' ("CHI") SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT: (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S-LENGTH, WITH PRICES SET AT FAIR MARKET VALUE. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL.
Form 990, Part VI, Line 15 PROCESS USED TO ESTABLISH COMP THE ORGANIZATION'S CEO AND OFFICERS ARE EMPLOYED BY CENTURA HEALTH CORPORATION ("CENTURA"). OUTSIDE CONSULTANTS ARE ENGAGED TO PROVIDE RECOMMENDATIONS TO CENTURA'S COMPENSATION COMMITTEE REGARDING THE COMPENSATION OF FACILITY CEOS AND CENTURA SENIOR EXECUTIVES. THE CONSULTANT'S RECOMMENDATIONS ARE THEN PRESENTED TO AND APPROVED BY THE COMPENSATION COMMITTEE. CENTURA'S HUMAN RESOURCES DEPARTMENT PERFORMS ANALYSES OF THE MARKET TO DETERMINE COMPENSATION RANGES FOR THE REMAINDER OF CENTURA EXECUTIVES WHICH ARE REVIEWED AND APPROVED BY CENTURA'S SENIOR LEADERSHIP. FOR THOSE REPORTABLE INDIVIDUALS (I.E. BOARD MEMBERS) WHOSE COMPENSATION IS PAID BY CATHOLIC HEALTH INITIATIVES ("CHI"), THEIR COMPENSATION WAS SET BY A COMPENSATION COMMITTEE UTILIZING AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION AMOUNTS THAT WERE BOARD APPROVED AND PAID TO THEM IN ACCORDANCE WITH A WRITTEN CONTRACT.
Form 990, Part VI, Line 6 Classes of members or stockholders ACCORDING TO THE BYLAWS OF CATHOLIC HEALTH INITIATIVES-COLORADO, 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 THE SOLE CORPORATE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, THE SOLE MEMBER SHALL FILL ALL VACANCIES ON THE BOARD OF TRUSTEES CREATED BY REMOVAL, RESIGNATION, OR DEATH.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders CATHOLIC HEALTH INITIATIVES-COLORADO'S ("CHIC") CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES ("CHI"). PURSUANT TO SECTION 5.4.1 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX EXCEPT TO THE EXTENT OTHERWISE PROVIDED IN ORGANIZATION'S ARTICLES AND BYLAWS. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE CHIC BOARD: - APPROVE MEMBERS OF THE CHIC BOARD - AMENDMENT OF THE CORPORATE DOCUMENTS OF CHIC - APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF CHIC - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR CHIC - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF CHIC The following rights are reserved to the CHI Board directly or through powers delegated to the CHI Chief Executive Officer: - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF CHIC - APPROVAL OF ISSUANCE OF DEBT BY CHIC - APPROVAL OF PARTICIPATION OF CHIC IN A JOINT VENTURE - APPROVAL OF FORMATION OF A NEW CORPORATION BY CHIC - APPROVAL OF A MERGER INVOLVING CHIC - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHIC - TO REQUIRE THE TRANSFER OF ASSETS BY CHIC TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CHI MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. IN ADDITION, PURSUANT TO THE AFFILIATION AGREEMENT BETWEEN CHI, CHIC, CENTURA HEALTH CORPORATION, AND ADVENTIST HEALTH SYSTEM, CERTAIN MATTERS AFFECTING CHIC MUST BE APPROVED BY BOTH PORTERCARE AND CHI. THOSE ITEMS INCLUDE: - THE TRANSFER OF ASSETS VALUED AT OVER $3,000,000 - THE ISSUANCE OF A DEBT INSTRUMENT IN EXCESS OF $250,000 - THE AMENDMENT OF THE ORGANIZING DOCUMENTS - THE ADMISSION OF A NEW SPONSOR - A MERGER OR DISSOLUTION OR REORGANIZATION - SETTLEMENT OF LEGAL PROCEEDINGS IN EXCESS OF $5,000,000 - CAPITAL EXPENDITURES IN EXCESS OF $2,000,000
Form 990, Part VI, Line 11b Review of form 990 by governing body ONCE THE RETURN IS PREPARED, A DRAFT OF THE FORM 990 IS PROVIDED TO MANAGEMENT, INCLUDING THE CFO, FOR REVIEW. THE RETURN IS E-MAILED TO THE ENTIRE BOARD FOR REVIEW PRIOR TO FILING. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Form 990, Part VI, Line 12c Conflict of interest policy PROCEDURE: 1. PROCEDURE FOR CONFLICT OF INTEREST REPORTING 1.1. THE CATHOLIC HEALTH INITIATIVES-COLORADO ("CHIC") COMPLIANCE DEPARTMENT ADMINISTERS AN ANNUAL CONFLICT OF INTEREST PROCESS (USUALLY STARTING IN NOVEMBER) COLLECTING AND ASSESSING ANY POTENTIAL CONFLICTS BOARD MEMBERS AND RELATED BOARD COMMITTEE MEMBERS, MATERIALS MANAGEMENT/SUPPLY CHAIN AS WELL AS CHIC MANAGEMENT MAY HAVE. THE FOLLOWING PROCESS IS FOLLOWED: 1.1.1. A COVER LETTER ALONG WITH THE CONFLICTS OF INTEREST POLICY AND THE CONFLICTS OF INTEREST DISCLOSURE STATEMENT ARE AUTOMATICALLY GENERATED AND DISTRIBUTED VIA EMAIL UTILIZING THE COMPLY TRACK SURVEY MANAGER TOOL. FOR THOSE WITHOUT EMAIL ADDRESSES, THE DOCUMENTS ARE SENT VIA US MAIL. 1.1.2. A REQUEST IS MADE TO COMPLETE THE DISCLOSURE STATEMENT FROM ONLINE AND SUBMIT AN ELECTRONIC SIGNATURE USING THE SURVEY TOOL. FOR THOSE WITHOUT AN EMAIL ADDRESS, A REQUEST IS MADE TO FAX OR MAIL ORIGINALS TO THE COMPLIANCE DEPARTMENT. 1.1.3. A REPORT IS COMPILED IDENTIFYING ALL REPORTED POTENTIAL CONFLICTS, NO RESPONSES AND NO NOTED CONFLICTS. 1.1.4. THE REPORT IS REVIEWED FOR POTENTIAL CONFLICTS AND CATEGORIZED BY TYPE OF CONFLICT. 1.1.5. A MEMO IS DISTRIBUTED TO EACH FACILITY CEO AND CFO ALONG WITH REPORTED CONFLICTS FOR PROCESSING AND RELEVANT ACTION OR FOLLOW UP. THE CEO OR CFO, ON BEHALF OF THE CEO, WILL DISTRIBUTE INFORMATION ABOUT SPECIFIC CONFLICTS TO RELEVANT DEPARTMENT MANAGEMENT FOR CONSIDERATION IN FUTURE BUSINESS DEALINGS/NEGOTIATIONS. 1.1.6. THE REPORT IS SHARED WITH THE CHIC BOARD FOR INFORMATION, DISCUSSION, AND POSSIBLE ACTION RELATIVE TO SPECIFIC CONFLICTIVE SITUATIONS. 2. PROCEDURE FOR DISCLOSURE 2.1. WHENEVER ANY MATTER COMES BEFORE A MEETING OF THE BOARD, A BOARD COMMITTEE MANAGEMENT OR MATERIALS MANAGEMENT/SUPPLY CHAIN THAT GIVES RISE TO A POTENTIAL CONFLICT OF INTEREST, THE FOLLOWING PROCEDURES SHALL APPLY: 2.1.1. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD, COMMITTEE MEETING OR MANAGEMENT MEETING BUT AFTER SUCH PRESENTATION, HE/SHE SHALL, IF REQUESTED BY THE BOARD OR COMMITTEE, LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. 2.1.2. THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. 2.1.3. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER CHIC CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. 2.1.4. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE, BY A MAJORITY VOTE OF THE DISINTERESTED MEMBERS, WHETHER THE TRANSACTION OR ARRANGEMENT IS IN CHIC'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO CHIC AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. 2.1.5. FOR TRANSACTIONS THAT ARE NEGOTIATED BY CHIC MANAGEMENT AND MATERIALS MANAGEMENT/SUPPLY CHAIN AND WHICH ARE NOT REQUIRED TO BE REPORTED TO THE BOARD, EACH MANAGER WILL TAKE PRECAUTIONS TO ENSURE THERE IS NO CONFLICT OR THE APPEARANCE OF A CONFLICT RELATIVE TO THE BUSINESS NEGOTIATIONS AND TRANSACTION. IF A CONFLICT, OR THE APPEARANCE OF A CONFLICT EXISTS, THE INTERESTED PERSON WILL REMOVE HIMSELF/HERSELF OR OTHER INTERESTED PARTY FROM THE NEGOTIATION/TRANSACTION. 3. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY 3.1. IF THE BOARD, COMMITTEE OR CHIC MANAGEMENT HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE INTERESTED PERSON TO DISCLOSE. 3.2. IF, AFTER HEARING THE RESPONSE OF THE INTERESTED PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD, COMMITTEE OR CHIC MANAGEMENT DETERMINES THAT THE INTERESTED PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. 4. RECORDS OF PROCEEDINGS 4.1. THE MINUTES OF THE BOARD AND ANY COMMITTEES WITH BOARD DELEGATED POWERS SHALL CONTAIN: 4.1.1. THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE CONFLICT, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST, IN FACT, EXISTED. 4.1.2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH AND A RECORD THAT THE PERSON(S) WITH A CONFLICT OF INTEREST DID NOT PARTICIPATE IN THE VOTE. 4.1.3. FOR BUSINESS TRANSACTIONS BEING NEGOTIATED OUTSIDE OF THOSE REQUIRED TO BE REPORTED TO THE BOARD AND ANY COMMITTEES, THE COMPLIANCE DEPARTMENT SHALL MAINTAIN DOCUMENTATION AS TO THE RESOLUTION AND APPROPRIATENESS OF ANY POTENTIAL CONFLICT RELATIVE TO MANAGEMENT AND MATERIALS MANAGEMENT/SUPPLY CHAIN ASSOCIATES CONDUCTING BUSINESS ON BEHALF OF CHIC. 5. COMPENSATION 5.1. A VOTING MEMBER OF A BOARD OR A BOARD COMMITTEE WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM CHIC FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 5.2. A PHYSICIAN WHO IS A VOTING MEMBER OF A BOARD OR BOARD COMMITTEE AND RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM CHIC FOR SERVICES IS PRECLUDED FROM DISCUSSING AND VOTING ON MATTERS PERTAINING TO THAT MEMBER AND OTHER PHYSICIANS' COMPENSATION. NO PHYSICIAN OR PHYSICIAN BOARD MEMBER OR COMMITTEE MEMBER, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO THE BOARD OR BOARD COMMITTEE REGARDING PHYSICIAN COMPENSATION. 6. ANNUAL STATEMENTS 6.1. ALL INTERESTED PERSONS MUST COMPLETE A DISCLOSURE STATEMENT ANNUALLY. THIS DISCLOSURE STATEMENT MAY BE MODIFIED FROM TIME TO TIME AS DEEMED APPROPRIATE. THE VICE PRESIDENT OF CHIC COMPLIANCE IS RESPONSIBLE FOR CIRCULATING, ENSURING COMPLETION OF THE DISCLOSURE STATEMENT BY ALL INTERESTED PERSONS OF CHIC, AND REPORTING THE RESULTS TO THE CHIC HEALTH BOARD. 7. PERIODIC REVIEWS 7.1. ANNUALLY, INTERNAL AUDIT WILL REVIEW COMPENSATION AND FINANCIAL ARRANGEMENTS FOR POTENTIAL CONFLICTS OF INTEREST.
Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE ON THE COLORADO SECRETARY OF STATE'S WEBSITE. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN THE CATHOLIC HEALTH INITIATIVES CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Miscellaneous Revenue - Total Revenue: 2069673, Related or Exempt Function Revenue: , Unrelated Business Revenue: 261886, Revenue Excluded from Tax Under Sections 512, 513, or 514: 1807787;
Form 990, Part IX, Line 11g Other Fees Consulting & Contract Labor - Total Expense: XXX-XX-XXXX, Program Service Expense: 99969574, Management and General Expenses: 6895366, Fundraising Expenses: 0; Purchased Services - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 25257727, Fundraising Expenses: ; Service Center Allocation - Total Expense: 27771268, Program Service Expense: 13885634, Management and General Expenses: 13885634, Fundraising Expenses: ; Corp Management Fee - Total Expense: 74146895, Program Service Expense: 37073448, Management and General Expenses: 37073447, Fundraising Expenses: ; Sponsor Management Fee - Total Expense: 19967473, Program Service Expense: 1996747, Management and General Expenses: 17970726, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances MINORITY INTEREST - -9698413; CAPITAL RESOURCE POOL CONTRIBUTIONS - -14472978; CHIC Foundation Debt Forgiveness - -7769781; Restructuring Losses - -2117395;
Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - JEFFREY BRICKMAN, COMPENSATION FROM UNRELATED ORGANIZATION - 1257111.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS
Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - JANIECE MCNICHOLS, COMPENSATION FROM UNRELATED ORGANIZATION - 266049.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS
Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - THOMAS GESSEL, COMPENSATION FROM UNRELATED ORGANIZATION - 658951.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPOERATION, TYPE OF COMPENSATION - WAGES AND BENEFITS
Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - JANE STROBEL, COMPENSATION FROM UNRELATED ORGANIZATION - 268202.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS
Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - BRIAN MOORE, COMPENSATION FROM UNRELATED ORGANIZATION - 483697.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS
Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - VANESSA KOCHEVAR, COMPENSATION FROM UNRELATED ORGANIZATION - 331057.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS
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
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
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
Catholic Health Initiatives Colorado
 
Employer identification number

84-0405257
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)ALEGENT CREIGHTON CLINIC
12809 W DODGE RD

OMAHA,NE68154
47-0765154
HEALTHCARE NE 501(c)(3 3 ACH
 
Yes
 
(2)ALEGENT CREIGHTON HEALTH
12809 W DODGE RD

OMAHA,NE68154
47-0757164
HEALTHCARE NE 501(c)(3 3 CHI NEBRASKA
 
Yes
 
(3)ALEGENT CREIGHTON HEALTH FOUNDATION
12809 W DODGE RD

OMAHA,NE68154
47-0648586
FUNDRAISING NE 501(c)(3 7 ACH
 
Yes
 
(4)ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM
7500 MERCY RD

OMAHA,NE68124
47-0484764
HEALTHCARE NE 501(c)(3 3 CHI NEBRASKA
 
Yes
 
(5)ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA
631 N 8TH ST

MISSOURI VALLEY,IA51555
42-0776568
HEALTHCARE IA 501(c)(3 3 CHI NEBRASKA
 
Yes
 
(6)ALEGENT HEALTH - IMMANUEL MEDICAL CENTER
6901 N 72ND ST

OMAHA,NE68122
47-0376615
HEALTHCARE NE 501(c)(3 3 CHI NEBRASKA
 
Yes
 
(7)ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER
104 W 17TH ST

SCHUYLER,NE68661
47-0399853
HEALTHCARE NE 501(c)(3 3 CHI NEBRASKA
 
Yes
 
(8)ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
PO BOX 368

CORNING,IA50841
42-0782518
HEALTHCARE IA 501(c)(3 3 CHI NEBRASKA
 
Yes
 
(9)ALVERNA APARTMENTS
300 SE 8TH AVE

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

BRECKENRIDGE,MN56520
41-1850500
SENIOR LIVING MN 501(c)(3 9 SFH
 
Yes
 
(11)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
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?



(k)
Percentage
ownership


Yes No Yes No
(1) Alegent Health Northwest Imaging Center LLC

3606 N 156th St
OMAHA,NE68116
06-1786985
OP Diagnostics NE ACH
 
Related -7,263 485,853   No 0 Yes   51 %
(2) Audubon Land Company LLC

5390 N Academy Blvd STE 300
COLORADO SPRINGS,CO80918
84-1513085
Real Estate CO CHIC
 
Related 250,214 23,193,712   No 0   No 50 %
(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   77 %
(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   65 %
(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 58 %
(6) BERYWOOD OFFICE PROPERTIES LLC

400 BERYWOOD TRAIL
CLEVELAND,TN37312
62-1875199
PHYS OFFICE TN MHCS
 
Related 127,778 958,445   No 0 Yes   63 %
(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 65 %
(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   80 %
(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   100 %
(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 51 %
(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   65 %
(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   100 %
(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   65 %
(14) CHICAMSURG Surgery Centers LLC

188 INVERNESS DRIVE WEST 500
ENGLEWOOD,CO80112
46-5683027
SURGERY CENTER CO CHIC
 
Related 0 0   No 0   No 51 %
(15) CHICLARKIN VENTURES LLC

188 INVERNESS DRIVE WEST 500
ENGLEWOOD,CO80112
47-4210888
URGENT CARE CO CHIC
 
Related 0 0   No 0 Yes   87 %
(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   40 %
(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 51 %
(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 100 %
(19) Heartland Oncology LLC

2337 E Crawford St
SALINA,KS67401
46-4265403
ONCOLOGY KS SCH
 
Related -457,809 1,985,911   No 0   No 51 %
(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 80 %
(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 54 %
(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 51 %
(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 54 %
(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 51 %
(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 57 %
(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 60 %
(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 60 %
(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 70 %
(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   51 %
(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   66 %
(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 51 %
(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   63 %
(33) SAINT JOSEPH - SCA HOLDINGS LLC

1451 Harrodsburg RD
LEXINGTON,KY40503
45-3801157
OP SURGERY DE SJHS
 
Related 0 0   No 0 Yes   51 %
(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 100 %
(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 51 %
(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 51 %
(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 61 %
(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 57 %
(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   51 %
(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   51 %
(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   51 %
(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   51 %
(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   51 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Alegent HealthCreighton St Joseph Managed Care Services Inc

12809 West Dodge Rd
Omaha,NE68154
47-0802396
Managed Care NE CHI Nebraska
 
C Corporation 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
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION

B 224,759 FMV
(2) CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION

C 6,482,720 FMV




Schedule R (Form 990) 2015
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2015
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