TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) RICKY NAPPER PRESIDENT/CEO SJHS, EX-OFFICIO TRUSTEE (BEG NOV 2015)	1.0 ................. 60.0	X	X	643,174	62,909
(2) JAMES P SCHUESSLER INTERIM PRESIDENT/CEO SJHS, EX-OFFICIO TRUSTEE (THROUGH NOV 2015)	1.0 ................. 49.0	X	X	767,624	0
(3) JAMES E BLAIR III CHAIRPERSON	2.0 ................. 14.0	X	X	0	0
(4) ANTHONY MORELOS VICE CHAIRPERSON	1.0 ................. 7.0	X	X	0	0
(5) ROBERT UPCHURCH SECRETARY	1.0 ................. 7.0	X	X	0	0
(6) Michael Covert EX-OFFICIO TRUSTEE	1.0 ................. 60.0	X		1,623,949	73,828
(7) SR NANCY SURMA OSF EX-OFFICIO TRUSTEE	1.0 ................. 8.0	X		0	0
(8) JOHN S GRUBE BOARD MEMBER	1.0 ................. 7.0	X		0	0
(9) MICHAEL STEINES MD BOARD MEMBER	1.0 ................. 49.0	X		754,454	24,861
(10) ANTONIO ARREOLA-RISA BOARD MEMBER	1.0 ................. 7.0	X		0	0
(11) PAUL BATISTA BOARD MEMBER (PARTIAL YEAR)	1.0 ................. 7.0	X		0	0
(12) MICHAEL COHEN MD BOARD MEMBER	1.0 ................. 7.0	X		0	0
(13) CHARLES A ELLISON BOARD MEMBER	1.0 ................. 7.0	X		0	0
(14) GINA FLORES BOARD MEMBER	1.0 ................. 7.0	X		0	0
(15) CAROLINE MCDONALD BOARD MEMBER	1.0 ................. 7.0	X		0	0
(16) GEORGE NELSON BOARD MEMBER (PARTIAL YEAR)	1.0 ................. 7.0	X		0	0
(17) STEVE OGDEN BOARD MEMBER	1.0 ................. 7.0	X		0	0

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
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

Burleson St Joseph Health Center

Employer identification number

74-2759890

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

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

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

Section C. Computation of Public Support Percentage

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

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

16a

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

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

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

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

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

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

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

Section D. Computation of Investment Income Percentage

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

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

19a

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

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

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

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

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

Section A. All Supporting Organizations

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

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

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2015

Name of the organization

Burleson St Joseph Health Center

Employer identification number

74-2759890

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)

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

Name of organization Burleson St Joseph Health Center

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

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

Page 3

Name of organization Burleson St Joseph Health Center		Employer identification number 74-2759890

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 Burleson St Joseph Health Center			Employer identification number 74-2759890
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

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

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

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

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

Burleson St Joseph Health Center

Employer identification number

74-2759890

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

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

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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

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

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

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

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

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

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

Yes

581

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

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

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

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

581

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $361 CATHOLIC HEALTH ASSOCIATION - $220
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $361 CATHOLIC HEALTH ASSOCIATION - $220

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Burleson St Joseph Health Center

Employer identification number

74-2759890

Part I

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

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....
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 ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...
b	Buildings	711,255	161,905	549,350
c	Leasehold improvements
d	Equipment ...	890,026	199,310	690,716
e	Other ...
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,240,066

Schedule D (Form 990) 2015

Page 3

Part VII

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

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

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

Part IX

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

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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
PAYABLE TO RELATED PARTIES	243,464
UNCLAIMED PROPERTY	30,353
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	273,817
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

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

BURLESON ST JOSEPH HEALTH CENTER'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION. CHI'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2016, READS AS FOLLOWS: "CHI IS A TAX-EXEMPT COLORADO CORPORATION AND HAS BEEN GRANTED AN EXEMPTION FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CHI OWNS CERTAIN TAXABLE SUBSIDIARIES AND ENGAGES IN CERTAIN ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE AND THEREFORE SUBJECT TO INCOME TAX. MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS."

Schedule D (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Burleson St Joseph Health Center

Employer identification number

74-2759890

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

100% 150% 200% Other %

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

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

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		104	125,370		125,370	0.94 %
b	Medicaid (from Worksheet 3, column a) . . . . .					0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .		132	152,411	201,170	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	236	277,781	201,170	125,370	0.94 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).					0	0 %
f	Health professions education (from Worksheet 5) . . .			3,209		3,209	0.02 %
g	Subsidized health services (from Worksheet 6) . . . .					0	0 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .		285	5,923		5,923	0.04 %
j	Total. Other Benefits . .	0	285	9,132	0	9,132	0.07 %
k	Total. Add lines 7d and 7j .	0	521	286,913	201,170	134,502	1.01 %

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

Schedule H (Form 990) 2015

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	0	0	0	0

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

3,718,190

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. ......

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

Section B. Medicare

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

5,569,721

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

5,598,760

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

-29,039

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	BURLESON ST JOSEPH HEALTH CENTER 1101 WOODSON DRIVE CALDWELL,TX77836 http://www.chistjoseph.org/ 000679	X	X	X

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	BURLESON ST JOSEPH HEALTH CENTER
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

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

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

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

Yes

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. ............................

Yes

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

Yes

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

Hospital facility’s website (list url): http://www.chistjoseph.org/about-us/community-benefit

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

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

Yes

If "Yes" (list url): http://www.chistjoseph.org/about-us/community-benefit

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

10b

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

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

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

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	BURLESON ST JOSEPH HEALTH CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

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

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

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

http://www.chistjoseph.org/about-us/financial-assistance

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

http://www.chistjoseph.org/about-us/financial-assistance

A plain language summary of the FAP was widely available on a website (list url):
http://www.chistjoseph.org/about-us/financial-assistance

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

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

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

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

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

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	BURLESON ST JOSEPH HEALTH CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - BURLESON ST JOSEPH HEALTH CENTER. In the fall of 2015, the Brazos County Health Department organized a group of local and regional health and health related organizations to serve as a steering committee to provide guidance to the health department in their pursuit of accreditation by the national Public Health Accreditation Board (PHAB). As part of this process, the steering committee would also work with the health department to establish a new regional health coalition, which the health department could collaborate through to address required components of the PHAB accreditation. The proposed coalition, the Brazos Valley Health Coalition, would act as a coordinated group to address health issues in the Brazos Valley; conduct a community health needs assessment; and create a "community health improvement plan". Steering committee members initially worked on developing the framework for the Brazos Valley Health Coalition and the assessment design and timeline. Once the coalition's proposed mission, purpose, and membership were determined, committee members turned their focus to the assessment process. Committee members provided feedback on the geographic scope and the components of the 2016 assessment and made recommendations on the population sectors to be included in the planned community discussion groups. Additionally, the committee identified the most useful type of secondary data to be gathered, analyzed, and reported on as part of the assessment. In January 2016, the steering committee held the organizational meeting of the Brazos Valley Health Coalition to present and gather feedback the proposed collaboration and the planned 2016 assessment. Over fifty representatives of local and regional health and community organizations, were invited to the inaugural meeting of the Brazos Valley Health Coalition. Participants were supportive of the new coalition and offered input into the assessment format and process. As was the case in each of the previous assessments, the local input provided aid in the customization of the assessment process to maximize usefulness of the findings to those audiences.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - BURLESON ST JOSEPH HEALTH CENTER. Hospital facilities participating in the CHNA were College Station Medical Center and CHI St. Joseph Health System (including St Joseph Regional Health Center, Grimes St Joseph Health Center, Burleson St Joseph Health Center, Madison St Joseph Health Center, and Bellville St Joseph Health Center).
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - BURLESON ST JOSEPH HEALTH CENTER. The Center for Community Health Development, (CCHD), at the Texas A&M University Health Science Center School of Public Health conducted the 2016 Brazos Valley Health Assessment in collaboration with the recently formed Brazos Valley Health Coalition. The Brazos Valley Health Coalition includes the Brazos County Health Department, the Mental Health Mental Retardation Authority of Brazos Valley, and the Brazos Valley Council of Governments as well as many other government and non-profit organizations.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - BURLESON ST JOSEPH HEALTH CENTER. Prioritized list of Significant Health Needs Given the broad scope of community health issues and the tremendous differences in health resources available in each community, CHI St. Joseph Health sought to identify priority needs for the community served with the resources most commonly available in all communities. Also taken into consideration were the priority needs based on the CHI National Strategy platform, internal and external stakeholder recommendations, including a discussion with the CHI St. Joseph Health Board of Directors, ongoing/emerging issues identified in the Brazos Valley Health Status Assessment, and current community benefit programs. The top four needs that CHI St. Joseph Health will address are: Diabetes Increase education opportunities in the counties that were identified as having the highest diabetes-related mortality and morbidity rates: Brazos, Grimes, and Austin County and improve diabetes education referral processes. * Higher morbidity rates in two or more counties for Type II Diabetes (Brazos and Grimes) - Morbidity rate refers to the incidence of ill-health in a population * Higher death rates in three or more counties for diabetes deaths (Austin, Brazos, and Grimes) - Mortality rate refers to the incidence of death for the number of deaths in a population Access to and Availability of Healthy Foods Encourage communities to promote efforts to provide fruits and vegetables in a variety of settings and encourage the establishment and use of direct-to-consumer marketing outlets such as farmers' markets and community gardens. * Rural residents report traveling greater distances to purchase groceries, averaging almost 30 miles for Leon County residents. * Food Environment Index (1 to 10 [10 =better]) score for counties varies from 4.3 for Brazos County to 7.2 for Austin County. Texas is 6.4, while "top performers" are 8.3. * The proportion of low income families in Brazos County and the distribution of quality sources of food are the likely contributors to that low score. Violence Prevention As a health care provider, CHI will always care for victims of violence. However, to make a difference in eradicating violence in the communities we serve, we must move beyond treatment and intervention and focus efforts on prevention. This will be accomplished by collaborating and partnering with local agencies to increase prevention and treatment resources in the area of family/domestic violence as it relates to violent crime. * The leading violent crime reported for the Greater Brazos Valley was family violence, followed by rape/sexual assault. * Given its significantly larger population, Brazos County had the highest average count of violent crime, while Leon County had the lowest. Injury Prevention Increase injury prevention education, awareness, and collaboration with other agencies to expand programs/outreach in the CHI St. Joseph Health service area. * Higher death rates in three or more counties for unintentional injury deaths (Burleson, Leon, and Madison Counties) * Higher death rates in three or more counties for motor vehicle deaths (Austin, Brazos, Burleson, Grimes, Leon, Madison, and Robertson) - The overall motor vehicle crash death rate (number of fatalities per 100,000 population) for the State of Texas is 13.1. The Greater Brazos Valley county average is 18.0. The rate varies across the counties from a low of 12.6 in Brazos County to a high of 31.6 in Leon County. Significant Health Needs Not Addressed Other significant health needs not being addressed by CHI St. Joseph Health directly are currently being addressed by a coalition of local organizations in the community. The Brazos Valley Health Coalition, led by the Brazos County Health Department, is developing a community health improvement plan (CHIP) with the help of a shared network of community stakeholders and residents throughout the community. The CHIP is an action-oriented strategic plan that outlines community-driven goals, objectives, strategies, and measures for addressing the following significant health needs: 1) Poor communication and coordination around health and human services, 2) lack of access to primary care, and 3) Access to mental health care. The CHI St. Joseph Health Healthy Communities department team serves on the steering committee of the Brazos Valley Health Coalition, providing executive oversight for the community health improvement planning and implementation process. Lack of reliable, affordable public transportation was also identified as a significant issue in every county in the CHI St. Joseph Health service area. While CHI St. Joseph Health has addressed some components of this need through partial funding of staft facilities, and transportation for the health resource centers in Burleson, Grimes, and Madison counties, this is still seen as a major barrier to accessing needed resources and services. This will need to be addressed at a higher level with collaboration between multiple county and city agencies. Finally, collaborating across the community is important in planning and implementing community benefit programs. Collaboration with local agencies allows CHI St. Joseph Health to 1) leverage existing assets in the community, creating the opportunity for broader impact; 2) avoid unnecessary duplication of programs or services, thereby maximizing the use of scarce resources; and 3) help build the capacity of local community members to engage in civic dialog and collaborative problem solving, positioning the community to build upon and sustain health improvement activities.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - BURLESON ST JOSEPH HEALTH CENTER. When Catholic Health Initiatives (the ultimate parent organization to Burleson St Joseph Health Center) established its financial assistance policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among urban and rural communities in 18 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the federal poverty guidelines (FPG), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. Burleson St Joseph Health Center bases its financial assistance eligibility on HUD's 130% of very low income guidelines based on geography, and affords the uninsured and underinsured the ability to obtain financial assistance write-offs, based on a sliding scale, ranging from 25%-100% of charges. An individual's income under the HUD guidelines is a significant factor in determining eligibility for financial assistance. However, in determining whether to extend discounted or free care to a patient, the patient's assets may also be taken into consideration. For example, a patient suffering a catastrophic illness may have a reasonable level of income, but a low level of liquid assets such that the payment of medical bills would be seriously detrimental to the patient's basic financial (and ultimately physical) well-being and survival. Such a patient may be extended discounted or free care based upon the facts and circumstances.
Schedule H, Part V, Section B, Line 22 Facility , 1	Facility , 1 - BURLESON ST JOSEPH HEALTH CENTER. FINANCIAL ASSISTANCE PATIENTS ARE CHARGED BASED ON THE HUD VERY LOW INCOME GUIDELINES. THE ORGANIZATION WILL NOT CHARGE INDIVIDUALS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE MORE THAN AMOUNTS GENERALLY BILLED TO THOSE WHO HAVE INSURANCE.

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?0
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, Part VI LINES 2, 4, & 5	Introduction Catholic health care organizations across the nation are challenged to provide quality care with compassion to those we serve, as well as to understand and respond to the needs of our communities. CHI St. Joseph Health (CHI SJHS) has been actively working to assess these unique needs and create plans that respond to them. The CHI St. Joseph Health community benefit program encompasses services provided, with little or no compensation, in response to identified community need, including: community health education activities, community screenings, cash and in-kind contributions to community organizations, efforts to improve access to health care, charity care to residents and the shortfall of federal and state health reimbursements for patients served. Established in 1936, CHI St. Joseph Health is a faith-based, not-for-profit health system committed to excellence and compassion in caring for the mind, body and spirit while also creating healthier communities. CHI St. Joseph Health is comprised of five hospital facilities across the Brazos Valley, including CHI St. Joseph Health Regional Hospital, the region's highest level trauma center. CHI St. Joseph Health is a part of Catholic Health Initiatives (CHI), one of the nation's largest Catholic health systems. As an active member of the communities it serves, CHI St. Joseph Health is a leader in health improvement and access and is proud to present the 2016 annual report of community benefit initiatives. Overview of the Community Served by CHI St. Joseph Health Located in Bryan,Texas, the CHI St. Joseph Health hospital service area includes a large rural area, as well as many smaller rural communities. The hospital service area includes 9 counties, with the majority of the service area found within Brazos County. CHI St. Joseph Health serves an area that is home to a population of over 350,000 residents that represent diverse ethnicities, backgrounds, and needs. Key descriptors of the community served by CHI St. Joseph Health include: * Age: The largest population in the CHI St. Joseph Health service area falls in the age category of 20-24 years (15.4%). The second-largest age category is 25-34 years (13.4%). There is the smallest number of persons in the CHI St. Joseph Health service area within the youngest (5-9} years (5.9%} and oldest (85+ years (1.5%)) age categories. * Race/Ethnicity: The majority of CHI St. Joseph Health's community residents identify as White, Not-Hispanic (60.7%) and Hispanic (22%). 12.2% of the population identifies as Black/African American, Not Hispanic and 5.1% as All Other Races, Not Hispanic. * Education: Most residents in the CHI St. Joseph Health community have more than or equal to a high school education and/or GED. CHI St. Joseph Health assesses the health needs of the community using internal and external information. The primary assessment tool is the Regional Health Partnership 17 Health Assessment, which includes an assessment of the Brazos Valley. This assessment is conducted every three years. Using information from the 2013 health needs assessment, CHI St. Joseph Health provided programs in 2016 to improve the health of residents, such as community-based health screenings, education, awareness and prevention programs, as well as programs designed to improve access to primary care providers. CHI St. Joseph Health also delivers uncompensated health services to residents qualifying for charitable care or those covered through state and federal programs, such as Medicare and Medicaid, where the reimbursement for services provided are less than the costs of providing that service. CHI St. Joseph Health 2016 Community Benefit Community Benefit provided by CHI St. Joseph Health can be broken down into three primary areas: - health care services delivered to patients meeting qualifications of the health system's charity care policy or government-sponsored indigent health care programs; - subsidized health care services and - programs aimed at improving community health overall. Health Care Needs of the Brazos Valley Community health initiatives completed by CHI St. Joseph Health in FY16 were based upon results of the 2013 Regional Health Partnership 17 Health Assessment, as well as state and national data. Those sources identified the leading causes of death in the Brazos Valley as: coronary heart disease, cancer, stroke, chronic obstructive pulmonary disease (COPD) and diabetes. The most frequently reported chronic diseases and conditions included: obesity, hypertension, high cholesterol, arthritis, rheumatism, diabetes, congestive heart failure, emphysema and COPD. As a part of the RHP 17 Assessment, the Brazos Valley region included Brazos, Burleson, Grimes, Leon, Madison, Robertson and Washington counties. The assessment identified obesity as a common health issue across the Brazos Valley, consistent with data collected in three previous surveys. In 2013 the assessment noted that obesity rates appeared to be leveling off, although they remain relatively high. Other significant health issues include: Disease RHP 17 (Rural Community Rates) U.S. Anxiety 23.7% (21.9%) 17% Depression 24.6% (20.0%) 12% Emphysema/COPD 5.4% (7.5%) 2% High Cholesterol 30.3% (37.0%) 13% Hypertension 33.9% (41.5%) 24% Obese/Morbidly Obese 29.6% (26.59%) 28% Community Benefit Plan Given the broad scope of community health issues and the tremendous differences in the types of health resources available in each community, CHI St. Joseph Health sought to identify goals that would impact as many health needs as possible with the resources most commonly available in all counties. The 2013 RHP 17 Health Assessment identified the following issues in the Brazos Valley: - Rural communities, low-income and minority populations continued to face substantial disparities both in access to resources and services and in health outcomes. - A greater proportion of uninsured populations did not have a regular health care provider. These individuals often delayed receiving medical care due to costs and rated their access to care as fair, poor or very poor. - The Federal Health Resources and Service Administration (HRSA) designated seven of the eight counties comprising the CHI St. Joseph Health primary service area as a Health Professional Shortage Area (HPSA) wholly or in part. One of the recommendations in the Needs Assessment called for providers to collaborate and leverage resources. CHI St. Joseph Health has sought to accomplish this through expansion of a medical home model, where one provider coordinates care to ensure patients receive the right resources at the right time to keep them healthy. Following discussions with key partners, CHI St. Joseph Health determined the wide variety of key health issues impacting residents across the Brazos Valley could be collectively addressed by: - expanding population health initiatives aimed at preventing chronic health issues; - improving primary care access and coordination through access to a medical home. As part of broader steps to address population health and access, CHI St. Joseph Health took an active role in the establishment of the Brazos Valley Health Coalition (BVHC) in January 2016. A collaboration of local health and human services authorities from both the public and private health sector, the BVHC's purpose is to: - collectively address health issues in the Brazos Valley; - conduct a community health assessment to identify the health needs and strengths of the region; - create a community health improvement plan, completed in May 2016, to determine health priorities and specific strategies for addressing the issues identified in the community health assessment.
Schedule H, Part VI LINES 2, 4, & 5	Access to Primary Care CHI St. Joseph Health is comprised of five hospital facilities, six rural clinics, three Express Care clinics, two skilled nursing facilities, one freestanding emergency room and a freestanding rehabilitation hospital, in partnership with HealthSouth. Rural clinics are located in Bellville, Navasota, Lexington, Hearne, Normangee and Brenham and, through a partnership with HealthPoint, in Franklin, Hearne, Somerville, Caldwell and Madisonville. Acute care facilities include: CHI St. Joseph Health Regional Hospital (Bryan), CHI St. Joseph Health Bellville Hospital (Bellville), CHI St. Joseph Health Burleson Hospital (Caldwell), CHI St. Joseph Health Grimes Hospital (Navasota) and CHI St. Joseph Health Madison Hospital (Madisonville). CHI St. Joseph Health Express Care, the urgent medical care clinic, has locations in Bryan, College Station and Brenham. These clinics provide services related to minor injuries, routine check-ups, physicals and drug screenings, as well as laboratory and imaging services. CHI St. Joseph Health works to accomplish its Mission to increase access to care and promote wellness throughout the Brazos Valley for rural residents through collaboration and coordination of services that address identified service needs of residents. In the rural areas, the top five community service needs identified included: - care of a medical specialist; - financial assistance; - work-related or employment services; - early childhood programs; - utility assistance. To help address rural access to medical specialists and the high incidence of uninsured residents, CHI St. Joseph Health secured a $19,000 grant to support efforts to educate residents about health insurance options and enroll them in coverage. In 2015, the Brazos Valley region had one of the state's lowest participation rates in health insurance exchange programs created by the Affordable Care Act (ACA). CHI St. Joseph Healthy Communities, a team that works to reduce the serious problem of chronic diseases in communities served by CHI St. Joseph Health, received the grant through a partnership with CHI and the Robert Wood Johnson Foundation. Efforts with Enroll Brazos Valley Coalition, a group of Brazos Valley health providers working collaboratively to educate residents on health insurance under the ACA, enabled the health system to help more than 2,700 local residents find and enroll in medical coverage. Also, to improve rural access to care and to remove some of the social barriers patients often face, CHI St. Joseph Health gives ongoing support to four Health Resource Centers operated by the Brazos Valley Health Partnership (BVHP). The BVHP works to improve health status and access to care through the collaboration of services and creation of local partnerships. Health professionals in these centers, in Caldwell and Somerville (Burleson County), Navasota (Grimes County), Centerville (Leon County) and Madisonville (Madison County) provide case management, referrals, telehealth counseling and specialty care. CHI St. Joseph Health Madison Hospital provided facilities and utilities to support the Madison Health Resource Center, offering 2,200 square feet of office space, utilities and internet access valued at $27,480 during FY16. Madison Hospital continues to employ the case manager and office manager, receiving funding for 90% of these costs from Madison County and the city of Madisonville. In Grimes County, CHI St. Joseph Health Grimes Hospital provides four office spaces for the Grimes Health Resource Center, including utilities and internet access. The Health Resource Center director is a Grimes Hospital employee. The Burleson Health Resource Center is housed in a facility provided by the Burleson County Hospital District. CHI St. Joseph Health Burleson Hospital employs and fully funds the Health Resource Center staff. The coordinator position at the Somerville Health Resource Center is funded by the Burleson County Hospital District through Burleson Hospital and the city of Somerville. All Health Resource Centers provide residents transportation to and from medical appointments and support other community needs. In 2016, CHI St. Joseph Health took steps to expand the network of Health Resource Centers by applying for and later receiving a $432,351 grant from the Episcopal Health Foundation to open a Health Resource Center in Bryan. The grant funds will cover staffing the Health Resource Center with four employees, a director, office manager and two community health advocates. The grant also funds Telehealth connectivity, capital purchases and start-up costs. The center will handle referrals, find resources to pay for assistance for unfunded patients discharged from the hospital when they have no means for obtaining medication, durable medical equipment or transportation to safely discharge home. In addition, the Health Resource Center will do home visits and management for people with complex social issues, addressing root causes of poverty in order to build a healthier community. In an effort to reduce cases of emergency department misuse and encourage residents with medical needs to establish care with primary care physicians, CHI St. Joseph Health continued its collaboration with Burleson Health Resource Center and the HealthPoint clinic -- both in Caldwell -- to address the issue of helping patients find a medical home. In conjunction with a high-alert patient program already in place in the emergency department at CHI St. Joseph Health Burleson Hospital, implementation of this program resulted in decreased ED visits among high-alert patients, improved communication among hospital, Health Resource Center and HealthPoint clinic personnel, and more patients being seen through the HealthPoint clinic for chronic conditions. Burleson Health Resource Center also saw an increase in clients utilizing resources related to financial help, nutrition, mental health and substance abuse. From July 2015 to June 2016 the Health Resource Center has provided vouchers enabling more than 50 patients to see a primary care physician, covering more than $1,400 in medical care. Prenatal Care Prenatal care was provided in rural communities with direct referral to the delivery site at CHI St. Joseph Health Regional Hospital. The Regional delivery site provides more comprehensive and coordinated care than is available locally. Regional Hospital partners with the Prenatal Clinic in Bryan to provide prenatal care for uninsured mothers and those covered under Medicaid. Approximately 200 mothers receiving care at the Prenatal Clinic delivered their babies at Regional Hospital from July 2015 to June 2016. This further improves the early onset of prenatal care and reduces the number of low birth-weight babies in the Brazos Valley. CHI SJH provides many educational opportunities to expectant parents before the birth of their child, including prepared childbirth, newborn care, breastfeeding and infant CPR classes free of charge. Additionally, teenage mothers delivering babies at CHI St. Joseph Health Regional Hospital receive a postpartum consultation with social services and a referral to other community agencies as needed. Health educators from CHI St. Joseph Health provide information and resources for teen parenting classes held at school districts in the Brazos Valley. CHI St. Joseph Health works in collaboration with the Prenatal Clinic on a Delivery System Reform Incentive Payment (DSRIP) project under the Texas 1115 Waiver program. The project's goals are to provide navigation services to help underserved pregnant women at risk for gestational diabetes access proper prenatal care and improve delivery outcomes. Mothers also receive postpartum education within eight weeks of delivery. As part of their transition of care, the hospital and clinic expect navigation patients to follow up with their primary care providers. The program began actively screening low-income pregnant women for diabetes and enrolling eligible patients in October 2014.
Schedule H, Part VI LINES 2, 4, & 5	Heart Disease and Stroke CHI St. Joseph Health promotes heart health and stroke awareness each year in the Brazos Valley by offering discounted blood screenings to Gold Medallion Club members, free blood pressure checks to the general community and evidence-based education. From July 2015 to June 2016, more than 1,000 community members received free blood pressure screenings at CHI St. Joseph Health facilities and health education fairs across the Brazos Valley. Additionally, close to 500 people received free or highly discounted blood glucose and or cholesterol screenings and nearly 5,000 received education on heart healthy habits, stroke and chest pain awareness. Dietitians offered monthly education for cardiac rehabilitation patients, including nutritional counseling and support as a part of their follow-up care. CHI St. Joseph Health Regional Hospital continues to maintain its status as the region's only Primary Stroke Center with Intervention Capabilities. The Chest Pain Center's protocol-driven and systematic approach to patient management allows physicians to reduce time to treatment during the critical early stages of a heart attack, when treatments are most effective, and to better monitor patients when it is not clear whether they are having a coronary event. Such observation helps ensure that patients are not sent home too early nor needlessly admitted. As the region's first Joint Commission Certified Primary Stroke Center, Regional Hospital was also awarded the American Stroke Association's (ASA) Get With The Guidelines Stroke Silver-Plus Target: Stroke Elite Plus Honor Roll Award. This level of recognition designates and recognizes CHI St. Joseph Health's commitment and success in implementing excellent care for stroke patients according to evidence-based guidelines. The Plus designation, a new award level in 2016, looked at best practices for treatment. Regional Hospital is required to organize a multidisciplinary stroke team to coordinate care among first responders, emergency room staff, physicians, diagnostic staff, rehabilitation staff and other health providers who care for stroke patients. The team implemented best practice protocols shown to provide the best outcomes when diagnosing and treating stroke patients. All three critical access hospitals have achieved Support Level (Level III) Stroke Facility designation by the Texas Department of State Health Services. CHI St. Joseph Health Bellville Hospital also received this designation, making CHI St. Joseph Health the only system in Texas that provides stroke care in all of its inpatient facilities. Each site has a stroke coordinator, who oversees the stroke program and ensures that Joint Commission- and state-defined timeframes for lab work, imaging, medications and other care components are met. In addition to a medical director and coordinator, each of these programs requires a multi-departmental effort for success, including the lab, pharmacy, director of nursing, floor and ER nurses and a representative from EMS to ensure a seamless transition from ambulance to ER team. Education programs are also a continuing part of stroke prevention education for all community residents in the seven-county area. In 2016 Regional Hospital also received the American College of Cardiology's National Cardiovascular Data Registry ACTION Registry Get With The Guidelines Gold Performance Achievement Award. As one of only 36 hospitals nationwide to receive the honor, Regional demonstrates its commitment and success in implementing a higher standard of care for heart attack patients. It also signifies that CHI St. Joseph Health offers patients the most appropriate treatment according to nationally-recognized clinical guidelines and recommendations established by the latest scientific evidence. In addition to this award, CHI St. Joseph Health is also recognized as an Accredited Chest Pain Center V5 with Primary PCI and Resuscitation, meaning the hospital offers a comprehensive program for the rapid diagnosis and treatment of heart attacks and cardiac conditions for patients who come into either Regional Hospital or South College Station Emergency departments. This was a new, higher accreditation for CHI St. Joseph Health for 2016. Trauma and Emergency Care In 2016, the trauma program at CHI St. Joseph Health Regional Hospital was re-verified as a Level II Trauma Center by the American College of Surgeons (ACS) and a designated Level II Trauma Center by the Texas Department of State Health Services (DSHS). This verification and designation makes CHI St. Joseph Health Regional Hospital the highest level trauma center in the region between Houston, Temple, Austin and San Antonio. This achievement recognizes CHI St. Joseph Health's dedication to providing optimal care for patients suffering from all types of injuries, including those that are life-threatening. Designation as a Trauma Center requires a commitment to organized, multidisciplinary care of the trauma victim throughout their hospitalization. Trauma care is delivered by numerous, highly-trained professionals throughout the hospital. Having this level of trauma care available in the region enables patient access to high-quality trauma care for the best possible outcome. In the last five years, CHI St. Joseph Health has cared for more than 16,500 trauma patients systemwide. Forty-five percent of the system's trauma cases were caused by a fall and approximately 30% were caused by car crashes. As a leader in trauma care in the region, Regional Hospital and CHI St. Joseph Health outlying facilities participate in the area Regional Advisory Council. This includes injury prevention programs that run throughout the year to help reduce the number of traumatic injuries. From July 2015 to June 2016, CHI St. Joseph Health provided trauma prevention education and awareness to nearly 3,600 residents in the region through the RED (Reality Education for Drivers) program, Shattered Dreams, community CPR/AED and First Aid education, EMS student training and community outreach, the Safe Sitter Program, newborn care and fall prevention education. In May 2016, CHI St. Joseph Health open a new 24,000-square-foot, 33-bed Emergency and Trauma Center located at Regional Hospital, more than doubling the size of its previous Emergency Department. The number of trauma patients CHI St. Joseph Health cares for has continued to increase since its Level II Trauma Center designation. In addition, according to U.S. Centers for Disease Control data, the CHI St. Joseph Health Emergency Department has cared for patients who are more acutely ill than national averages. The new, larger facility has improved patient flow, reduced wait times and improved the privacy and comfort level of patients. Regional Hospital receives ambulance transport service from more than 15 counties across the Brazos Valley and is the primary 911 Service Provider for Burleson, Grimes, Leon and Madison counties. The trauma program operates both a ground and air ambulance service. Through CHI St. Joseph Health Air Medical, housed at Regional Hospital, crew members gain hospital experience in emergency and trauma care while rounding with emergency department physicians and trauma surgeons. CHI St. Joseph Health EMS Services also provided more than 1,700 hours of EMS standby time at a cost of over $37,000, for support or educational demonstrations across the Brazos Valley. Obesity Awareness and Prevention CHI St. Joseph Health collaborated with the Texas A&M School of Public Health to offer programs to address obesity and its health impact, given it is the most significant health problem in every county that CHI St. Joseph Health serves. Fit & Strong! is a physical activity and behavioral change, evidence-based program that is structured around two key components - physical activity and health education/group problem-solving. This program was offered at several CHI St. Joseph Health facilities in Brazos and Grimes County. Community education was also provided for people who are overweight or obese, covering nutrition, exercise, emotional wellness and other topics related to weight loss. Weight and BMI screenings were also offered at no charge. Meeting space was provided for a weekly support group that discussed lifestyle changes and shared tips for weight loss. From July 2015 to June 2016, CHI St. Joseph Health provided obesity awareness and prevention education to over 1,700 area residents.
Schedule H, Part VI LINES 2, 4, & 5	Diabetes Management Education CHI St. Joseph Health provides free community education for diabetes prevention and management. The Living Well with Diabetes Program focuses on Type 2 diabetes and prediabetes and is taught by a Certified Diabetes Educator and Registered Dietitian. The program includes two, 3-hour core sessions (offered bi-monthly) that focus on proper nutrition using carbohydrate counting, exercise, blood glucose monitoring, foot care and other topics. Additional one-hour informational seminars are offered monthly and cover topics like Setting Yourself Up for Success: It All Starts in the Kitchen!, Staying in Control of Your Diabetes While You Travel, Foot Care, How to Have a Healthy Heart with Diabetes and more. A monthly grocery store tour led by a Registered Dietician, is included in the program and has been expanded to multiple locations in an effort to better serve community demographics. Participants receive a one-month membership in the CHI St. Joseph Health Wellness Program. Local healthcare providers refer newly diagnosed patients to the bi-monthly diabetes education program. CHI St. Joseph Health dietitians also provide program information to diabetes patients in all its facilities. In addition to the Living Well with Diabetes Program, education efforts have continued with participation in area health fairs by providing diabetes education and glucose screenings, reaching nearly 800 residents from July 2015 to June 2016. CHI St. Joseph Health also collaborated with the Texas A&M AgriLife Extension Service to offer the "Do Well, Be Well with Diabetes" course to residents in rural communities. Support Groups Having a support system is essential to the community's health and well-being. CHI St. Joseph Health publications and website highlight a listing of 16 area support groups offered at CHI St. Joseph Health facilities and throughout the community, many of which meet in CHI SJH facilities or are facilitated by CHI SJH team members. Senior Life Services As the population ages, care for older adults has become increasingly important. CHI St. Joseph Health, through its affiliates, offers this group many opportunities for care and growth, including assisted living, intermediate and skilled nursing care at CHI St. Joseph Health Skilled Nursing & Rehabilitation in Bryan and Caldwell and senior education and outreach events throughout the Brazos Valley. Lifelong fitness is also encouraged through the CHI St. Joseph Health Wellness Program, which offers cardiac rehabilitation, water aerobics, group fitness and physical strength training. The CHI St. Joseph Health Gold Medallion Club provides health education classes and seminars, social outings, local discounts and hospital benefits in all facilities for over 4,000 members ages 50 and up. From July 2015 to June 2016, more than 1,700 senior citizens attended seminars, various social events and health fairs and 518 members traveled on day trips, domestic and international trips. With a service area spanning 10 counties, CHI St. Joseph Health Helpline, an in-home personal emergency response service operated by Philips Lifeline, offered safety, security and independence to 400 seniors to support them in safely living at home. More than 40 Helpline subscribers received a discounted rate based on their income. CHI St. Joseph Health also partners with PremierCare, Inc. to offer Senior Renewal programs in several of the counties it serves. The Senior Renewal program, located in the critical access facilities in Caldwell, Navasota and Madisonville, is an outpatient counseling service that helps to renew quality of life for senior adults. CHI St. Joseph Health broke ground on the MatureWell Lifestyle Center in March 2016. Developed in partnership with Texas A&M Health Science Center College of Medicine, the center will provide access to health resources for mature adults and bring seniors' wellness needs together under one roof. Located in Bryan, the 23,000-square-foot, two-story facility will offer services and programs designed to meet the needs of a growing senior population. Services include: a dedicated Personal Liaison (one point of contact to help patients find their way around, answer questions and schedule appointments and classes), clinical services (medication management, a clinical social worker, nutrition counseling, outpatient therapy services) and wellness resources (fitness coaching, educational seminars and cooking classes, disease and lifestyle management programs, social engagement opportunities and support groups). Special Events More than 600 community members joined CHI St. Joseph Health to celebrate the opening of the new Emergency and Trauma Center at CHI St. Joseph Health Regional Hospital. The event involved an injury prevention health fair with activities including: Hands-Only CPR/how to recognize the signs of heart attack and stroke, head injury prevention with bicycle helmet fit testing and free helmet giveaways, fall prevention, child passenger safety, a Driving While Intoxicated (DWI) and Distracted Driving Simulator, DWI peddle-car obstacle course, Texas Department of Transportation (TXDot) Rollover Convincer, fire prevention information and an Ambulance "Show & Tell" with the Lucas Device as a demonstration. In Brazos County, CHI St. Joseph Health supports special health and wellness events in the community, such as the annual Texas Brain and Spine Institute Neurosciences Symposium, the American Heart Association's Go Red for Women luncheon, Food for Families Food Drive, Junior League Kids in the Kitchen and the Gran Fondo Cycling Event. In 2016 the Gran Fondo cycling event had 250 rider participants who raised money for cancer services and developed awareness of the importance of cancer screenings. Community health fairs provide an avenue for increasing access to care and promoting wellness for residents across the seven-county region. Annual health fairs in Caldwell, Navasota and Madisonville provide rural residents the opportunity to participate in free health screenings related to health assessment findings, such as obesity, cancer, diabetes, heart disease and pulmonary issues. More than 1,000 free flu shots were administered across the Brazos Valley. CHI St. Joseph Health Madison Hospital funded the Shiitake 5K Health Run during the county's annual Mushroom Festival, supported local Relay for Life activities and participated in the Health First Health Fest annual community-wide health fair. In Burleson County, community benefit initiatives included participation in the annual Kolache Festival held in Caldwell. CHI St. Joseph Health Burleson Hospital provided a minor first aid and water station for the event. EMS services for major emergencies were also provided during this two-day event and for Chilifest, an annual fundraiser in the town of Snook. CHI St. Joseph Health Grimes Hospital also actively participated in many community benefit initiatives, including Special Olympics, Senior Day, Red Cross Health & Safety Day and various health and wellness fairs and screenings for local school district employees and businesses. In Austin County, Bellville Hospital supported the annual "Safety Day" for school-aged children in Austin County and numerous community fundraising efforts. They also supported the Friend-to-Friend voucher program, offering free women's health screenings and mammograms, general wellness education and cancer prevention education to underserved women in Austin County.
Schedule H, Part VI LINES 2, 4, & 5	Other Educational Opportunities More than 11,000 residents in the seven-county area benefited from over 300 free educational seminars and events from July 2015 to June 2016. Topics presented included weight loss and dieting, fall prevention, injury prevention, violence prevention, financial stability training, chronic disease self-management, arthritis and cancer awareness. Other topics included sleep disorders, diabetes management, healthy eating, heart health, stroke prevention, CPR and First Aid, parenting, family health counseling, anger management and more. Education was provided on areas of need identified by the health status assessment, as well as prevention and rehabilitation for a variety of other health issues. A certified Child Passenger Safety Technician with CHI St. Joseph Healthy Communities offers free education to parents and guardians on how to properly install car and booster seats. The proper use of child safety seats reduces the risk of injury and death, leading to reduced medical costs, avoidance of loss of future earnings and improved quality of life. CHI St. Joseph Health continues to partner with Texas A&M AgriLife Extension and the Brazos Valley Injury Prevention Coalition to offer Reality Education for Drivers (RED). The free program is a one-day, hospital-based injury prevention tool targeted to young drivers. Using the path of injury as a backdrop, RED provides young persons who have exhibited risky behavior involving alcohol, drugs and motor vehicles with fact-based information they can use to make better decisions. The goal is to reduce the number of motor vehicle crashes involving young drivers by encouraging them to drive sober, silent and secure, within the speed limit. This program is designed for ages 15-21, uses pre- and post-tests to gauge learning and is facilitated by clinical staff at CHI St. Joseph Health Regional Hospital. From July 2015 to June 2016, four classes were held at CHI St. Joseph Health Regional Hospital, and one class was held at CHI St. Joseph Health Burleson Hospital, reaching 171 participants. Because of the success of this program, more classes have been scheduled at CHI St. Joseph Health facilities than ever before, and the classroom portion of the program had to be moved to a larger space! CHI St. Joseph Health is also an organizational partner in the Brazos Interfaith Immigration Network (BIIN). This collaboration works to serve and support the immigrant community in Brazos County by increasing access to legal, educational and social services. BIIN provides information and referral services for immigrants, regardless of legal status; information for the larger community about immigrants and their needs; and immigration information and services provided by volunteers, in cooperation with private attorneys and attorneys and staff from Catholic Charities Legal Immigration Services. Health Professions Education Educational opportunities for certain health professions are provided through several of our facilities and physician partnerships. CHI St. Joseph Health collaborates with the physician program at the Texas A&M College of Medicine, Texas A&M Family Medicine Residency, Physician Assistant program at the University of Texas Medical Branch, Nurse Practitioner Program at University of Texas at Tyler, Emergency Medical Residency at Darnall Army Medical Center and University of Toledo. From July 2015 to June 2016, 56 first, second and third year residents, physician assistants, nurse practitioners and emergency medical residents were trained in facilities throughout the system. Clinical rotation opportunities are also provided for area students in health professions such as nursing, EMT (basic and paramedic), radiology, pharmacy and physical therapy. School partnerships include the Blinn College RN and LVN program, radiology technician program, physical therapy assistant program and emergency medical services (EMS), Lone Star College Ultrasound Program, Oregon Institute of Technology Nuclear Medicine Program, Rangel College of Pharmacy through the Texas A&M Health Science Center, Texas A&M Health Science Center College of Nursing, Texas A&M Health Science Center - Corpus Christi College of Nursing and the Texas Engineering Experiment Station (TEEX) Emergency Medical Services through the Texas A&M University System, physical therapy and physical therapy assistant programs from University of St. Augustine, University of Texas - El Paso, Texas Woman's University - Dallas, University of Incarnate Word and Wharton County Junior College. From July 2015 through June 2016, over 1,000 students were trained in our facilities, working more than 46,000 hours in various departments. Amount of Charity Care & Government Sponsored Indigent Health Care Provided Charity Care The total amount of unreimbursed cost of charity care provided by CHI St. Joseph Health Regional Hospital (CHI SJHR) was $21,576,913 from July 2015 to June of 2016, which is CHI St. Joseph Health's 2016 reporting period. The unreimbursed cost of providing care to financially- and medically-indigent patients totaled $20,453,504. The organization made an additional $1,123,409 in financial contributions to other charitable organizations in the community, including support to Burleson, Madisonville and Bellville Hospitals, as well as CHI St. Joseph Health's Indigent Patient Prescription Program, which provides limited, essential pharmaceuticals for home use to indigent patients. Performance Net patient revenue for the hospital totaled $139,327,341, and expenses totaled $123,817,710. Due to the hospital's participation in the Medicaid disproportionate share hospital program during the 2016 reporting period, the hospital is deemed in compliance of the law as it relates to the Health and Safety Code. The 2016 cost for providing charity care and government-sponsored indigent health care was $21,576,913, or 8.1% of net patient revenue. Unreimbursed Costs of Medicare, Champus/Tricare and other Government Sponsored Programs The estimated unreimbursed cost of government-sponsored health care programs provided by CHI St. Joseph Health for 2016 was $8,705,917. Unreimbursed Cost of Miscellaneous Other Community Benefits The estimated unreimbursed cost of miscellaneous other community benefits provided by CHI St. Joseph Health for 2016 was $16,048,493, detailed as follows: - Unreimbursed cost of subsidized Health Services $26,384,573 - Donations made by the Hospital $1,296,218 - Unreimbursed Education-Related Costs $1,146,881 - Total $28,827,672 Total unreimbursed cost of community benefits The total amount of community benefits rendered by CHI St. Joseph Health for 2016, including charity care and government-sponsored indigent health care, other government-sponsored health care programs, and miscellaneous other community benefits were $59,110,502, or 22.1% of net patient revenues. Reporting and Disclosure The annual report of the community benefits plan has been filed with the Center for Health Statistics at the Texas Department of State Health Services. In addition to the annual report, a completed worksheet, as required by Subsection (a)(5), will be filed no later than 10 working days after the date the hospital files its Medicare cost report. A statement has been prepared that notifies the public that the annual report of the community benefits plan is public information, that it has been filed with the Texas Department of State Health Services and that it is available to the public on request from the department. The statement will be posted in prominent places throughout the hospital, including but not limited to the emergency room waiting area and the admissions office waiting area. The statement will also be printed in the hospital patient guide or other material that provides the patient with information about the admissions criteria of the hospital. The hospital will provide, to each person who seeks any health care service at the hospital, notice in appropriate languages, if possible, about the charity care program, including the charity care and eligibility policies of the program, and how to apply for charity care. These notices will be conspicuously posted in the general waiting area, in the waiting area for emergency services, in the business office and in such other locations as the hospital deems likely to give notice of the charity care program and policies. The hospital will annually publish notice of its charity care program and policies in a local newspaper of general circulation in the county.
Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care	When Catholic Health Initiatives (the ultimate parent organization to Burleson St Joseph Health Center) established its financial assistance policy it was determined that establishing a household income scale based on the HUD very low income guidelines more accurately reflects the socioeconomic dispersions among urban and rural communities in 18 states served by CHI hospitals and health care facilities. In comparing HUD guidelines to the Federal Poverty Guidelines (FPG), we find that on average HUD guidelines compute to approximately 200% to 250% (and sometimes 300%) of FPG. Burleson St Joseph Health Center bases its financial assistance eligibility on HUD's 130% of Very Low Income Guidelines based on geography, and affords the uninsured and underinsured the ability to obtain financial assistance write-offs, based on a sliding scale, ranging from 25%-100% of charges. An individual's income under the HUD guidelines is a significant factor in determining eligibility for financial assistance. However, in determining whether to extend discounted or free care to a patient, the patient's assets may also be taken into consideration. For example, a patient suffering a catastrophic illness may have a reasonable level of income, but a low level of liquid assets such that the payment of medical bills would be seriously detrimental to the patient's basic financial (and ultimately physical) well-being and survival. Such a patient may be extended discounted or free care based upon the facts and circumstances.
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	ST JOSEPH REGIONAL HEALTH CENTER - EIN 74-1282696
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	3718190
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	Cost accounting data and general ledger amounts, less bad debt and cost of charity care, were used to complete the Medicaid (line 7b) and other means tested government programs (line 7c) lines. The hospital's cost accounting records were used to complete the other benefits section (line 7e - 7i.)
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	The bad debt expense reported on Part III, Line 2 is the bad debt expense reported on Form 990, Part IX.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	Burleson St Joseph Health Center does not believe that any portion of bad debt expense could reasonably be attributed to patients who qualify for financial assistance since amounts due from those individuals' accounts will be reclassified from bad debt expense to charity care within 30 days following the date that the patient is determined to qualify for charity care.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Burleson St Joseph Health Center does not issue separate company audited financial statements. However, the organization is included in the consolidated financial statements of Catholic Health Initiatives. The consolidated footnote reads as follows: "The provision for bad debts is based upon management's assessment of historical and expected net collections, taking into consideration historical business and economic conditions, trends in health care coverage, and other collection indicators. Management routinely assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payor category. The results of these reviews are used to modify, as necessary, the provision for bad debts and to establish appropriate allowances for uncollectible net patient accounts receivable. After satisfaction of amounts due from insurance, CHI follows established guidelines for placing certain patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by each facility. The provision for bad debts is presented on the consolidated statements of operations as a deduction from patient services revenues (net of contractual allowances and discounts) since CHI accepts and treats substantially all patients without regard to the ability to pay."
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Burleson St Joseph Health Center is designated as a Critical Access Hospital (CAH). CAHs are rural community hospitals that are certified to receive cost-based reimbursement from Medicare. The reimbursement that CAHs receive is intended to improve their financial performance and thereby reduce hospital closures. CAHs are certified under a different set of Medicare Conditions of Participation (CoP). Shortfalls are created when a facility receives payments that are less than the costs of caring for program beneficiaries. Because shortfalls are based on costs, not charges, Burleson St Joseph Health Center, due to their designation as a CAH, received cost-based reimbursement for Medicare purposes, Burleson St Joseph Health Center will not experience Medicare related shortfalls. Although not presented on the Medicare cost report, in order to facilitate a more accurate understanding of the "true" cost of services (for "shortfall" purposes) the CHI Workbook allows a health care facility not to offset costs that Medicare considers to be non-allowable, but for which the facility can legitimately argue are related to the care of the facility's patients. In addition, although not reportable on the Medicare cost report, the CHI workbook includes the cost of services that are paid via a set fee-schedule rather than being reimbursed based on costs (e.g. outpatient clinical laboratory). Finally, the CHI Workbook allows a facility to include other health care services performed by a separate facility (such as a physician practice) that are maintained on separate books and records (as opposed to the main facility's books and records which has its costs of service included within a cost report). True costs of Medicare computed using this methodology: Total Medicare Revenue: $5,569,721 Total Medicare costs: $5,598,760 Surplus or Shortfall: ($29,039) Burleson St Joseph Health Center believes that excluding Medicare losses from community benefit makes the overall community benefit report more credible for these reasons: Unlike subsidized areas such as burn units or behavioral-health services, Medicare is not a differentiating feature of tax-exempt health care organizations. In fact, for-profit hospitals focus on attracting patients with Medicare coverage, especially in the case of well-paid services that include cardiac and orthopedics. Significant effort and resources are devoted to ensuring that hospitals are reimbursed appropriately by the Medicare program. The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency, carefully studies Medicare payment and the access to care that Medicare beneficiaries receive. The commission recommends payment adjustments to Congress accordingly. Though Medicare losses are not included by Catholic hospitals as community benefit, the Catholic Health Association guidelines allow hospitals to count as community benefit some programs that specifically serve the Medicare population. For instance, if hospitals operate programs for patients with Medicare benefits that respond to identified community needs, generate losses for the hospital, and meet other criteria, these programs can be included in the CHA framework in Category C as "subsidized health services." Medicare losses are different from Medicaid losses, which are counted in the CHA community benefit framework, because Medicaid reimbursements generally do not receive the level of attention paid to Medicare reimbursement. Medicaid payment is largely driven by what states can afford to pay, and is typically substantially less than what Medicare pays.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	Catholic Health Initiatives' (the ultimate parent organization to Burleson St Joseph Health Center) debt collection policy provides that BURLESON ST JOSEPH HEALTH CENTER will perform a reasonable review of each inpatient account prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment, to assure that the patient and patient guarantor are not eligible for any assistance program (e.g. Medicaid) and do not qualify for coverage through BURLESON ST JOSEPH HEALTH CENTER community assistance policy. After having been turned over to a third-party collection agent, any patient account that is subsequently determined to meet the BURLESON ST JOSEPH HEALTH CENTER community assistance policy is required to be returned immediately by the third-party collection agent to BURLESON ST JOSEPH HEALTH CENTER for appropriate follow-up. BURLESON ST JOSEPH HEALTH CENTER requires its third-party collection agents to include a message on all statements indicating that if a patient or patient guarantor meets certain stipulated income requirements, the patient or patient guarantor may be eligible for financial assistance. All of Catholic Health Initiatives' hospitals' contracts with third party collection agencies include the following standards: * Neither CHI hospitals nor their collection agencies will request bench or arrest warrants as a result of non-payment; * Neither CHI hospitals nor their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No Catholic Health Initiatives' collection agency may seek court action without hospital approval. Finally, collection agencies are trained on the Catholic Health Initiatives Mission, Core Values and Standard of Conduct to make sure all patients are treated with dignity and respect.
Schedule H, Part V, Section B, Line 16a FAP website	- BURLESON ST JOSEPH HEALTH CENTER: Line 16a URL: http://www.chistjoseph.org/about-us/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- BURLESON ST JOSEPH HEALTH CENTER: Line 16b URL: http://www.chistjoseph.org/about-us/financial-assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- BURLESON ST JOSEPH HEALTH CENTER: Line 16c URL: http://www.chistjoseph.org/about-us/financial-assistance;
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Burleson St Joseph Health Center includes information concerning its financial assistance policy on its website. In addition, Burleson St Joseph Health Center prominently displays its financial assistance policy in both English and Spanish in obvious locations throughout the hospitals, including the emergency rooms and other patient intake areas, as well as in Burleson St Joseph Health Center outpatient facilities. In addition, Burleson St Joseph Health Center registration clerks are trained to provide consultation to those who have no insurance or potentially inadequate insurance concerning their financial options including application for Medicaid and for financial assistance under Burleson St Joseph Health Center's financial assistance policy. Upon registration (and once all EMTALA requirements are met), patients who are identified as uninsured (and not covered by Medicare or Medicaid) are provided with a packet of information that addresses the financial assistance policy and procedures including an application for assistance. Burleson St Joseph Health Center registration clerks read the organization's medical assistance policy to those who appear to be incapable of reading, and provide translators for non-English-speaking individuals. Burleson St Joseph Health Center's staff will also assist the patient/guarantor with applying for other available coverage (such as Medicaid), if necessary. Counselors assist Medicare eligible patients in enrollment by providing referrals to the appropriate government agencies.
Schedule H, Part VI, Line 6 Affiliated health care system	Burleson St Joseph Health Center, along with its affiliated outpatient facilities, is part of Catholic Health Initiatives. Catholic Health Initiatives (CHI) is a national faith-based nonprofit health care organization with headquarters in Englewood, Colorado. CHI's exempt purpose is to serve as an integral part of its national system of hospitals and other charitable entities, which are described as market-based organizations, or MBOs. An MBO is a direct provider of care or services within a defined market area that may be an integrated health system and/or a stand-alone hospital or other facility or service provider. CHI serves as the parent corporation of its MBOs which are comprised of 104 hospitals, including four academic medical centers, and 30 critical access facilities; community health service organizations; accredited nursing colleges; home health agencies; and other facilities that span the inpatient and outpatient continuum of care. Together, these facilities provided $1.1 billion in financial assistance and community benefit in the 2016 fiscal year, including services for the poor, free clinics, education and research. CHI provides strategic planning and management services as well as centralized "shared services" for the MBOs. The provision of centralized management and shared services - including areas such as accounting, human resources, payroll and supply chain -- provides economies of scale and purchasing power to the MBOs. The cost savings achieved through CHI's centralization enable MBOs to dedicate additional resources to high-quality health care and community outreach services to the most vulnerable members of our society. Burleson St Joseph Health Center operates with its wholly owned affiliates and community partners, along with its fundraising arm, the St Joseph Foundation, to serve the health care needs of the communities within the Brazos Valley in Texas.
Schedule H, Part VI, Line 7 State filing of community benefit report	TX

Schedule H (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
Burleson St Joseph Health Center

Employer identification number
74-2759890

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) ST JOSEPH REGIONAL HEALTH CENTER
2801 FRANCISCAN DRIVE
BRYAN,TX77802

74-1282696

501(c)(3)

2,557,208

N/A

program support

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1) CHARITY CARE AND FINANCIAL ASSISTANCE	104	0	515,950	BOOK	REDUCTION OR WRITE OFF OF PATIENT SERVICES
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

Schedule I, Part III PROCEDURES FOR GRANT TO INDIVIDUALS

BURLESON ST JOSEPH HEALTH CENTER recognizes the right to quality healthcare regardless of age, sex, race, religion, national origin, or ability to pay. Business office staff helps patients seek local, state, and federal reimbursement at no charge when no other source of payment is available. Financial assistance is provided to patients with demonstrated inability to pay for medically necessary services. These funds are directly used to offset the patients accounts receivable.

Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.

Grants included are to community organizations that engage in activities that benefit the community at large. No consideration is received in exchange for these contributions, as they are considered to be a gift to be used by the recipients in accordance with their charitable purposes. As such, use of the funds given to the grantees is not monitored beyond distribution.

Schedule I (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Burleson St Joseph Health Center

Employer identification number

74-2759890

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

Any related organization?

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

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

The organization?

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1RICKY NAPPER PRESIDENT/CEO SJHS, EX-OFFICIO TRUSTEE (BEG NOV 2015)	(i) (ii)	0 ------------- 425,661	0 ------------- 144,433	0 ------------- 73,080	0 ------------- 49,975	0 ------------- 12,934	0 ------------- 706,083	0 ------------- 0
2JAMES P SCHUESSLER INTERIM PRESIDENT/CEO SJHS, EX-OFFICIO TRUSTEE (THROUGH NOV 2015)	(i) (ii)	0 ------------- 767,624	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 767,624	0 ------------- 0
3Michael Covert EX-OFFICIO TRUSTEE	(i) (ii)	0 ------------- 1,137,434	0 ------------- 207,077	0 ------------- 279,438	0 ------------- 0	0 ------------- 73,828	0 ------------- 1,697,777	0 ------------- 0
4MICHAEL STEINES MD BOARD MEMBER	(i) (ii)	0 ------------- 591,970	0 ------------- 162,484	0 ------------- 0	0 ------------- 6,560	0 ------------- 18,301	0 ------------- 779,315	0 ------------- 0
5KATHLEEN KRUSIE COO (through August 2015)	(i) (ii)	0 ------------- 240,180	0 ------------- 45,984	0 ------------- 0	0 ------------- 10,400	0 ------------- 10,182	0 ------------- 306,746	0 ------------- 0
6DANIEL GOGGIN CFO	(i) (ii)	0 ------------- 308,965	0 ------------- 76,202	0 ------------- 0	0 ------------- 10,400	0 ------------- 18,025	0 ------------- 413,592	0 ------------- 0
7RICARDO DIAZ INTERIM COO (beg August 2015)	(i) (ii)	0 ------------- 225,478	0 ------------- 48,579	0 ------------- 0	0 ------------- 6,809	0 ------------- 17,802	0 ------------- 298,668	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 4a SEVERANCE PAYMENTS	Post-termination payments are addressed in executive employment agreements for Catholic Health Initiatives (CHI) and related organizations' employees at the level of Vice President and above, including the MBO CEOs. These employment agreements require that in order for the executive to receive post-termination payments, these individuals must execute a general release and settlement agreement. Post-termination payment arrangements are periodically reviewed for overall reasonableness in light of the executive's overall compensation package.
Schedule J, Part I, Line 3 COMPENSATION OF TOP MANAGEMENT OFFICIAL	Compensation for the top management official was established and paid by Catholic Health Initiatives (CHI), a related organization. CHI used the following to establish the top management official's compensation: (1) Compensation Committee; (2) Independent Compensation Consultant; (3) Written Employment Contracts; (4) Compensation Survey or Study; (5) Approval by the Board or Compensation Committee.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	DURING THE 2015 CALENDAR YEAR CATHOLIC HEALTH INITIATIVES (CHI), A RELATED ORGANIZATION, MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR MBO CEOS/PRESIDENTS AND OTHER CHI EMPLOYEES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. THE FOLLOWING REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE IN THAT PLAN: RICKY NAPPER MICHAEL COVERT DURING 2015 THE FOLLOWING CONTRIBUTIONS WERE MADE BY CHI TO THE DEFERRED COMPENSATION PLAN: RICKY NAPPER - $34,200 DUE TO THE "SUPER" VESTING RULES UNDER THE CHI DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS AGE, YEARS OF SERVICE OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2015 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2015, THE FOLLOWING CONTRIBUTIONS THAT WOULD HAVE BEEN MADE BY CHI TO THE DEFERRED COMPENSATION PLAN WERE PAID IN CASH: MICHAEL COVERT - $175,553

Schedule J (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Burleson St Joseph Health Center

Employer identification number

74-2759890

Return Reference	Explanation
Form 990, Part III, Line 1 ORGANIZATION'S MISSION	The Corporation, sponsored by a lay-religious partnership, calls other Catholic sponsors and systems to unite to ensure the future of Catholic health care. To fulfill this mission, the Corporation, as a values-based organization, will assure the integrity of the ministry in both current and developing organizations and activities; research and develop new ministries that integrate health, education, pastoral, and social services; promote leadership development and formation for ministry throughout the entire organization; advocate for systemic changes with specific concern for persons who are poor, alienated, and underserved; and steward resources by general oversight of the entire organization.
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 4,848,989 including grants of $ 1,072,684)(Revenue $ 5,365,574) Other program services include cardiopulmonary (respiratory therapy) services, physical therapy, supply provision, pharmacy services, imaging services, and senior renewal services.
Form 990, Part VI, Line 15a PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT OFFICIAL	The organization's top management official's compensation is paid by Catholic Health Initiatives (CHI), a related organization. CHI has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses The Korn Ferry Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Korn Ferry Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Korn Ferry Hay Group to the HR committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September 13, 2016. In addition, Korn Ferry Hay Group completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels have been reviewed annually since and revised based on market data, where applicable.
Form 990, Part VI, Line 15b PROCESS FOR DETERMINING COMPENSATION OF OTHER OFFICERS	ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	Pursuant to Section 8.6 of the Bylaws of BURLESON ST JOSEPH HEALTH CENTER, the Executive Committee is composed of the board chair, the board vice chair, and the President, each of whom shall serve as an ex officio voting member of the Executive Committee. Each individual appointed to the Executive Committee shall serve for a term of one year or until his or her successor is duly appointed by the Board of Directors. The Executive Committee shall consist of only directors of the Corporation. Pursuant to Section 8.1 of the Corporation's bylaws, committees, such as the executive committee, that are granted the authority to act on behalf of the board of directors may include only directors of the corporation. Further, pursuant to Section 8.6 of the Corporation's bylaws, the executive committee has and may exercise such powers as may be delegated to it by the board of directors. The Executive Committee also possesses the power to transact routine business of the corporation in the interim period between regularly scheduled meetings of the board of directors.
Form 990, Part VI, Line 6 Classes of members or stockholders	According to the bylaws of BURLESON ST JOSEPH HEALTH CENTER, the entity's sole member is ST JOSEPH SERVICES CORPORATION d/b/a St Joseph Health System, a Texas nonprofit corporation.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	According to the organization's bylaws, directors shall be appointed or refused by the corporate member. The corporate member may appoint one or more individuals to the board of directors, and may at any time remove, with or without cause, any member of the board of directors. According to the organization's bylaws, directors of the corporation shall be appointed by the corporate member no later than June 30 of each year. The names and qualifications of each individual accepted by the board of directors shall be submitted to the corporate member, who shall appoint or refuse each nominee in accordance with the corporate member's bylaws and with endorsement of the senior vice president of operations. The corporate member may unilaterally appoint one or more individuals to the board of directors should the board fail to furnish the corporate member with a list of individuals qualified to serve on the board of directors of the corporation.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	The organization's corporate member is ST JOSEPH SERVICES CORPORATION. Pursuant to Section 5.4 of the organization's bylaws, both ST JOSEPH SERVICES CORPORATION and Catholic Health Initiatives (CHI) (ST JOSEPH SERVICES CORPORATION's sole corporate member) have reserved powers as outlined in the CHI governance matrix. Pursuant to the governance matrix the following rights are held by the ST JOSEPH SERVICES CORPORATION Board: * Approve members of the BURLESON ST JOSEPH HEALTH CENTER board * Amendment of the corporate documents of BURLESON ST JOSEPH HEALTH CENTER * Approve removal of a member of the governing body of BURLESON ST JOSEPH HEALTH CENTER * Adoption of long range and strategic plans for BURLESON ST JOSEPH HEALTH CENTER The following rights are reserved to the CHI Board directly or through powers delegated to the CHI Chief Executive Officer: * Substantial change in the mission or philosophy of BURLESON ST JOSEPH HEALTH CENTER * Removal of a member of the governing body of BURLESON ST JOSEPH HEALTH CENTER * Approval of issuance of debt by BURLESON ST JOSEPH HEALTH CENTER * Approval of participation of BURLESON ST JOSEPH HEALTH CENTER in a joint venture * Approval of formation of a new corporation by BURLESON ST JOSEPH HEALTH CENTER * Approval of a merger involving BURLESON ST JOSEPH HEALTH CENTER * Approval of the sale of all or substantially all of the assets of BURLESON ST JOSEPH HEALTH CENTER * To require the transfer of assets by BURLESON ST JOSEPH HEALTH CENTER to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. Pursuant to Section 5.5 of the organization's bylaws, ST JOSEPH SERVICES CORPORATION or CHI may, in exercise of their approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and its President and the Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate.
Form 990, Part VI, Line 11b Review of form 990 by governing body	Once the return is prepared, the form 990 and accompanying schedules were made available to all trustees either electronically or by hard copy, depending upon the trustees preference, before the company finalized and sent the documents to the IRS. This draft was also available at the administrative offices of the reporting entity for trustees' review before the final form 990 and accompanying schedules were finalized and sent to the IRS. The review was under the direction of the CFO and/or tax return preparers, Catholic Health Initiatives, if requested by the trustees. 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	Catholic Health Initiatives ("CHI") has a Conflicts of Interest ("COI") policy in place to maintain the integrity of all of its activities. The policy applies to CHI Board of Stewardship Trustees and members of its committees; all board and board committee members of CHI Entities; all CHI employees; all CHI physicians (both employed and non-employed) and all physician administrators and leaders; advanced practice clinicians (both employed and non-employed); and all CHI research personnel (both employed and non-employed). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure process. Each person has a general ongoing obligation to promptly and fully report to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The person must report the actual or potential conflict as soon as she/he becomes aware of it. In any situation where the person may be in doubt, a full disclosure should be made to permit an impartial and objective determination. In addition to the general ongoing obligation, there are initial disclosure obligations. The board, board committee members, and new employees are required to make disclosures at the time of their initial hiring/appointment. All non-employed, credentialed or contracted physicians are required to make disclosures at the time of their credentialing and during any subsequent reappointment or recredentialing. All researchers are required to make disclosures upon consideration of affiliation with a research sponsor. In addition to the general ongoing and initial disclosure obligations, there is an annual disclosure obligation. All corporate officers, board and board committee members, employees at the level of manager and above, researchers, supply chain employees, employed physicians, physician administrators and leaders, and employed advanced practice clinicians must complete a new conflict of interest disclosure annually. Disclosures of perceived, potential or actual conflicts involving financial interests are forwarded to the Conflicts of Interest Review Committee ("C-CIRC") or Legal Services Group for review depending on the position of the person involved. The C-CIRC reviews COI questionnaires containing disclosures of perceived or possible conflicts for employees at a level of manager or above, supply chain employees, researchers and physicians, physician administrators and leaders, and advanced practice clinicians (both employed and non-employed). In the determination of a conflict, a COI management plan will be developed for that person. With respect to those audiences for which the C-CIRC has review responsibility, the C-CIRC will facilitate development of any such conflict of interest management plan in collaboration with local CRP staff. A designated CHI Entity staff will be responsible for monitoring the COI management plan and for documenting monitoring activities. At its sole discretion, a CHI Entity may reject a Person's request to enter into the relationship in question, or require the relationship be sufficiently altered to avoid a potential COI. If the C-CIRC determines that there is a potential or actual conflict of interest that does not currently have appropriate controls to address the conflict of interest, it may recommend that the disclosing person be allowed to participate in the activity or transaction subject to restrictions as outlined in the COI management plan. If a Person does not agree with a determination made by the C-CIRC, its interpretation of the Policy or Addenda, or seeks an exemption or exception, the following steps should be followed. The Employee disputing the review decision, interpretation of the Policy, or seeking exemption or exception must present the matter to the Employee's immediate direct manager or supervisor for review and determination. If the Employee and the manager do not agree with the review decision, interpretation of the Policy, or seek exemption or exception, the manager shall consult with the manager's Vice President (or higher if the manager is a Vice President) to reach a determination. If the matter remains unresolved, it shall be referred to the CHI Vice President of Human Resources and the CHI Corporate Responsibility Officer. If they are unable to reach agreement, the matter shall be referred to the CHI General Counsel, whose decision shall be final. Reviews and determinations involving board and board committee members and corporate officers will be the responsibility of the board, board executive committee, or board chair, with guidance from the Legal Services Group (LSG). Annual COI disclosures of all trustee and corporate officers will be reviewed by the CHI Senior Vice President, Legal Services, and General Counsel or his or her designee who will report potential conflicts to the applicable Board Chair. The Board Chair or designee shall make such further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the Board Chair, the Vice Chair will assume the Chair's role. Based on review and evaluation of the relevant facts and circumstances, the Board Chair will make an initial determination as to whether a conflict of interest exists and whether, pursuant to the COI Policy, review and approval or other action by the Board is required. A written record of the Board Chair's determination, including relevant facts and circumstances, will be made. The Board Chair shall then make an appropriate report to the Executive Committee of the Board concerning such review, evaluation and determination. If a difference of opinion exists between the Board Chair and another Trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether Board review and approval or other action is required within the COI Policy, the matter shall be submitted to the Board's Executive Committee, which shall make a final determination as to the matter presented. Such determination, including relevant facts and circumstances, will be reflected in the Executive Committee minutes and will be reported to the Board. When any conflict of interest is considered by the board, the trustee or corporate officer, as appropriate, must disclose all of the material facts to the Board. The trustee shall not vote and the trustee or corporate officer shall not use his or her personal influence on the matter. The trustee or corporate officer shall be excused from the meeting during discussion and vote on the conflict of interest. In reviewing such transactions between CHI or CHI Entities and vendors or other contractors who are, or are affiliated with, Trustees or Corporate Officers, the Board will act as it would in reviewing transactions with unrelated third parties. The transaction is not to be approved unless the Board determines that the transaction is fair to CHI or the CHI Entity. The Board must approve the transaction by a majority of the Trustees on the Board, without counting the vote of any individual who has an interest in the transaction. All determinations of conflicts of interest are reported as required by law, regulations, and CHI policy.
Form 990, Part VI, Line 19 Required documents available to the public	THE ORGANIZATION'S FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINITIATIVES.ORG OR AT WWW.DACBOND.ORG. GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.
Form 990, Part IX, Line 11g Other Fees	PHYSICIAN FEES - Total Expense: 1138589, Program Service Expense: 1138589, Management and General Expenses: , Fundraising Expenses: ; ADMINISTRATIVE PURCHASE SERVICES - Total Expense: 1129832, Program Service Expense: 940085, Management and General Expenses: 189747, Fundraising Expenses: ; ADMINISTRATIVE FEES - Total Expense: 296512, Program Service Expense: , Management and General Expenses: 296512, Fundraising Expenses: ; PATIENT FINANCIAL SERVICES - Total Expense: 640842, Program Service Expense: , Management and General Expenses: 640842, Fundraising Expenses: ; ENVIRONMENTAL SERVICES - Total Expense: 41035, Program Service Expense: , Management and General Expenses: 41035, Fundraising Expenses: ; OTHER CONTRACTED PROFESSIONALS - Total Expense: 5260264, Program Service Expense: 4382749, Management and General Expenses: 877515, Fundraising Expenses: ;

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Burleson St Joseph Health Center

Employer identification number

74-2759890

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA,NE68154 47-0765154	HEALTHCARE	NE	501(c)(3	3	ACH	Yes
(2)ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA,NE68154 47-0757164	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(3)ALEGENT CREIGHTON HEALTH FOUNDATION 12809 W DODGE RD OMAHA,NE68154 47-0648586	FUNDRAISING	NE	501(c)(3	7	ACH	Yes
(4)ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA,NE68124 47-0484764	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(5)ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IA 631 N 8TH ST MISSOURI VALLEY,IA51555 42-0776568	HEALTHCARE	IA	501(c)(3	3	CHI NEBRASKA	Yes
(6)ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA,NE68122 47-0376615	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(7)ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER,NE68661 47-0399853	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(8)ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING,IA50841 42-0782518	HEALTHCARE	IA	501(c)(3	3	CHI NEBRASKA	Yes
(9)ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS,MN56345 41-1351177	LTERM CARE	MN	501(c)(3	9	CHI	Yes
(10)APPLETREE COURT 601 OAK ST BRECKENRIDGE,MN56520 41-1850500	SENIOR LIVING	MN	501(c)(3	9	SFH	Yes
(11)BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS,TX77384 27-4499340	PHYSICIANS	TX	501(c)(3	9	SLCHS	Yes
(12)BELLEVILLE ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 27-4005511	HEALTHCARE	TX	501(c)(3	3	SHSC	Yes
(13)BISHOP DRUMM RETIREMENT CENTER 1111 6TH AVE DES MOINES,IA50314 42-0725196	LTERM CARE	IA	501(c)(3	9	CHI-IA CORP	Yes
(14)BORNEMANN HEALTHCARE CORPORATION 2500 BERNVILLE RD PO BOX 316 READING,PA19603 23-2187242	HEALTHCARE	PA	501(c)(3	Type I	CHI	Yes
(15)BRAZOSPORT HEALTH FOUNDATION INC 129 CIRCLE WAY STE 102 LAKE JACKSON,TX77566 76-0080110	FUNDRAISING	TX	501(c)(3	Type I	BRHS	Yes
(16)BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON,TX77566 80-0240261	HEALTHCARE	TX	501(c)(3	3	BRHS	Yes
(17)BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2759890	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(18)BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2913931	HEALTHCARE	TX	501(c)(3	9	SJSC	Yes
(19)CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON,ND58421 45-0227311	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(20)CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 47-0617373	HEALTHCARE	CO	501(c)(3	Type I	NA	Yes
(21)CATHOLIC HEALTH INITIATIVES - COLORADO 188 INVERNESS DRIVE WEST STE 500 ENGLEWOOD,CO80112 84-0405257	HEALTHCARE	CO	501(c)(3	3	CHI	Yes
(22)CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES,IA50314 42-0680448	HEALTHCARE	IA	501(c)(3	3	CHI	Yes
(23)CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 6385 CORPORATE DR STE 301 COLORADO SPRINGS,CO80919 84-0902211	FUNDRAISING	CO	501(c)(3	7	CHIC	Yes
(24)CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 6385 CORPORATE DR COLORADO SPRINGS,CO80919 27-0930004	FUNDRAISING	CO	501(c)(3	Type I	CHI	Yes
(25)CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-0992796	HEALTHCARE	CO	501(c)(3	Type I	CHINS	Yes
(26)CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG,OR97471 26-3946191	PHYSICIANS	OR	501(c)(3	9	MMC	Yes
(27)CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND,KS67530 48-0543724	SURGERY CENTER	KS	501(c)(3	3	CHI	Yes
(28)CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO,ND58104 27-1966847	HEALTHCARE	MN	501(c)(3	9	CHI	Yes
(29)CHI INSTITUTE FOR RESEARCH AND INNOVATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 27-1050565	HEALTHCARE	CO	501(c)(3	Type I	CHI	Yes
(30)CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER,KY41018 20-2741651	HEALTHCARE	KY	501(c)(3	Type I	CHI	Yes
(31)CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 45-1261716	HEALTHCARE	CO	501(c)(3	9	CHI NS	Yes
(32)CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 45-2532084	HEALTHCARE	CO	501(c)(3	Type I	CHI	Yes
(33)CHI NEBRASKA 6940 O ST STE 200 LINCOLN,NE68510 36-3233121	HEALTHCARE	NE	501(c)(3	Type I	CHI	Yes
(34)CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER,PA17602 23-2342997	HEALTHCARE	PA	501(c)(3	Type I	CHI	Yes
(35)CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE,NM87102 71-0897107	COMMUNITY	NM	501(c)(3	Type I	CHI	Yes
(36)CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER 6624 FANNIN ST HOUSTON,TX77030 74-1161938	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes
(37)CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS,AR71913 71-0236913	HEALTHCARE	AR	501(c)(3	3	CHISVHS	Yes
(38)CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS,AR71913 26-1125064	HOLDING CO	AR	501(c)(3	Type II	SVIMC	Yes
(39)CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 1 MERCY LANE STE 201 HOT SPRINGS,AR71913 26-1125131	HEALTHCARE	AR	501(c)(3	3	CHISVHS	Yes
(40)COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK ST ACCOUNTING-3 W CINCINNATI,OH45206 23-7419853	HOLDING CO	OH	501(c)(2		GSH	Yes
(41)COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION 631 N 8TH ST MISSOURI VALLEY,IA51555 42-1294399	FUNDRAISING	IA	501(c)(3	Type I	AH-CMHMV	Yes
(42)CONTINUING CARE HOSPITAL 150 NORTH EAGLE CREEK DR LEXINGTON,KY40509 61-1400619	LT ACH	KY	501(c)(3	3	SJHS	Yes
(43)COVENANT HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 23-2028429	HOME HEALTH	PA	501(c)(3	Type II	CHI NHC	Yes
(44)ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1450 BATTERSBY AVE ENUMCLAW,WA98022 91-0715805	HEALTHCARE	WA	501(c)(3	3	FHS	Yes
(45)FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN,KY40004 61-1345363	HEALTHCARE	KY	501(c)(3	3	KOH	Yes
(46)FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN,KY40004 56-2351341	FUNDRAISING	KY	501(c)(3	Type I	FH	Yes
(47)FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO,OH43623 34-1931806	HEALTHCARE	OH	501(c)(3	9	FLC	Yes
(48)FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA,WA98405 91-1145592	FUNDRAISING	WA	501(c)(3	9	FHS	Yes
(49)FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA,WA98405 91-0564491	HEALTHCARE	WA	501(c)(3	3	CHI	Yes
(50)FRANCISCAN HEALTH VENTURES FKA SJMGROUP TACOMA FNC CTR BLDG 1145 BROADWAY TACOMA,WA98402 43-1882377	PHYSICIANS	MO	501(c)(3	9	CHI	Yes
(51)FRANCISCAN LIVING COMMUNITIES 5942 RENAISSANCE PLACE STE A TOLEDO,OH43623 34-1892096	HEALTHCARE	OH	501(c)(3	Type I	SFH	Yes
(52)FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA,WA98402 91-1939739	HEALTHCARE	WA	501(c)(3	9	FHS	Yes
(53)FRANCISCAN VILLA OF SOUTH MILWAUKEE INC 3601 S CHICAGO AVE SOUTH MILWAUKEE,WI53172 39-1093829	HEALTHCARE	WI	501(c)(3	9	CHI	Yes
(54)GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON,ND58540 45-0227752	HEALTHCARE	ND	501(c)(3	3	SAMC	Yes
(55)GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 20-1536108	MINISTRIES	CO	501(c)(3	Type I	CHI	Yes
(56)GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 619 OAK ST ACCOUNTING-3 W CINCINNATI,OH45206 31-1778403	EDUCATION	OH	501(c)(3	2	GSH	Yes
(57)GOOD SAMARITAN FOUNDATION OF CINCINNATI INC 619 OAK ST ACCOUNTING-3 W CINCINNATI,OH45206 31-1206047	FUNDRAISING	OH	501(c)(3	Type I	GSH	Yes
(58)GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY,NE68848 47-0379755	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(59)GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY,NE68847 47-0659443	FUNDRAISING	NE	501(c)(3	7	GSH	Yes
(60)GOOD SAMARITAN HOSPITAL FOUNDATION - DAYTON 110 N MAIN ST STE 500 DAYTON,OH45402 23-7296923	FUNDRAISING	OH	501(c)(3	7	SHP	Yes
(61)HARRISON MEDICAL CENTER 2520 CHERRY AVE BREMERTON,WA98310 91-0565546	HEALTHCARE	WA	501(c)(3	3	FHS	Yes
(62)HARRISON MEDICAL CENTER FOUNDATION 2520 CHERRY AVE BREMERTON,WA98310 91-1197626	FUNDRAISING	WA	501(c)(3	7	HMC	Yes
(63)HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 76-0761782	FUNDRAISING	MN	501(c)(3	Type I	SFMC	Yes
(64)HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN,WA98166 91-0712166	HEALTHCARE	WA	501(c)(3	3	FHS	Yes
(65)HOUSE OF MERCY 1111 6TH AVE DES MOINES,IA50314 42-1323808	SHELTER	IA	501(c)(3	7	CHI-IA CORP	Yes
(66)JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 61-1029768	HEALTHCARE	KY	501(c)(3	3	KOH	Yes
(67)KENTUCKYONE HEALTH MEDICAL GROUP INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 61-1352729	HEALTHCARE	KY	501(c)(3	9	JHSMH	Yes
(68)KENTUCKYONE HEALTH INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 61-1029769	HEALTHCARE	KY	501(c)(3	9	CHI	Yes
(69)LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE,MN56623 41-0758434	HEALTHCARE	MN	501(c)(3	3	CHI	Yes
(70)LAKEWOOD REGIONAL HEALTHCARE FOUNDATION 600 MAIN AVE S BAUDETTE,MN56623 41-1893795	FUNDRAISING	ND	501(c)(3	7	LHC	Yes
(71)LINUS OAKES INC 2700 STEWART PKWY ROSEBURG,OR97471 93-0821381	SENIOR LIVING	OR	501(c)(3	9	MMC	Yes
(72)LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON,ND58054 82-0558836	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(73)LUFKIN VISION ACQUISITIONS PO BOX 1447 LUFKIN,TX75901 82-0563768	PROPERTY MGMT	TX	501(c)(3	Type III-FI	MHSET	Yes
(74)MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2761145	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(75)MADONNA MANOR INC 2344 AMSTERDAM ROAD VILLA HILLS,KY51017 61-0654635	LIVING ASSIST	KY	501(c)(3	1	FLC	Yes
(76)MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC 2525 DE SALES AVE CHATTANOOGA,TN37404 62-1839548	FUNDRAISING	TN	501(c)(3	7	MHCS	Yes
(77)MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVE CHATTANOOGA,TN37404 62-0532345	HEALTHCARE	TN	501(c)(3	3	CHI	Yes
(78)MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD RD STE 500 CHATTANOOGA,TN37411 03-0417049	HEALTHCARE	TN	501(c)(3	9	MHCS	Yes
(79)MEMORIAL HEALTH SYSTEM OF EAST TEXAS PO BOX 1447 LUFKIN,TX75902 75-0755367	HEALTHCARE	TX	501(c)(3	3	CHI	Yes
(80)MEMORIAL MEDICAL CENTER - LIVINGSTON PO BOX 1447 LUFKIN,TX75902 76-0436439	HEALTHCARE	TX	501(c)(3	3	MHSET	Yes
(81)MEMORIAL MEDICAL CENTER - SAN AUGUSTINE PO BOX 1447 LUFKIN,TX75902 75-2663904	HEALTHCARE	TX	501(c)(3	3	MHSET	Yes
(82)MEMORIAL MULTISPECIALTY ASSOCIATES 1201 FRANK AVE LUFKIN,TX95904 75-2721155	PHYSICIANS	TX	501(c)(3	Type III-FI	MHSET	Yes
(83)MEMORIAL SPECIALTY HOSPITAL PO BOX 1447 LUFKIN,TX95902 75-2492741	HEALTHCARE	TX	501(c)(3	3	MHSET	Yes
(84)MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVE DES MOINES,IA50314 42-6076069	AUXILIARY	IA	501(c)(3	Type I	MF-DM IA	Yes
(85)MERCY CLINICS INC 1111 6TH AVE DES MOINES,IA50314 42-1193699	PHYSICIANS	IA	501(c)(3	9	CHI-IA CORP	Yes
(86)MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVE DES MOINES,IA50314 42-1511682	EDUCATION	IA	501(c)(3	2	CHI-IA CORP	Yes
(87)MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVE DES MOINES,IA50314 23-7358794	FUNDRAISING	IA	501(c)(3	7	CHI-IA CORP	Yes
(88)MERCY FOUNDATION INC 2700 STEWART PKWY ROSEBURG,OR97471 93-6088946	FUNDRAISING	OR	501(c)(3	7	MMC	Yes
(89)MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING,IA50841 42-1461064	FUNDRAISING	IA	501(c)(3	Type I	AHMH-Corning	Yes
(90)MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BLVD VALLEY CITY,ND58072 45-0435338	FUNDRAISING	ND	501(c)(3	Type I	MHVC	Yes
(91)MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DR COUNCIL BLUFFS,IA51503 42-1178204	FUNDRAISING	IA	501(c)(3	Type I	AHBMHS	Yes
(92)MERCY HOSPITAL OF DEVILS LAKE 1031 7TH ST NE DEVILS LAKE,ND58301 45-0227012	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(93)MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 7TH ST NE DEVILS LAKE,ND58301 35-2367360	FUNDRAISING	ND	501(c)(3	7	MHDL	Yes
(94)MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BLVD VALLEY CITY,ND58072 45-0226553	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(95)MERCY MEDICAL CENTER 1301 15TH AVE WEST WILLISTON,ND58801 45-0231183	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(96)MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE,IA52544 42-0680308	HEALTHCARE	IA	501(c)(3	3	CHI-IA CORP	Yes
(97)MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER 1111 6TH AVE DES MOINES,IA50314 42-1470935	PHYSICIANS	IA	501(c)(3	9	CHI-IA CORP	Yes
(98)MERCY MEDICAL CENTER INC 2700 STEWART PKWY ROSEBURG,OR97471 93-0386868	HEALTHCARE	OR	501(c)(3	3	CHI	Yes
(99)MERCY MEDICAL FOUNDATION 1301 15TH AVE WEST WILLISTON,ND58801 45-0381803	FUNDRAISING	ND	501(c)(3	Type I	MMC	Yes
(100)NEBRASKA HEART HOSPITAL 7500 S 91ST ST LINCOLN,NE68526 39-2031968	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(101)North Central Health Care Alliance dba PrimeCare Health Group 401 N 9th St BISMARCK,ND585014507 45-0439894	HEALTHCARE	ND	501(c)(3	9	NHCA	Yes
(102)OAKES COMMUNITY HOSPITAL 1200 N 7TH ST OAKES,ND58474 45-0231675	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(103)OAKES COMMUNITY HOSPITAL FOUNDATION 1200 N 7TH ST OAKES,ND58474 71-0966606	FUNDRAISING	ND	501(c)(3	Type I	OCH	Yes
(104)PINEYWOODS MEDICAL DEVELOPMENT CORP PO BOX 1447 LUFKIN,TX75902 75-2493116	PROPERTY MGMT	TX	501(c)(3	Type III-FI	MHSET	Yes
(105)PROVIDENCE CARE CENTER 2025 HAYES AVENUE SANDUSKY,OH44870 34-1658625	HEALTHCARE	OH	501(c)(3	9	FLC	Yes
(106)PROVIDENCE CARE CENTERS 2025 HAYES AVENUE SANDUSKY,OH44870 34-1826099	HOLDING CO	OH	501(c)(3	Type II	FLC	Yes
(107)PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION 5055 PROVIDENCE DRIVE SANDUSKY,OH44870 34-1896807	LIVING COMM	OH	501(c)(3	9	FLC	Yes
(108)PUEBLO STEPUP 1925 E ORMAN AVE STE G52 PUEBLO,CO81004 84-1234295	COMMUNITY	CO	501(c)(3	7	CHIC	Yes
(109)REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE 12844 MILITARY RD S TUKWILA,WA98168 91-1170040	HEALTHCARE	WA	501(c)(3	3	FHS	Yes
(110)SET OF COLORADO SPRINGS INC 2864 S CIRCLE DR STE 450 COLORADO SPRINGS,CO80906 84-1183335	LTERM CARE	CO	501(c)(3	7	CHIC	Yes
(111)SAINT CLARE'S COMMUNITY CARE INC 25 POCONO RD DENVILLE,NJ07834 22-2876836	HEALTHCARE	NJ	501(c)(3	Type II	SCHS	Yes
(112)SAINT CLARE'S FOUNDATION INC 25 POCONO RD DENVILLE,NJ07834 22-2502997	FUNDRAISING	NJ	501(c)(3	7	SCHS	Yes
(113)SAINT CLARE'S HEALTH SERVICES INC 25 POCONO RD DENVILLE,NJ07834 22-3639733	MANAGEMENT	NJ	501(c)(3	Type II	CHI	Yes
(114)SAINT CLARE'S HOSPITAL INC 25 POCONO RD DENVILLE,NJ07834 22-3319886	HEALTHCARE	NJ	501(c)(3	3	SCHS	Yes
(115)SAINT ELIZABETH FOUNDATION 555 S 70TH ST LINCOLN,NE68510 47-0625523	FUNDRAISING	NE	501(c)(3	7	SERMC	Yes
(116)SAINT ELIZABETH HEALTH SERVICES 555 S 70TH ST LINCOLN,NE68510 36-3233120	HEALTHCARE	NE	501(c)(3	3	SERMC	Yes
(117)SAINT ELIZABETH REGIONAL MEDICAL CENTER 555 S 70TH ST LINCOLN,NE68510 47-0379836	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(118)SAINT FRANCIS MEDICAL CENTER 2620 W FAIDLEY GRAND ISLAND,NE68803 47-0376601	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(119)SAINT FRANCIS MEDICAL CENTER FOUNDATION PO BOX 9804 GRAND ISLAND,NE68802 47-0630267	FUNDRAISING	NE	501(c)(3	7	SFMC	Yes
(120)SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC 305 ESTILL ST BEREA,KY40403 26-0152877	FUNDRAISING	KY	501(c)(3	7	SJHS	Yes
(121)SAINT JOSEPH HEALTH SYSTEM INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 61-1334601	HEALTHCARE	KY	501(c)(3	3	KOH	Yes
(122)SAINT JOSEPH HOSPITAL FOUNDATION INC ONE SAINT JOSEPH DRIVE LEXINGTON,KY40504 61-1159649	FUNDRAISING	KY	501(c)(3	Type I	SJHS	Yes
(123)SAINT JOSEPH LONDON FOUNDATION INC 1001 SAINT JOSEPH LANE LONDON,KY40741 26-0438748	FUNDRAISING	KY	501(c)(3	7	SJHS	Yes
(124)SAINT JOSEPH MOUNT STERLING FOUNDATION INC 225 FALCON DR MOUNT STERLING,KY40353 27-2884584	FUNDRAISING	KY	501(c)(3	7	SJHS	Yes
(125)SAINT JOSEPH'S HOSPITAL FOUNDATION 30 WEST 7TH ST DICKINSON,ND58601 36-3418207	FUNDRAISING	ND	501(c)(3	Type I	SJHHC	Yes
(126)SAMARITAN BEHAVIORAL HEALTH INC 601 S EDWIN C MOSES BLVD DAYTON,OH45417 02-0633634	HEALTHCARE	OH	501(c)(3	7	SHP	Yes
(127)SAMARITAN HEALTH PARTNERS 110 N MAIN ST STE 500 DAYTON,OH45402 31-1107411	HEALTHCARE	OH	501(c)(3	Type I	CHI	Yes
(128)SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC 104 W 17TH ST SCHUYLER,NE68661 36-3630014	FUNDRAISING	NE	501(c)(3	Type I	AHMHS	Yes
(129)SJRMC JOPLIN MISSOURI 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 44-0545809	HEALTHCARE	MO	501(c)(3	3	CHI	Yes
(130)SL AUGUSTA CORP PO BOX 20269 HOUSTON,TX77225 76-0226623	TITLE HOLDING	TX	501(c)(2		SLPC	Yes
(131)ST ALEXIUS MEDICAL CENTER 900 EAST BROADWAY AVENUE BISMARCK,ND58501 45-0226711	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(132)ST ANTHONY HOSPITAL 1601 SE COURT AVE PENDLETON,OR97801 93-0391614	HEALTHCARE	OR	501(c)(3	3	CHI	Yes
(133)ST ANTHONY HOSPITAL FOUNDATION 1601 SE COURT AVE PENDLETON,OR97801 93-0992727	FUNDRAISING	OR	501(c)(3	Type I	SAH	Yes
(134)ST ANTHONY'S HOSPITAL ASSOCIATION FOUR HOSPITAL DR MORRILTON,AR72110 71-0245507	HEALTHCARE	AR	501(c)(3	3	SVIMC	Yes
(135)ST CATHERINE HOSPITAL 401 EAST SPRUCE ST GARDEN CITY,KS67846 48-0543721	HEALTHCARE	KS	501(c)(3	3	CHI	Yes
(136)ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION 401 EAST SPRUCE ST GARDEN CITY,KS67846 20-0598702	FUNDRAISING	KS	501(c)(3	Type I	SCH	Yes
(137)ST CLARE COMMONS 5942 RENAISSANCE PLACE STE A TOLEDO,OH43623 27-0163752	LIVING COMM	OH	501(c)(3	9	FLC	Yes
(138)ST DOMINIC OF ONTARIO OREGON 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 93-0433692	HEALTHCARE	OR	501(c)(4		CHI	Yes
(139)ST FRANCIS HOME 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 41-0729978	LTERM CARE	MN	501(c)(3	9	CHI	Yes
(140)ST FRANCIS LIFE CARE CORPORATION 19 POCONO RD DENVILLE,NJ07834 22-2536017	ELDERLY CARE	NJ	501(c)(3	9	SCHS	Yes
(141)ST FRANCIS MEDICAL CENTER 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 41-0695598	HEALTHCARE	MN	501(c)(3	3	CHI	Yes
(142)ST FRANCIS OF BAKER CITY 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 93-0412495	HEALTHCARE	OR	501(c)(3	3	CHI	Yes
(143)ST JOSEPH FOUNDATION OF BRYAN TEXAS 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2351158	FUNDRAISING	TX	501(c)(3	Type I	SJSC	Yes
(144)ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2847594	HEALTHCARE	TX	501(c)(3	9	SJSC	Yes
(145)ST JOSEPH MEDICAL CENTER INC 201 INTERNATIONAL CIRCLE STE 212 HUNT VALLEY,MD21030 52-0591461	HEALTHCARE	MD	501(c)(3	3	CHI	Yes
(146)ST JOSEPH PHYSICIAN ASSOCIATES 2801 FRANCISCAN DRIVE BRYAN,TX77802 20-3159302	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(147)ST JOSEPH PHYSICIAN ENTERPRISE INC 201 INTERNATIONAL CIRCLE STE 212 HUNT VALLEY,MD21030 52-1311775	PHYSICIANS	MD	501(c)(3	Type I	SJMC	Yes
(148)ST JOSEPH REGIONAL HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-1282696	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(149)ST JOSEPH REGIONAL HEALTH PARTNERS 2801 FRANCISCAN DRIVE BRYAN,TX77802 45-4088170	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(150)ST JOSEPH REGIONAL HEALTH PARTNERS ACO 2801 FRANCISCAN DRIVE BRYAN,TX77802 46-3265423	HEALTHCARE	TX	501(c)(3	3	SJSC	Yes
(151)ST JOSEPH SERVICES CORPORATION 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2455161	MANAGEMENT	TX	501(c)(3	Type I	SFH	Yes
(152)ST JOSEPH'S AREA HEALTH SERVICES 600 PLEASANT AVE PARK RAPIDS,MN56470 41-0695603	HEALTHCARE	MN	501(c)(3	3	CHI	Yes
(153)ST JOSEPH'S HOSPITAL AND HEALTH CENTER 30 WEST 7TH ST DICKINSON,ND58601 45-0226429	HEALTHCARE	ND	501(c)(3	3	CHI	Yes
(154)ST LEONARD 8100 CLYO ROAD CENTERVILLE,OH45458 34-1940863	LIVING COMM	OH	501(c)(3	9	FLC	Yes
(155)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-0274448	MANAGEMENT	TX	501(c)(3	Type I	SLHS	Yes
(156)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC 6624 FANNIN ST STE 2505 HOUSTON,TX77030 27-3733278	HEALTHCARE	TX	501(c)(3	3	SLCDC	Yes
(157)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-1947374	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes
(158)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-0335902	HEALTHCARE	TX	501(c)(3	3	SLCDC	Yes
(159)ST LUKE'S COMMUNITY HEALTH SERVICES 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0536234	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes
(160)ST LUKE'S FOUNDATION 1213 HERMANN DRIVE STE 855 HOUSTON,TX77004 45-3811485	FUNDRAISING	TX	501(c)(3	7	SLHS	Yes
(161)ST LUKE'S HEALTH SYSTEM CORPORATION 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0536232	MANAGEMENT	TX	501(c)(3	Type I	CHI	Yes
(162)ST LUKE'S HOSPITAL AT THE VINTAGE 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-3734606	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes
(163)ST LUKE'S MEDICAL GROUP 6624 FANNIN ST HOUSTON,TX77030 76-0458535	PHYSICIANS	TX	501(c)(3	3	SLHS	Yes
(164)ST LUKE'S MEDICAL TOWER CORPORATION 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0531713	PROPERTY MGMT	TX	501(c)(3	Type I	CHI-SLH	Yes
(165)ST LUKE'S PROPERTIES CORPORATION 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0531716	PROPERTY MGMT	TX	501(c)(3	Type I	SLHS	Yes
(166)ST LUKE'S SUGAR LAND PROPERTIES CORPORATION 6624 FANNIN ST STE 2505 HOUSTON,TX77030 45-4120549	PROPERTY MGMT	TX	501(c)(3	Type I	SLCDC-SL	Yes
(167)ST MARY'S COMMUNITY HOSPITAL 1314 3RD AVE NEBRASKA CITY,NE68410 47-0443636	HEALTHCARE	NE	501(c)(3	3	CHI NEBRASKA	Yes
(168)ST MARY'S HOSPITAL FOUNDATION 1314 3RD AVE NEBRASKA CITY,NE68410 47-0707604	FUNDRAISING	NE	501(c)(3	7	SMCH	Yes
(169)ST VINCENT FOUNDATION TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 51-0169537	FUNDRAISING	AR	501(c)(3	Type I	SVIMC	Yes
(170)ST VINCENT INFIRMARY MEDICAL CENTER TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0236917	HEALTHCARE	AR	501(c)(3	3	CHI	Yes
(171)ST VINCENT MEDICAL GROUP TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0830696	HEALTHCARE	AR	501(c)(3	9	SVIMC	Yes
(172)SYLVANIA FRANCISCAN HEALTH 1715 INDIAN WOOD CIR 200 MAUMEE,OH43537 34-1412964	HEALTHCARE	OH	501(c)(3	Type I	CHI	Yes
(173)SYLVANIA FRANCISCAN HEALTH FOUNDATION 1715 INDIAN WOOD CIR 200 MAUMEE,OH43537 45-5357161	FUNDRAISING	OH	501(c)(3	Type I	FLC	Yes
(174)THE COMMONS OF PROVIDENCE 5000 PROVIDENCE DRIVE SANDUSKY,OH44870 34-1826097	ASSIST LIVING	OH	501(c)(3	9	FLC	Yes
(175)THE COMMUNITY HOSPITAL OF BRAZOSPORT 100 MEDICAL DRIVE LAKE JACKSON,TX77566 74-1385192	HEALTHCARE	TX	501(c)(3	3	SLHS	Yes
(176)THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH 619 OAK ST ACCOUNTING-3 W CINCINNATI,OH45206 31-0537486	HEALTHCARE	OH	501(c)(3	3	CHI	Yes
(177)THE PHYSICIAN NETWORK 2000 Q ST STE 500 LINCOLN,NE68503 47-0780857	PHYSICIANS	NE	501(c)(3	Type I	CHI NEBRASKA	Yes
(178)TOTAL HEALTHCARE 188 INVERNESS DRIVE WEST STE 500 ENGLEWOOD,CO80112 84-0927232	HEALTHCARE	CO	501(c)(3	3	CHIC	Yes
(179)TRINITY HEALTH FOUNDATION 380 SUMMIT AVENUE STEUBENVILLE,OH43952 31-1329423	FUNDRAISING	OH	501(c)(3	Type I	THS	Yes
(180)TRINITY HEALTH SYSTEM 380 SUMMIT AVENUE STEUBENVILLE,OH43952 34-1818681	HEALTHCARE	OH	501(c)(3	Type I	SFH	Yes
(181)TRINITY HEALTH SYSTEM GROUP 380 SUMMIT AVENUE STEUBENVILLE,OH43952 30-0752920	HEALTHCARE	OH	501(c)(3	3	THS	Yes
(182)TRINITY HOSPITAL HOLDING COMPANY 380 SUMMIT AVENUE STEUBENVILLE,OH43952 34-1842025	HEALTHCARE	OH	501(c)(3	3	THS	Yes
(183)TRINITY HOSPITAL TWIN CITY 819 NORTH FIRST STREET DENNISON,OH44621 27-5401105	HEALTHCARE	OH	501(c)(3	3	CHI	Yes
(184)TRI-STATE HEALTH SERVICES INC ONE ROSS PARK BLVD STEUBENVILLE,OH43952 34-1522484	ASSIST LIVING	OH	501(c)(3		THS	Yes
(185)UNITY FAMILY HEALTHCARE 815 SE 2ND ST LITTLE FALLS,MN56345 41-0721642	HEALTHCARE	MN	501(c)(3	3	CHI	Yes
(186)VILLA NAZARETH INC 801 PAGE DR FARGO,ND58103 45-0226714	LTERM CARE	ND	501(c)(3	9	CHI	Yes
(187)VISITING NURSE ASSOCIATION OF ST CLARE'S INC 191 WOODPORT RD SPARTA,NJ07871 22-1768334	HOME HEALTH	NJ	501(c)(3	9	SCHS	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Alegent Health Northwest Imaging Center LLC 3606 N 156th St OMAHA,NE68116 06-1786985	OP Diagnostics	NE	ACH	Related	-7,263	485,853		No	0	Yes		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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) Alegent HealthCreighton St Joseph Managed Care Services Inc 12809 West Dodge Rd Omaha,NE68154 47-0802396	Managed Care	NE	CHI Nebraska	C Corporation	8,129,445	5,108,822	100 %	Yes
(2) All Saints Insurance Company SPC Ltd PO BOX 10073 APO Georgetown,GRAND CAYMANKY11001 CJ 98-0556913	Insurance	CJ	CHI	C Corporation	0	0	100 %	Yes
(3) ALLIANCE HEALTH PROVIDERS OF BRAZOS Valley Inc 2801 FRACNISCAN DRIVE BRYAN,TX77802 74-2466914	Healthcare	TX	SJSC	C Corporation	204,115	535,165	100 %	Yes
(4) Alternative Insurance Management Service Inc 3900 OLYMPIC BLVD STE 400 Erlanger,KY41018 84-1112049	Management Services	CO	CHI	C Corporation	0	6,056,338	100 %	Yes
(5) AMERICAN NURSING CARE Inc 1700 EDISON DR MILFORD,OH45150 31-1085414	HOME HEALTH	OH	CHS	C Corporation	91,903,143	55,758,044	100 %	Yes
(6) AMERIMED INC 1700 EDISON DR MILFORD,OH45150 31-1158699	HOME HEALTH	OH	ANC	C Corporation	21,464,273	12,744,198	100 %	Yes
(7) BC HOLDING COMPANY INC 1850 BLUEGRASS AVE LOUISVILLE,KY40215 31-1542851	Fitness Club	KY	JHSMH	C Corporation	0	0	100 %	Yes
(8) BrazoSport Health Alliance 1 WEST WAY COURT LAKE JACKSON,TX77566 76-0518376	Health Care	TX	BRHS	C Corporation	0	0	100 %	Yes
(9) Caduceus Medical Associates INC 5600 Brainerd Road Ste 500 Chattanooga,TN37411 62-1570736	Healthcare	TN	MHCS	C Corporation	0	1,008	100 %	Yes
(10) Captive Management Initiatives Ltd PO BOX 10073 APO Georgetown,GRAND CAYMANKY11001 CJ 98-0663022	Captive Management	CJ	CHI	C Corporation	29,750	112,461	100 %	Yes
(11) Carmona-DeSoto Building Horizontal Property Regime Inc 300 Werner St Hot Springs,AR71913 71-0771076	Healthcare	AR	CHI-SVHS	C Corporation	0	0	100 %	Yes
(12) Catholic Health Initiatives Center for Translational Research 198 INVERNESS DRIVE WEST Englewood,CO80112 27-2269511	Research	CO	CIRI	C Corporation	510,763	3,054,989	100 %	Yes
(13) CHI St Luke's Health Baylor College of Medicine Medical Center Condominium Assoc 6624 Fannin STE 1100 Houston,TX77030 46-5079545	Condo Assoc	TX	CHI-SLHBCM	C Corporation	0	0	100 %	Yes
(14) ClearRiver Health 198 INVERNESS DRIVE WEST Englewood,CO80112 46-4495960	Insurance	TN	PHPSI	C Corporation	-186,666	6,973,984	100 %	Yes
(15) Comcare Services Inc 5570 DTC Parkway Englewood,CO80111 84-0904813	Inactive	CO	CHIC	C Corporation	0	0	100 %	Yes
(16) CONSOLIDATED HEALTH SERVICES 1700 EDISON DR MILFORD,OH45150 31-1378212	HOME HEALTH	OH	CHI	C Corporation	247,400	51,845,030	100 %	Yes
(17) Des Moines Medical Center Inc 1111 6TH AVE Des Moines,IA50314 42-0837382	Real Estate	IA	CHI-IA Corp	C Corporation	71,628	1,151,078	93 %	Yes
(18) Diversified Health Resources Inc 100 MEDICAL DRIVE LAKE JACKSON,TX77566 76-0222679	Health Care	TX	BRHS	C Corporation	0	0	100 %	Yes
(19) East Texas Clinical Services Inc 2801 Via Fortuna 500 Austin,TX78746 45-4736213	Healthcare	TX	MHSET	C Corporation	0	16,782	100 %	Yes
(20) First Initiatives Insurance LTD PO BOX 10073 APO Georgetown,GRAND CAYMANKY11001 CJ 98-0203038	Insurance	CJ	CHI	C Corporation	0	0	100 %	Yes
(21) Franciscan Services Inc 198 INVERNESS DRIVE WEST Englewood,CO80112 23-2487967	Healthcare	CO	CHI	C Corporation	318,497	11,891,645	100 %	Yes
(22) Good Samaritan Outreach Services PO Box 1990 Kearney,NE68848 47-0659440	Medical Clinic	NE	CHI Nebraska	C Corporation	0	0	100 %	Yes
(23) HarvestPlains Health of Iowa 32129 Weyerhaeuser Way S STE 201 FEDERAL WAY,WA98001 47-3451750	Insurance	WA	QCHPS	C Corporation	2,182	3,002,182	100 %	Yes
(24) Health Systems Enterprises Inc 1700 EDISON DR MILFORD,OH45150 47-0664558	MGMT	NE	GSH	C Corporation	84,269	1,115,210	100 %	Yes
(25) Healthcare MGMT Services Organization INC 1149 MARKET ST Tacoma,WA98402 91-1865474	Health Org.	WA	FHS	C Corporation	0	0	100 %	Yes
(26) HeartlandPlains Health 198 INVERNESS DRIVE WEST Englewood,CO80112 46-4368223	Insurance	NE	PHPSI	C Corporation	1,755,860	3,679,133	100 %	Yes
(27) Highline Medical Group 15811 AMBUAN Blvd SW STE A Burien,WA98166 91-1407026	Medical Services	WA	HMC	C Corporation	0	0	100 %	Yes
(28) Medquest 1301 15TH AVENUE WEST Williston,ND58801 45-0392137	Sale of DME	ND	MMC Williston	C Corporation	677,839	1,583,325	100 %	Yes
(29) Memorial CV Service Line Management Company LLC 1201 W Frank Ave Lufkin,TX75904 46-3622849	Heath Care	TX	MHSET	C Corporation	0	0	100 %	Yes
(30) Mercy Park Apartments LTD 1111 6th AVE Des Moines,IA50314 42-1202422	Housing	IA	CHI-IA Corp	C Corporation	1,888,173	2,376,812	100 %	Yes
(31) Mercy Services Corp 2700 STEWART PARKWAY Roseburg,OR97471 93-0824308	Retail Sales	OR	MMC	C Corporation	2,502,051	1,446,108	100 %	Yes
(32) MHI Clinical Services 1201 W Frank Ave Lufkin,TX75904 46-1967952	Healthcare	TX	MHSET	C Corporation	10,063,699	1,339,619	100 %	Yes
(33) Mountain Management Services Inc 6028 Shallowford Rd Chattanooga,TN37421 62-1570739	MGMT SVC ORG	TN	MHCS	C Corporation	31,344,101	6,237,932	100 %	Yes
(34) Nazareth Assurance Company PO BOX 10073 APO Georgetown,GRAND CAYMANKY11001 CJ 03-0304831	Insurance	CJ	CHI	C Corporation	0	0	100 %	Yes
(35) PATIENT TRANSPORT SERVICES INC 1700 EDISON DR MILFORD,OH45150 31-1100798	HOME HEALTH	OH	ANC	C Corporation	9,010,987	6,688,783	100 %	Yes
(36) PhysicianHealth System Network 1149 MARKET ST Tacoma,WA98402 91-1746721	Health Org.	WA	FHS	C Corporation	0	0	100 %	Yes
(37) QCA Health Plan Inc 12615 Chenal Parkway STE 300 Little Rock,AR72211 71-0794605	Insurance	AR	QCHI	C Corporation	104,106,960	86,204,029	100 %	Yes
(38) QualChoice Advantage 32129 WEYERHAEUSER WAY S STE 201 FEDERAL WAY,WA98001 47-3433912	Insurance	WA	QCPS	C Corporation	2,767	3,502,767	100 %	Yes
(39) QualChoice Health Plan Services Inc (fka CollabHealth Plan Services Inc) 198 INVERNESS DRIVE WEST Englewood,CO80112 46-1224037	Admin Services	CO	QCHI	C Corporation	17,917,443	64,152,898	100 %	Yes
(40) QualChoice Health Inc (fka CollabHealth Managed Solutions Inc) 198 INVERNESS DRIVE WEST Englewood,CO80112 46-1222808	Holding Co	CO	CHI	C Corporation	2,010,400	-2,237,656	100 %	Yes
(41) QualChoice Holdings Inc 12615 Chenal Parkway STE 300 Little Rock,AR72211 27-4075520	Holding Co	AR	PHPS	C Corporation	0	10,190	100 %	Yes
(42) QualChoice Life and Health Insurance Company Inc 12615 Chenal Parkway STE 300 Little Rock,AR72211 71-0386640	Insurance	AR	QCH	C Corporation	19,949,469	19,444,633	100 %	Yes
(43) QualChoice of Nebraska 2401 S 73rd St Omaha,NE68124 81-0738827	Insurance	NE	QCH	C Corporation	0	0	100 %	Yes
(44) RiverLink Health 198 INVERNESS DRIVE WEST Englewood,CO80112 46-4380824	Insurance	OH	PHPS	C Corporation	2,069,874	3,679,879	100 %	Yes
(45) RiverLink Health of Kentucky Inc 198 INVERNESS DRIVE WEST Englewood,CO80112 46-4828332	Insurance	KY	PHPS	C Corporation	1,590,037	5,958,786	100 %	Yes
(46) Ross Park Pharmacy Inc 380 SUMMIT AVE STEUBENVILLE,OH43952 34-1832654	Pharmacy	OH	THS	C Corporation	1,104,611	2,024,431	100 %	Yes
(47) Saint Clare's Primary Care Inc 66 FORD RD Denville,NJ07834 22-2441202	Billing Services	NJ	SCCC	C Corporation	499,042	1,183,247	100 %	Yes
(48) SAMARITAN FAMILY CARE INC 40 W FOURTH ST STE 1700 Dayton,OH45402 31-1299450	Healthcare	OH	SHP	C Corporation	0	0	100 %	Yes
(49) SJH Services Corporation 198 INVERNESS DRIVE WEST Englewood,CO80112 23-2307408	Healthcare	CO	FSI	C Corporation	2,007,370	2,441,286	100 %	Yes
(50) SJL PHYSICIAN MANAGEMENT SERVICES INC 424 LEWIS HARGETT CR STE 160 Lexington,KY40503 27-0164198	Mgmt	KY	SJHS	C Corporation	41	0	100 %	Yes
(51) SLMT Parking Inc 6624 Fannin STE 800 Houston,TX77030 76-0637140	Parking	TX	SLHS	C Corporation	3,345,698	205,200	100 %	Yes
(52) SoundPath Health Inc 32129 Weyerhaeuser Way S STE 201 Federal Way,WA98001 42-1720801	Insurance	WA	PHPS	C Corporation	138,106,211	32,840,909	100 %	Yes
(53) St Alexius Health Services Inc 900 East Broadway Avenue Bismarck,ND58501 45-0402812	Healthcare	ND	SAMC	C Corporation	0	0	100 %	Yes
(54) St Anthony Development Company 1415 Southgate Pendleton,OR97801 93-1216943	Athletic Club	OR	SAH	C Corporation	1,541,465	2,192,287	100 %	Yes
(55) St Joseph Development Company Inc 1717 SOUTH J ST Tacoma,WA98405 91-1480569	Rental	WA	FSI	C Corporation	3,758,845	12,828,493	100 %	Yes
(56) ST JOSEPH OFFICE PARK ASSOCIATION 1401 HARRODSBURG RD BLDG B70 Lexington,KY40504 61-1079899	Mgmt	KY	SJHS	C Corporation	200,108	1,137,660	85 %	Yes
(57) St Luke's 6620 Main Condominium Association 6624 Fannin STE 1100 Houston,TX77030 30-0355517	Condo Assoc	TX	SLPC	C Corporation	0	0	100 %	Yes
(58) St Luke's Anesthesiology Associates 6624 Fannin STE 1100 Houston,TX77030 46-1517163	Medical Clinic	TX	CHI-SLH	C Corporation	0	0	100 %	Yes
(59) St Luke's Episcopal Hospital Physician Hospital Organization Inc 6720 Bertner MC4-262 Houston,TX77030 76-0377932	PHO	TX	CHI-SLH	C Corporation	0	0	60 %	Yes
(60) St Luke's Health System Holdings Inc 6624 Fannin STE 800 Houston,TX77030 76-0637138	Holding Co	TX	SLHS	C Corporation	2,163,924	4,389,084	100 %	Yes
(61) St Luke's Medical Arts Center I Condominium Association 6624 Fannin STE 1100 Houston,TX77030 30-0355518	Condo Assoc	TX	SLPC	C Corporation	0	0	100 %	Yes
(62) St Luke's Medical Tower Condominium Association 6624 Fannin STE 1100 Houston,TX77030 76-0298751	Condo Assoc	TX	SLMTC	C Corporation	0	0	100 %	Yes
(63) St Vincent Community Health Services Inc TWO ST VINCENT CIRCLE Little Rock,AR72205 71-0710785	Healthcare	AR	SVIMC	C Corporation	4,033,444	16,764,150	100 %	Yes
(64) StableView Health Inc 198 INVERNESS DRIVE WEST Englewood,CO80112 46-4373713	Insurance	KY	PHPS	C Corporation	301,615	5,787,296	100 %	Yes
(65) Sugar Land Doctor Group 1317 Lake Point Parkway Sugar Land,TX77478 45-4270163	Medical Clinic	TX	SLCDC-SL	C Corporation	0	0	100 %	Yes
(66) The Texas Heart Institute at St Luke's Episcopal Hospital Denton A Cooley B uilding Comdominium Association 6624 Fannin STE 1100 Houston,TX77030 90-0064009	Condo Assoc	TX	CHI-SLH	C Corporation	0	0	100 %	Yes
(67) Towson Management Inc 7601 OSLER DR Towson,MD21204 52-1710750	Mgmt Services	MD	FSI	C Corporation	0	0	100 %	Yes
(68) TRINITY MANAGEMENT SERVICES ORGANIZATION 380 SUMMIT AVE STEUBENVILLE,OH43952 34-1471026	Mgmt Services	OH	THS	C Corporation	-76,969	259,991	100 %	Yes
(69) Vintage Doctor Group 6624 Fannin STE 1100 Houston,TX77030	Medical Clinic	TX	CHI-SLH	C Corporation	0	0	100 %	Yes

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

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

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

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	763,127	29,823
9	Program service revenue (Part VIII, line 2g) .........	7,070,244	15,373,991
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	392	90,211
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	15,964	40,127
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	7,849,727	15,534,152
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	133,591	3,073,563
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	2,954,484	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	4,078,110	13,986,788
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	7,166,185	17,060,351
19	Revenue less expenses. Subtract line 18 from line 12.......	683,542	-1,526,199
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	3,582,994	3,396,575
21	Total liabilities (Part X, line 26).............	735,356	2,216,255
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,847,638	1,180,320

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 4,391,842 including grants of $ 971,554 ) (Revenue $ 4,859,724 )
	BURLESON ST. JOSEPH PROVIDED EMERGENCY CARE FOR 5,867 PATIENT ENCOUNTERS DURING FYE 6/30/2016.

4b	(Code: ) (Expenses $ 2,478,727 including grants of $ 548,339 ) (Revenue $ 2,742,797 )
	BURLESON ST. JOSEPH HEALTH CENTER PROVIDED INPATIENT SERVICES FOR 1,898 PATIENT DAYS DURING FYE 6/30/2016.

4c	(Code: ) (Expenses $ 2,174,263 including grants of $ 480,986 ) (Revenue $ 2,405,896 )
	BURLESON ST. JOSEPH PERFORMED 54,765 LABORATORY PROCEDURES TO INPATIENTS AND OUTPATIENTS DURING FYE 6/30/2016.

	(Code: ) (Expenses $ 4,848,989 including grants of $ 1,072,684 ) (Revenue $ 5,365,574 )
	Other program services include cardiopulmonary (respiratory therapy) services, physical therapy, supply provision, pharmacy services, imaging services, and senior renewal services.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 4,848,989 including grants of $ 1,072,684 ) (Revenue $ 5,365,574 )
4e	Total program service expenses13,893,821

(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
(A) Name and Title
(18) TIMOTHY RABROKER BOARD MEMBER	1.0 .......................7.0	X		0	0	0
(19) MARK SCARMARDO BOARD MEMBER	1.0 .......................7.0	X		0	0	0
(20) KATHLEEN KRUSIE COO (through August 2015)	1.0 .......................49.0		X	0	286,164	20,582
(21) DANIEL GOGGIN CFO	1.0 .......................49.0		X	0	385,167	28,425
(22) RICARDO DIAZ INTERIM COO (beg August 2015)	1.0 .......................49.0		X	0	274,057	24,611

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	4,734,589	235,216

1	Briefly describe the organization’s mission or most significant activities: BURLESON ST JOSEPH HEALTH CENTER'S PRIMARY MISSION IS TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF BURLESON COUNTY, TEXAS, THROUGH ITS ACUTE CARE AND SPECIALTY CARE FACILITIES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	20
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

(A) Name and business address	(B) Description of services	(C) Compensation
BRAZOS VALLEY EMERGENCY PHYSICIANS 6300 LA CALMA DRIVE SUITE 200 AUSTIN,TX78752	ER PHYSICIAN SERVICES	965,085
SHARED IMAGING LLC LOCKBOX 88544 MILWAUKEE,WI532880544	IMAGING SERVICES	164,120



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 2

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	8,427
e	Government grants (contributions)		1e	21,396

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

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		29,823

			Business Code
2a	NET PATIENT SERVICES	900099	15,373,991	15,373,991
b
c
d
e
f	All other program service revenue.			0	0	0	0
g Total.Add lines 2a–2f.....			15,373,991

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			211			211
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		37,459
b	Less: rental expenses
c	Rental income or (loss)	0	37,459
d	Net rental income or (loss)......			37,459			37,459
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	190,000
b	Less: cost or other basis and sales expenses	100,000
c	Gain or (loss)	90,000	0
d	Net gain or (loss).....			90,000			90,000
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	VENDING MACHINE		722515	878			878
b	MISCELLANEOUS REVENUE		900099	1,790			1,790
c
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			2,668
12	Total revenue. See Instructions......			15,534,152	15,373,991	0	130,338

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	2,557,613	2,557,613
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	515,950	515,950
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
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
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........	6,700		6,700
d	Lobbying ...........	581		581
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)	8,507,074	6,461,423	2,045,651	0
12	Advertising and promotion ....	7,948		7,948
13	Office expenses .......	277,945	104,901	173,044
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	723,380	99,174	624,206
17	Travel ............	22,868	15,177	7,691
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	226,323		226,323
23	Insurance ...	49,883		49,883
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 DEBT	3,718,190	3,718,190
b	MEDICAL SUPPLIES	426,949	414,351	12,598
c	DUES & SUBSCRIPTIONS	15,652	3,747	11,905
d	RECRUITMENT & RELOCATION	3,000	3,000
e	All other expenses	295	295	0	0
25	Total functional expenses. Add lines 1 through 24e	17,060,351	13,893,821	3,166,530	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			480	1	480
2	Savings and temporary cash investments .........			141,651	2	69,059
3	Pledges and grants receivable, net ......			140,938	3	0
4	Accounts receivable, net .............			1,289,666	4	1,747,666
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 ....				7
8	Inventories for sale or use ........			113,412	8	122,957
9	Prepaid expenses and deferred charges ......			47,005	9	32,540
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,601,281
b	Less: accumulated depreciation	10b	361,215	1,474,957	10c	1,240,066
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............			183,807	14	183,807
15	Other assets. See Part IV, line 11 ...........			191,078	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)...			3,582,994	16	3,396,575

17	Accounts payable and accrued expenses .....	25,738	17	1,927,033
18	Grants payable ...		18
19	Deferred revenue .........	0	19	15,405
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	709,618	25	273,817
26	Total liabilities. Add lines 17 through 25..	735,356	26	2,216,255

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	2,706,700	27	1,180,320
28	Temporarily restricted net assets ...........	140,938	28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	2,847,638	33	1,180,320
34	Total liabilities and net assets/fund balances ........	3,582,994	34	3,396,575