TY 2018 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) SISTER M ALINE SHULTZ...................................................................... TRUSTEE AND VP ADMIN SERVICES	45.0 ................. 0.0	X		0	0
(2) SISTER M CLARE REUILLE...................................................................... TRUSTEE	5.0 ................. 0.0	X		0	0
(3) SISTER ROSE AGNES PFAUTSCH...................................................................... TRUSTEE	5.0 ................. 15.0	X		0	0
(4) SISTER M ANGELA MELLADY...................................................................... TRUSTEE	5.0 ................. 0.0	X		0	0
(5) SISTER M MARLENE SHAPLEY...................................................................... TRUSTEE AND VP OF MISSION	45.0 ................. 0.0	X		0	0
(6) SISTER MARILYN OLIVER...................................................................... TRUSTEE	5.0 ................. 0.0	X		0	0
(7) KATHLEEN GOEPPINGER PHD...................................................................... TRUSTEE	5.0 ................. 0.0	X		0	0
(8) SISTER M MADONNA ROUGEAU...................................................................... TRUSTEE	5.0 ................. 15.0	X		0	0
(9) SISTER JANE MARIE KLEIN...................................................................... CHAIRPERSON AND TRUSTEE	40.0 ................. 21.0	X	X	0	0
(10) SISTER M ANN KATHLEEN MAGIERA...................................................................... TREAS/TRUSTEE/VP MISSION-FHLA	40.0 ................. 16.0	X	X	0	0
(11) KEVIN D LEAHY...................................................................... PRESIDENT AND TRUSTEE	40.0 ................. 21.0	X	X	1,934,452	7,332
(12) DONALD J KERNER MD...................................................................... TRUSTEE	5.0 ................. 0.0	X		0	0
(13) JAIRO CRUZ MD...................................................................... PHYSICIAN (UNPAID TRUSTEE)	45.0 ................. 0.0	X		256,086	15,794
(14) ERNEST IANNOTTA...................................................................... TRUSTEE	5.0 ................. 0.0	X		0	0
(15) JAMES MONKS MD...................................................................... TRUSTEE (THROUGH 8/31/2018)	5.0 ................. 0.0	X		0	0
(16) KENNETH HERLIN...................................................................... TRUSTEE	5.0 ................. 0.0	X		0	0
(17) SISTER M PETRA NIELSEN...................................................................... TRUSTEE/VP MISSION INTEGR. NIR	45.0 ................. 0.0	X		0	0

(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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) BISHOP DONALD HYING........................................................................ TRUSTEE	5.0 .......................0.0	X					0	0	0
(19) SISTER LETHIA MARIE LEVEILLE........................................................................ SECRETARY	40.0 .......................16.0		X				0	0	0
(20) EUGENE C DIAMOND........................................................................ SR VP/COO INPATIENT SERVICES	40.0 .......................0.0			X			1,079,158	0	-176,232
(21) ROBERT J BRODY........................................................................ SR VP/COO AMBULATORY SERVICES	40.0 .......................0.0			X			1,072,096	0	-5,298
(22) JENNIFER P MARION........................................................................ SENIOR VP FINANCE, CFO	40.0 .......................0.0			X			1,197,086	0	-154,469
(23) THOMAS GRYZBEK........................................................................ SR VP OF POST ACUTE SRVCS DIV	40.0 .......................0.0			X			678,667	0	-180,163
(24) ROWLAND O MBAOMA........................................................................ PHYSICIAN	40.0 .......................0.0				X		1,839,519	0	28,687
(25) NADEEM IKHLAQUE........................................................................ PHYSICIAN	40.0 .......................0.0				X		1,420,184	0	23,444
(26) TERRENCE E WILSON........................................................................ PRESIDENT/CEO - LAFAYETTE	40.0 .......................0.0				X		1,264,649	0	-84,922
(27) JAMES J SIEGERT........................................................................ PHYSICIAN	40.0 .......................0.0				X		1,126,686	0	23,310
(28) NEEL JAIN........................................................................ PHYSICIAN	40.0 .......................0.0				X		1,125,503	0	21,843
(29) ARNOLD KIMMEL........................................................................ FMR PRES/CEO - OLYMPIA FIELDS	0.0 .......................0.0					X	314,417	0	-7,579

(A) Name and business address	(B) Description of services	(C) Compensation
METT THERAPY, 801 S BRIGGS STREET SECOND FLOOR JOLIET,IL60433	THERAPY SERVICES	7,625,048
NORTHSTAR ANESTHESIA OF ILLINOIS L, 6225 N STATE HWY 161 SUITE 200 IRVING,TX75038	PHYSICIAN SERVICES	6,282,458
INPATIENT CONSULTANTS OF ILLINOIS, PO BOX 844929 LOS ANGELES,CA90084	PHYSICIAN SERVICES	6,096,501
HEALTHTRUST WORKFORCE SOLUTIONS LL, PO BOX 742696 ATLANTA,GA30374	CONTRACT LABOR	6,022,696
EMCARE INC, 7032 COLLECTIONS CENTER DRIVE CHICAGO,IL60693	PHYSICIAN SERVICES	6,017,805
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 245

- 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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

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 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. 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—2017. 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—2018. 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—2017. 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) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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—2017. 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) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2018

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) 2018

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 (explain in Part VI). 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) 2018

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

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) 2018

Additional Data

Software ID:
Software Version:

- 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.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization FRANCISCAN ALLIANCE INC

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization FRANCISCAN ALLIANCE INC		Employer identification number 35-1330472

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization FRANCISCAN ALLIANCE INC			Employer identification number 35-1330472
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) (2018)

Additional Data

Software ID:
Software Version:

- 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

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

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

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 (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

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) 2018

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) 2015	(b) 2016	(c) 2017	(d) 2018	(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) 2018

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

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

Yes

351,373

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

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

Yes

150,465

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

501,838

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	DESCRIPTION OF LOBBYING ACTIVITIES FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") ENGAGES IN INSUBSTANTIAL AMOUNTS OF LOBBYING ACTIVITIES. FRANCISCAN MAKES GRANTS TO OTHER ORGANIZATIONS THAT LOBBY ON ITS BEHALF INCLUDING VARIOUS HEALTH AND HOSPITAL ASSOCIATIONS. FRANCISCAN ALSO ENGAGES IN DIRECT CONTACT WITH LEGISLATORS AND THEIR STAFFS ON TOPICS RELATED TO FRANCISCAN'S HEALTHCARE MISSION.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- 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.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

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 7/25/06, 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) 2018

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 ....	3,718,716	8,127,360	8,051,417	8,262,909	13,300,275
b	Contributions ...		10,000	15,000	10,000	15,000
c	Net investment earnings, gains, and losses	39,140	153,000	90,000	-193,000	182,000
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	173,049	4,571,644	29,057	28,492	104,051
f	Administrative expenses ....
g	End of year balance ......	3,584,807	3,718,716	8,127,360	8,051,417	13,393,224

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

100.000 %

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)

Yes

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

3a(ii)

Yes

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

Yes

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 .....	156,200,280		156,200,280
b	Buildings ....	1,312,729,159	911,476,160	401,252,999
c	Leasehold improvements	43,930,656	28,563,871	15,366,785
d	Equipment ....	1,788,931,642	663,549,430	1,125,382,212
e	Other .....	251,295,385	0	251,295,385
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,949,497,661

Schedule D (Form 990) 2018

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	0
ACCRUED PENSION LIABILITY	199,677,616
ACCRUED PAYROLL	114,868,961
SWAP VALUATION	53,215,294
DUE TO THIRD PARTY PAYORS	44,775,989
ACCRUED PROF & GEN'L LIABILITY	17,524,106
ACCRUED INTEREST PAYABLE	6,088,600
OTHER SHORT & LONG TERM LIABIL	114,908,136
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	551,058,702
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) 2018

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	2,856,967,135
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-272,791,974
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-22,282,735
e	Add lines 2a through 2d .....................			2e	-295,074,709
3	Subtract line 2e from line 1..................			3	3,152,041,844
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	-5,965,432
c	Add lines 4a and 4b....................			4c	-5,965,432
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	3,146,076,412

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	2,895,208,345
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	5,965,432
e	Add lines 2a through 2d....................			2e	5,965,432
3	Subtract line 2e from line 1...................			3	2,889,242,913
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	2,889,242,913

Part XIII

Supplemental Information

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

Return Reference	Explanation
SCHEDULE D, PART V, LINE 4	FRANCISCAN ALLIANCE, INC. USES ITS ENDOWMENT FUNDS FOR CAPITAL EXPENDITURES FOR EQUIPMENT, CAPITAL PROJECTS, OR OTHER CAPITAL NEEDS; MEDICAL EDUCATION PROGRAMS; AND HEALTH CARE PROGRAMS FOR MEDICAL AND PATIENT SERVICES IN ACCORDANCE WITH ANY STIPULATED DONOR RESTRICTIONS. SCHEDULE D, PART X, LINE 2 THE TAX CUTS AND JOBS ACT ("TCJA") WAS ENACTED ON DECEMBER 22, 2017. FOR TAX-EXEMPT ENTITIES, TCJA REQUIRES ORGANIZATIONS TO CATEGORIZE CERTAIN FRINGE BENEFITS AS A SOURCE OF UNRELATED BUSINESS INCOME SUBJECT TO TAX; PAY AN EXCISE TAX ON COMPENSATION ABOVE CERTAIN THERSHOLDS; AND FOR TAX DETERMINATION PURPOSES, RECORD INCOME OR LOSSES FROM UNRELATED BUSINESS ACTIVITIES ON AN ACTIVITY-BY-ACTIVITY BASIS; AMONG OTHER PROVISIONS. REGULATIONS NECESSARY TO IMPLEMENT CERTAIN ASPECTS OF TCJA ARE EXPECTED TO BE PROMULGATED BY THE INTERNAL REVENUE SERVICE ("IRS") IN 2019. AS OF AND FOR THE YEAR ENDED DECEMBER 31, 2018, THE CORPORATION HAS MADE REASONABLE ESTIMATES OF THE PROVISION FOR INCOME TAXES AND THE COMPENSATION EXCISE TAX BASED ON GUIDANCE INCLUDED IN ACCOUNTING STANDARDS CODIFICATION ("ASC") 740, INCOME TAXES. THE CORPORATION WILL CONTINUE TO REFINE ITS CALCULATIONS IN FUTURE PERIODS, AS ADDITIONAL REGULATIONS AND GUIDANCE ARE ISSUED BY THE IRS.
SCHEDULE D, PART XI, LINE 2D	EQUITY IN EARNINGS OF AFFILIATES $ 40,935,707 MINORITY INTEREST IN AFFILIATES 185,200 EQUITY TRANSFERS TO/FROM AFFILIATES (10,220,980) UNREALIZED GAIN ON SWAP CONTRACTS 4,226,575 UNREALIZED LOSS ON HILLS (16,354,339) DIVIDENDS RECEIVED FROM AFFILIATES 3,897,409 OTHER COMPREHENSIVE INCOME (25,802,823) OTHER CHANGES IN NET ASSETS (404,837) ------------- TOTAL REVENUE/EXPENSE ON BOOKS NOT ON RETURN (22,282,735)
SCHEDULE D, PART XI, LINE 4B	RENT EXPENSE $ (5,965,432) ----------- TOTAL EXPENSE ON RETURN NOT ON BOOKS (5,965,432) SCHEDULE D, PART XII, LINE 2D RENT EXPENSE $ 5,965,432 ----------- TOTAL EXPENSE ON RETURN NOT ON BOOKS 5,965,432

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in region
	Central America and the Caribbean	Investments	19,453,086
	Europe (Including Iceland and Greenland)	Investments	22,507,843
	North America	Investments	3,053,243














3a	Sub-total .....		45,014,172
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)		45,014,172

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2018

Schedule F (Form 990) 2018

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2018

Schedule F (Form 990) 2018Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

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

Schedule F (Form 990) 2018

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2018

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation

Schedule F (Form 990) 2018

Additional Data

Software ID:
Software Version:

- 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

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

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:

Yes

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: . . . . . . . .

Yes

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		(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) . . .	95,046,602		95,046,602	3.310 %
b	Medicaid (from Worksheet 3, column a) . . . . .	469,474,477	341,688,707	127,785,770	4.450 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	293,103		293,103	0.010 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	564,814,182	341,688,707	223,125,475	7.770 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	10,388,310	244,086	10,144,224	0.350 %
f	Health professions education (from Worksheet 5) . . .	22,437,303	7,780,226	14,657,077	0.510 %
g	Subsidized health services (from Worksheet 6) . . . .	103,222,550	62,688,690	40,533,860	1.410 %
h	Research (from Worksheet 7) .	1,639,079		1,639,079	0.060 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	1,791,911	5,535	1,786,376	0.060 %
j	Total. Other Benefits . .	139,479,153	70,718,537	68,760,616	2.390 %
k	Total. Add lines 7d and 7j .	704,293,335	412,407,244	291,886,091	10.160 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

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.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	108,910		108,910	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	481		481	0 %
7	Community health improvement advocacy	1,934		1,934	0 %
8	Workforce development	7,460,221	5,838,729	1,621,492	0.060 %
9	Other	50,540		50,540	0 %
10	Total	7,622,086	5,838,729	1,783,357	0.060 %

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. ......

49,458,441

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).....

772,521,953

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

1,193,254,697

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

-420,732,744

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 %
1SEE PART VI
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

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?12Name, 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)								Other (describe)	Facility reporting group
1	FRANCISCAN HEALTH INDIANAPOLIS 8111 SOUTH EMERSON AVENUE INDIANAPOLIS,IN46217 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 11-004972-1	X	X	X	X	X			A
2	FRANCISCAN HEALTH LAFAYETTE 1701 S CREASY LANE LAFAYETTE,IN47905 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005096-1	X	X	X		X			A
3	FRANCISCAN HEALTH OLYMPIA FIELDS 20201 SOUTH CRAWFORD AVE OLYMPIA FIELDS,IL60461 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 0005074	X	X	X		X			A
4	FRANCISCAN HEALTH HAMMOND 5454 HOHMAN AVENUE HAMMOND,IN46320 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005004-1	X	X	X		X			A
5	FRANCISCAN HEALTH MICHIGAN CITY 301 W HOMER STREET MICHIGAN CITY,IN46360 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005015-1	X	X			X	X		A
6	FRANCISCAN HEALTH CROWN POINT 1201 SOUTH MAIN STREET CROWN POINT,IN46307 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005107-1	X	X	X		X			A
7	FRANCISCAN HEALTH DYER 24 JOLIET STREET DYER,IN46311 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005080-1	X	X	X		X			A
8	FRANCISCAN HEALTH MOORESVILLE 1201 HADLEY ROAD MOORESVILLE,IN46158 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 14-005052-1	X	X	X	X	X			A
9	FRANCISCAN HEALTH MUNSTER 701 SUPERIOR STREET MUNSTER,IN46321 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005615-1	X	X	X		X			A
10	FRANCISCAN HEALTH CHICAGO HEIGHTS 1423 CHICAGO ROAD CHICAGO HEIGHTS,IL60411 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 002436	X	X	X		X		FACILITY CLOSED IN 10/2018	A
11	FRANCISCAN HEALTH CRAWFORDSVILLE 1710 LAFAYETTE ROAD CRAWFORDSVILLE,IN47933 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 15-005021-1	X	X			X			A
12	FRANCISCAN HEALTH CARMEL 12188-B N MERIDIAN STREET CARMEL,IN46032 WWW.FRANCISCANALLIANCE.ORG/HOSPITALS 13-012826-1	X	X						B

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	A
Name of hospital facility or letter of facility reporting group

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

Yes

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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): SEE PART V-C

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): SEE PART V-C

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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
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 200.% and FPG family income limit for eligibility for discounted care of 400.%

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)

Was widely publicized 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):

SEE SECTION C

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

SEE SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C

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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

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)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	A
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2018

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)

	B
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?........................

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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): SEE PART V-C

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): SEE PART V-C

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

10b

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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	B
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 200.% and FPG family income limit for eligibility for discounted care of 400.%

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

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)

Was widely publicized 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):

SEE SECTION C

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

SEE SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C

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)

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	B
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	B
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

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) 2018

Page 8

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, 16j, 18e, 19e, 20e, 21c, 21d, 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 - SUPPLEMENTAL INFORMATION	LINE 3E: PLEASE SEE THE RESPONSE TO SCHEDULE H, PART V, LINE 11 BELOW FOR AN EXPLANATION OF HOW THE HEALTH NEEDS IDENTIFIED IN THE CHNA WERE PRIORITIZED. LINE 5: INPUT FROM INDIVIDUALS IN THE COMMUNITY IN INDIANA, A STATEWIDE FOCUS GROUP WAS HELD TO DISCUSS REGIONAL ISSUES WITH STATE PUBLIC HEALTH LEADERS. THE FOCUS GROUP WAS CO-SPONSORED BY INDIANA UNIVERSITY HEALTH, ST. VINCENT HEALTH, COMMUNITY HEALTH NETWORK, AND FRANCISCAN ALLIANCE ATTENDEES INCLUDED: - FRANCISCAN ALLIANCE, INC. - KATE HILL-JOHNSON, ADMINISTRATIVE DIRECTOR, COMMUNITY HEALTH IMPROVEMENT - HEALTH BY DESIGN/ALLIANCE FOR HEALTH PROMOTION KIM IRWIN, EXECUTIVE DIRECTOR - HEALTH OCCUPATION STUDENT ASSOCIATION (INDIANA) EDDIE ERICKSON, STATE COORDINATOR; HOLLI FRODGE, STATE PRESIDENT - HOOSIER ENVIRONMENTAL COUNCIL INDRA FRANK, ENVIRONMENTAL HEALTH PROJECT DIRECTOR - INDIANA AREA HEALTH EDUCATION CENTERS DR. JENNIFER TAYLOR, DIRECTOR OF EVALUATION - INDIANA ASSOCIATION OF AREA AGENCIES ON AGING KRISTEN LAEACE, CEO; DAWNE LYON; ELVA JAMES, EXECUTIVE DIRECTOR, AREA 4 AGENCY OF AGING - LEADING AGE INDIANA JIM LEICH, EXECUTIVE DIRECTOR; KATHY JOHNSON, DIRECTOR OF TRAINING - INDIANA CARDIOVASCULAR AND DIABETES COALITION SHARA WESLEY, COALITION MANAGER; JENNIFER PFERRER, CHAIRPERSON - INDIANA COALITION AGAINST DOMESTIC VIOLENCE COLLEEN YEAKLE, COORDINATOR OF PREVENTION INITIATIVES - INDIANA CANCER CONSORTIUM KEYLEE WRIGHT, CANCER CONTROL SECTION DIRECTOR - INDIANA JOINT ASTHMA COALITION - KELLI MCCRARY, COALITION COORDINATOR - IU HEALTH - JOYCE HERTKO - INDIANA HEALTHY WEIGHT INITIATIVE - ERIC BEERS, COALITION COORDINATOR - INDIANA HOSPITAL ASSOCIATION - BERNIE ULRICH, VICE PRESIDENT - INDIANA IMMUNIZATION COALITION - LISA ROBERSON, DIRECTOR - INDIANA MINORITY HEALTH COALITION - ANITA OHMIT, DIRECTOR OF RESEARCH; CALVIN ROBERSON, VP OF PLANNING AND PROGRAM DEVELOPMENT - INDIANA NURSES ASSOCIATION - BLAYNE MILEY, DIRECTOR OF POLICY AND ADVOCACY - INDIANA PSYCHOLOGICAL ASSOCIATION - DR. KATHLEEN VOGLER, PAST PRESIDENT; TABITHA ARNETTE, EXECUTIVE DIRECTOR - INDIANA PRIMARY HEALTH CARE ASSOCIATION - PHIL MORPHEW, CEO; ELAINE WILLIAMS, RESOURCE DEVELOPMENT PROGRAM DIRECTOR - INDIANA SCHOOL NURSES ASSOCIATION - CAROLYN SNYDER, EXECUTIVE DIRECTOR - INDIANA STATE DEPARTMENT OF HEALTH - DR. JOAN DUWVE, CHIEF MEDICAL OFFICER; KATELIN RYAN, DIRECTOR OF PROGRAM EVALUATION; J. DAVID HOPPER, DIRECTOR, LOCAL HEALTH DEPARTMENT OUTREACH DIVISION - INDIANA SOCIETY FOR PUBLIC HEALTH EDUCATION - HEIDI HANCHER-RAUCH, ADVOCACY CHAIR; JENNIFER CONNER, PRESIDENT - IUPUI FAIRBANKS SCHOOL OF PUBLIC HEALTH - SULA HOOD; CYNTHIA STONE - IUPUI POLIS CENTER - KAREN COMER - YMCA OF GREATER INDIANA - CHELSY WINTERS, ASSOCIATE DIRECTOR OF HEALTH PARTNERSHIPS PROGRAMS; ANN GRAVES, DIRECTOR OF HEALTH INITIATIVES AND PARTNERSHIPS IN ADDITION, LOCAL PUBLIC HEALTH AND SOCIAL LEADERS WERE CONSULTED ON THE COMMUNITY HEALTH ISSUES, PRIORITIZATION OF NEEDS, AND COMMUNITY STRENGTHS. THE ASSESSMENT TASK FORCE FOR FRANCISCAN HEALTH CARMEL, FRANCISCAN HEALTH INDIANAPOLIS, AND FRANCISCAN HEALTH MOORESVILLE INCLUDED: - DAN HODGKINS, VICE PRESIDENT OF HEALTH PROMOTION AND COMMUNITY BENEFIT, COMMUNITY HEALTH NETWORK - ANN YEAKLE, COMMUNITY BENEFIT COORDINATOR, COMMUNITY HEALTH NETWORK - JOHN WHITCOMB, CONSULTANT, FRANCISCAN ALLIANCE - KATE HILL-JOHNSON, COMMUNITY BENEFIT AND ENGAGEMENT, FRANCISCAN HEALTH INDIANAPOLIS - PAYGE LIGGETT, COMMUNITY BENEFIT ASSISTANT, FRANCISCAN HEALTH INDIANAPOLIS - MANDI EGGERT, SERVICE EXCELLENCE, FRANCISCAN HEALTH CROWN POINT - RACHEL BUCKMAN, HEALTH EDUCATOR, HENDRICKS COUNTY HEALTH DEPARTMENT - STEPHANIE BERRY, COMMUNITY OUTREACH AND ENGAGEMENT, INDIANA UNIVERSITY HEALTH - ANYAH LAND, COMMUNITY OUTREACH AND ENGAGEMENT, INDIANA UNIVERSITY HEALTH - REBECCA YORK, DIRECTOR OF NURSING, MORGAN COUNTY HEALTH DEPARTMENT - KELLY PEISKLER, COMMUNITY BENEFIT, ST. VINCENT HEALTH - STEPHANIE ULLIANA, COMMUNITY BENEFIT, ST. VINCENT HEALTH - AMBER BLACKMON, INDIANA UNIVERSITY SCHOOL OF PUBLIC HEALTH BLOOMINGTON - HEATHER DOLNE, INDIANA UNIVERSITY SCHOOL OF PUBLIC HEALTH BLOOMINGTON - VIDHI JOSHI, INDIANA UNIVERSITY SCHOOL OF PUBLIC HEALTH BLOOMINGTON - ASHLEY WEISHAAR, INDIANA UNIVERSITY SCHOOL OF PUBLIC HEALTH BLOOMINGTON - JACOB HARTMEISTER, INDIANA UNIVERSITY SCHOOL OF PUBLIC AND ENVIRONMENTAL AFFAIRS BLOOMINGTON - ZACH LOTFALION, INDIANA UNIVERSITY SCHOOL OF PUBLIC AND ENVIRONMENTAL AFFAIRS BLOOMINGTON - LAYNIE MASON, MARION UNIVERSITY SCHOOL OF MEDICINE - H705 PUBLIC HEALTH CAPSTONE COURSE SPRING 2015 STUDENTS, INDIANA UNIVERSITY, RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH AT IUPUI, DR. CINDY STONE, CLINICAL ASSOCIATE PROFESSOR - HEALTHIER MORGAN COUNTY INITIATIVE - HENDRICKS COUNTY HEALTH PARTNERSHIP - PARTNERSHIP FOR HEALTHY HAMILTON COUNTY - JERRY KING, INDIANA PUBLIC HEALTH ASSOCIATION - CAROLYN M. MUEGGE, INDIANA UNIVERSITY RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH AT IUPUI - JOE GIBSON, MARION COUNTY HEALTH DEPARTMENT - TAMMY NELSON, MARION COUNTY HEALTH DEPARTMENT - KAREN COMER-FREDRICKSON, THE POLIS CENTER AT IUPUI THE ASSESSMENT TASK FORCE FOR FRANCISCAN HEALTH CRAWFORDSVILLE INCLUDED: - MAYOR TODD BARTON, CITY OF CRAWFORDSVILLE, MAYORS OFFICE - FAWN JOHNSON, DIRECTOR, CITY OF CRAWFORDSVILLE PARKS & RECREATION - STEVE HOUSE, DIRECTOR, CHAMBER OF COMMERCE - REX RYKER, ASSISTANT SUPERINTENDENT, CRAWFORDSVILLE SCHOOL CORPORATION - TERRY KLEIN, VP/COO, FRANCISCAN HEALTH CRAWFORDSVILLE - SISTER M. RUTH LUTHMAN OSF, DIRECTOR OF MISSION INTEGRATION, FRANCISCAN HEALTH CRAWFORDSVILLE - MATT OATES, MARKETING SPECIALIST, FRANCISCAN HEALTH CRAWFORDSVILLE - JOBETH MCCARTHY-JEAN, MPH, DIRECTOR, CENTER FOR PUBLIC HEALTH PRACTICE, - INDIANA PUBLIC HEALTH TRAINING CENTER, AND LIAISON, PUBLIC HEALTH CORPS - DR. CYNTHIA STONE, DRPH, RN, CLINICAL ASSOCIATE PROFESSOR, HEALTH POLICY AND MANAGEMENT CONCENTRATION DIRECTOR, INDIANA UNIVERSITY INDIANAPOLIS - RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH - ZACH CHURNEY, DEPUTY DIRECTOR, INDIANA WEST ADVANTAGE - JILL ROGERS, PRESIDENT OF THE BOARD OF MCT (MEDICAL CARE TRUST) - NANCY SENNETT, PRESIDENT, MONTGOMERY COUNTY HEALTH BOARD - DR. SCOTT DOUGLAS, VICE-PRESIDENT, MONTGOMERY COUNTY HEALTH BOARD - MONICA NAGELE, DIRECTOR, MONTGOMERY COUNTY PURDUE EXTENSION - AMBER REED, ADMINISTRATOR, MONTGOMERY COUNTY HEALTH DEPARTMENT - LUKE WREN, ACCREDITATION COORDINATOR, MONTGOMERY COUNTY HEALTH DEPARTMENT - SAMANTHA SWEARINGEN, HEALTH EDUCATOR, MONTGOMERY COUNTY HEALTH DEPARTMENT - REBECCA LANG, PUBLIC HEALTH NURSE, MONTGOMERY COUNTY HEALTH DEPARTMENT - MARK DAVIDSON, MONTGOMERY COUNTY COUNCIL - LEAH SINNET, NUCOR STEEL - DAVID JOHNSON, EXECUTIVE DIRECTOR, MUFFY - DR. SARA DRURY, STRATEGIC PLANNING FACILITATOR, WABASH COLLEGE - KYLE STUCKER, WABASH STUDENT - KATE HILL-JOHNSON, ADMINISTRATIVE DIRECTOR OF COMMUNITY HEALTH IMPROVEMENT, FRANCISCAN HEALTH - JESS CORBIN, DIRECTOR, ACO CARE MANAGEMENT, FRANCISCAN HEALTH CRAWFORDSVILLE - RAYMOND P. MILLER, DIVISION CHIEF OF EMS CRAWFORDSVILLE FIRE DEPARTMENT - JOSHUA S. KRUMENACKER, M.D., MEDICAL DIRECTOR FOR PARAMEDICINE AND FRANCISCAN PHYSICIAN NETWORK ("FPN") PHYSICIAN THE ASSESSMENT TASK FORCE FOR FRANCISCAN HEALTH LAFAYETTE INCLUDED REPRESENTATIVES FROM: - ACTION FOR HEALTHY KIDS - AMERICAN HEALTH NETWORK - AREA IV ON AGING AND COMMUNITY ACTION PROGRAMS - CITY OF LAFAYETTE - CITY OF WEST LAFAYETTE - COMMUNITY VOLUNTEERS - DRUG FREE COALITION OF TIPPECANOE COUNTY - EMPLOYEE BENEFITS SOLUTIONS - EMPLOYERS HEALTH NETWORK - FRANCISCAN HEALTH LAFAYETTE - GREATER LAFAYETTE COMMERCE - GREATER LAFAYETTE PARISH NURSE - GROUP HOMES FOR CHILDREN - HANNA/MINORITY HEALTH COALITION - HENRIOTT GROUP - KATHRYN WEIL CENTER - PHOENIX GROUP - IU HEALTH ARNETT - KIRBY RISK - LAFAYETTE SCHOOL CORPORATION WELLNESS COMMITTEE - LAFAYETTE FAMILY YMCA - LAFAYETTE YWCA - LAFAYETTE URBAN MINISTRY - MENTAL HEALTH AMERICA - MISSION COMMITTEE OF THE WESTERN INDIANA BOARD OF FRANCISCAN HEALTH LAFAYETTE - NUTRIPLEDGE - PARISH NURSES - PURDUE EXTENSION - PURDUE DEPARTMENT OF HEALTH & KINESIOLOGY - RIGGS COMMUNITY HEALTH CENTER - TIPPECANOE COUNTY HEALTH DEPARTMENT - TOBACCO FREE PARTNERSHIP - UNITED WAY OF GREATER LAFAYETTE - UNITY HEALTHCARE - WOMEN, INFANT, CHILDREN (WIC) PROGRAM THE ASSESSMENT TASK FORCE FOR FRANCISCAN HEALTH DYER, FRANCISCAN HEALTH HAMMOND, FRANCISCAN HEALTH MUNSTER, AND FRANCISCAN HEALTH CROWN POINT INCLUDED REPRESENTATIVES FROM: - 411 NEWSPAPER - COMMUNITY CARE NETWORK, INC. (CCNI) - CITY OF EAST CHICAGO HEALTH DEPARTMENT - CITY OF EAST CHICAGO - CITY OF GARY COMMUNITY DEVELOPMENT DEPARTMENT - COMMUNITY HEALTHNET INC. - EDGEWATER BEHAVIORAL HEALTH SERVICES - FRANCISCAN ALLIANCE - FRANCISCAN HEALTH - DYER, HAMMOND, MUNSTER, AND CROWN POINT - GARY HEALTH AND HUMAN SERVICES DEPARTMENT - GARY MENTAL HEALTH - GEMINUS CORPORATION - GREATER PORTAGE CHAMBER OF COMMERCE - HEALTHLINC - HOOSIER ENVIRONMENTAL COUNCIL - HOBART FAMILY YMCA - IVY TECH COMMUNITY COLLEGE - JASPER COUNTY HEALTH DEPARTMENT - LAKE AREA UNITED WAY - LAKESHORE CHAMBER OF
LINES 6A AND 6B: ALL FACILITIES	IN INDIANA, ALL FRANCISCAN ALLIANCE HOSPITAL FACILITIES COLLABORATED IN A STATEWIDE PARTNERSHIP WITH ST. VINCENT HEALTH, INDIANA UNIVERSITY HEALTH, COMMUNITY HEALTH NETWORK, INDIANA UNIVERSITY RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH AT INDIANAPOLIS, AND WITH EACH FACILITY WITHIN THE FRANCISCAN HEALTH SYSTEM. LINES 6A AND 6B: FRANCISCAN HEALTH DYER, FRANCISCAN HEALTH HAMMOND, FRANCISCAN HEALTH MUNSTER, AND FRANCISCAN HEALTH CROWN POINT ALSO COLLABORATED WITH METHODIST HEALTH SYSTEMS AND COMMUNITY HEALTH SYSTEM. A THIRD PARTY, PROFESSIONAL RESOURCE CONSULTANT, WAS USED FOR KEY LEADER SURVEYS AND INTERVIEWS. LINES 6A AND 6B: FRANCISCAN HEALTH CHICAGO HEIGHTS AND FRANCISCAN HEALTH OLYMPIA FIELDS ALSO PARTNERED WITH THE COOK COUNTY COLLABORATIVE, WHICH INCLUDES THE HEALTH DEPARTMENTS AND HOSPITALS SYSTEMS IN CHICAGO AND CHICAGO SUBURBS. LINE 6B: FRANCISCAN HEALTH MOORESVILLE PARTNERED WITH THE HENDRICKS COUNTY HEALTH DEPARTMENT AND THE MORGAN COUNTY HEALTH DEPARTMENT TO MEET THE LOCAL HEALTH DEPARTMENT ACCREDITATION STANDARDS AND THE COMMUNITY BENEFIT REQUIREMENTS. LINE 6B: FRANCISCAN HEALTH CRAWFORDSVILLE PARTNERED WITH THE MONTGOMERY COUNTY HEALTH DEPARTMENT TO MEET THE LOCAL HEALTH DEPARTMENT ACCREDITATION STANDARDS AND THE COMMUNITY BENEFIT REQUIREMENTS. LINE 6B: FRANCISCAN HEALTH LAFAYETTE PARTNERED WITH THE TIPPECANOE HEALTH DEPARTMENT TO MEET THE LOCAL HEALTH DEPARTMENT ACCREDITATION STANDARDS AND THE COMMUNITY BENEFIT REQUIREMENTS.
LINE 7: ALL FACILITIES	ALL CHNA REPORTS ARE AVAILABLE ON FRANCISCAN ALLIANCES WEBSITE AT HTTPS://WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH LINE 10: ALL FACILITIES ALL IMPLEMENTATION PLANS ARE AVAILABLE ON FRANCISCAN ALLIANCES WEBSITE AT HTTPS://WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH
LINE 11: COMMUNITY HEALTH NEEDS ASSESSMENT	FRANCISCAN ALLIANCE PARTNERED WITH MULTIPLE COMMUNITY PARTNERSHIPS AND ADDITIONAL HEALTH SYSTEMS TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE PARTNERSHIP WITH THE LARGEST HEALTH SYSTEMS IN INDIANA AND THE COMMUNITY PARTNERSHIPS ALLOWED FOR BETTER DATA COLLECTION, REDUCED BURDEN ON RESIDENTS TO COMPLETE SURVEYS, AND A PLATFORM TO COMBINE EFFORTS ON VARIOUS COMMUNITY HEALTH NEEDS THROUGHOUT THE STATE. READERS WILL FIND THAT CHNAS FROM THESE SYSTEMS ARE ALIGNED, THOUGH EACH MAY HAVE PARTICULAR AREAS OF EMPHASIS DEPENDING ON THE SPECIFIC POPULATION SERVED AND THE GEOGRAPHIC LOCATION OF HOSPITALS. BECAUSE INDIANA OPERATES AS A HOME RULE STATE (THE INDIANA STATE CONSTITUTION ALLOWS FOR MUNICIPALITIES TO PASS LAWS TO GOVERN THEMSELVES AS THEY SEE FIT, WHICH LEADS TO A DECENTRALIZED GOVERNMENT), EACH COUNTY HAS A DIFFERENT PUBLIC HEALTH INFRASTRUCTURE AND RESOURCES IN ADDITION TO THE VARIATIONS BASED ON URBAN/RURAL STATUS, POPULATION, AND ECONOMIC MIX. DATA ON ZIP CODE OR CENSUS TRACK IS HIGHLY LACKING; THEREFORE THE DESIGN WAS BUILT ON A COUNTY BASIS. ELEVEN COUNTIES OF 28 INCLUDED IN THE ASSESSMENT ARE HOME TO MORE THAN ONE OF THE HEALTH SYSTEMS IN THE COLLABORATIVE. IN THESE COUNTIES, A COUNTY 'CAPTAIN' WAS ELECTED TO COORDINATE THE CHNA PROCESS ON BEHALF OF THE PARTNERSHIP. IN THE REMAINING COUNTIES WHERE ONLY ONE HEALTH SYSTEM WAS REPRESENTED, THE HEALTH SYSTEM IN THE COUNTY USED THE COLLABORATIVE MATERIALS AND RESOURCES, BUT COMPLETED THE WORK INDEPENDENTLY. THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP)MODEL, DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO), GUIDED THE ASSESSMENT PROCESS IN HENDRICKS AND MORGAN COUNTIES, AS BOTH COUNTY HEALTH DEPARTMENTS ARE WORKING ON ACCREDITATION THROUGH THE PUBLIC HEALTH ACCREDITATION BOARD (PHAB). THE MAPP MODEL INCLUDES SEVERAL COMPONENTS FOR COMMUNITY ASSESSMENT. FRANCISCAN PARTICIPATED IN ALL OF THE ASSESSMENT ACTIVITIES THAT WERE IN PROCESS DURING THE PERIOD OF THE HOSPITAL PARTNERSHIPS TIME FRAME. MARION COUNTY IS SEEKING ACCREDITATION, BUT HAD ALREADY COMPLETED THEIR COMMUNITY HEALTH ASSESSMENT PRIOR TO THE COLLABORATIVES TIME FRAME. INDIANA DOES NOT REQUIRE PHAB ACCREDITATION BY COUNTY HEALTH DEPARTMENTS AND A VAST MAJORITY OF HEALTH DEPARTMENTS ARE NOT SEEKING ACCREDITATION. IN THE REMAINING COUNTIES IDENTIFIED IN THIS ASSESSMENT, THE PRECEDE PROCEDE METHOD WAS UTILIZED. THIS ASSESSMENT REFLECTS PHASES 1 THROUGH 5. COMMUNITY BENEFIT PROFESSIONALS FROM EACH HEALTH SYSTEM WORKED TOGETHER ON DATA COLLECTED IN FOUR WAYS: 1. COMMUNITY HEALTH SURVEY: A CORE OF 20 MANDATORY QUESTIONS BASED ON PERCEPTION OF COMMUNITY AND PERSONAL NEEDS WAS CREATED. IN ADDITION, PROFESSIONALS ASSIGNED TO EACH COUNTY WORKED WITH ESTABLISHED COMMUNITY HEALTH COLLABORATIVES, LOCAL HOSPITALS, AND THE LOCAL HEALTH DEPARTMENT TO DEVELOP VOLUNTARY QUESTIONS SPECIFIC TO THE COUNTY. THIS RESULTED IN A SURVEY WITH 20 TO 29 QUESTIONS, DEPENDENT ON THE RESPONDENTS COUNTY OF RESIDENCE. 2. THE SURVEY WAS DISTRIBUTED ELECTRONICALLY AND ON PAPER. THE GOAL WAS TO ATTAIN A SAMPLE SIZE WITH A 95% CONFIDENCE LEVEL AND + OR 5% MARGIN OF ERROR. IN MOST COUNTIES, THE SAMPLE SIZE MET THIS GOAL; HOWEVER, PARTICULAR EMPHASIS ON VULNERABLE POPULATIONS MEANS THE SURVEY RESULTS ARE NOT A TRUE REPRESENTATION OF THE ENTIRE COUNTY POPULATION; BUT SKEWED TO REPRESENT THE MOST IN NEED. IN ADDITION TO THE QUANTITATIVE DATA, FREE TEXT RESPONSES WERE CODED AND CALCULATED TO PROVIDE FURTHER CLARIFICATION OF THE QUANTITATIVE DATA. 3. FOCUS GROUPS: BECAUSE FOCUS GROUPS ARE FACILITATED BASED ON THE CONVERSATION OF THE PARTICIPANTS, THE COLLABORATIVE DETERMINED OUTCOMES TO BE ACHIEVED DURING THE TWO-HOUR SESSIONS. MOST FOCUS GROUPS INCLUDED 15-60 COMMUNITY LEADERS FROM GOVERNMENTAL PUBLIC HEALTH, HEALTH CARE, SOCIAL SERVICE AGENCIES, RELATED NON-PROFITS, AND GRASSROOTS/NEIGHBORHOOD ORGANIZATIONS. IN LARGER FOCUS GROUPS, SUB- GROUPS WERE UTILIZED TO GIVE ALL PARTICIPANTS A VOICE. EACH FOCUS GROUP DETERMINED THE TOP FOUR TO SIX HEALTH NEEDS IN THE COMMUNITY; POTENTIAL RESOURCES OR PARTNERS; AND SOME ACTIONS/INTERVENTIONS THAT MIGHT WORK BEST. 4. SECONDARY DATA COLLECTION: WITH THE ASSISTANCE OF PUBLIC HEALTH UNDERGRADUATE AND GRADUATE STUDENTS, DATA ON HEALTH AND WELLNESS ISSUES WAS COLLECTED. SOURCES INCLUDE COUNTY HEALTH RANKINGS, CENSUS BUREAU DATA, VARIOUS REPORTS FROM THE INDIANA STATE DEPARTMENT OF HEALTH, AND OTHER NATIONAL REPORTS. INDIANA INDICATORS, COMMUNITY COMMONS, AND HEALTHY COMMUNITIES INSTITUTE DATA MANAGEMENT SYSTEMS ALSO CONTRIBUTED TO THE SECONDARY DATA USED. SOURCES OF THE SECONDARY DATA ARE IDENTIFIED THROUGHOUT THIS REPORT. IN ADVANCE OF THE FOCUS GROUPS, A FOCUS GROUP FOR STATE-WIDE ORGANIZATIONS WAS HELD FOR INDIANA. LEADERS FROM ORGANIZATIONS THAT SERVE THE ENTIRE STATE OF INDIANA GATHERED TO DISCUSS TRENDS AND GROWING CONCERNS BY PREPAREDNESS DISTRICT AND BY AGE OF THE POPULATION. THE RESULTS WERE USED AS A PROBE IN THE REMAINING FOCUS GROUPS AND AS AREAS FOR FURTHER STUDY IN SECONDARY DATA. A FOCUS GROUP OF HIGH SCHOOL STUDENTS CONVENED BY THE INDIANA CHAPTER OF HEALTH OCCUPATION STUDENT ASSOCIATION DURING THEIR ANNUAL CONFERENCE ALSO OFFERED SOME INSIGHT. THIS FOCUS GROUP YIELDED SOME INTERESTING INSIGHTS FROM THE TEEN PERSPECTIVE. IN DETERMINING COMMUNITY HEALTH INTERVENTIONS FOR THE SELECTED PRIORITY HEALTH NEEDS, HEALTH EQUITY, SUSTAINABILITY, AND CONSIDERATION OF THE SOCIAL DETERMINANTS OF HEALTH ARE KEY PRINICIPLES. WHILE MOST INTERVENTIONS FOCUS ON THE INDIVIDUAL LIFESTYLE FACTORS, KNOWLEDGE, SKILLS, AND BEHAVIORS, CONSIDERATION OF THE CULTURAL AND ENVIRONMENTAL CONTEXTS ARE JUST AS IMPORTANT. FRANCISCAN ALLIANCE ACKNOWLEDGES THAT TRUE CHANGE COMES WITH MAJOR SHIFTS IN ALL AREAS. THE FIRST CRITERIA USED TO DETERMINE IMPLEMENTATION STRATEGIES IS THE CONNECTION TO THE SOCIO-ECOLOGICAL MODEL AND SOCIAL DETERMINENTS OF HEALTH. INTERVENTIONS IMPLEMENTED BY FRANCISCAN ALLIANCE ARE PERSON-CENTERED AND DESIGNED TO CREATE LASTING CHANGE. MALCOLM KNOWLES PRINCIPLES OF ANDRAGOGY PROVIDED THE FRAMEWORK. WHILE THIS MODEL IS BASED ON EDUCATIONAL PROGRAMMING, IT APPLIES TO ALL TYPES OF INTERVENTIONS. FOR EXAMPLE, IN THE PROVISION OF CLINICAL CARE OR MEDICATION ASSISTANCE, PARTICIPANTS NOT ONLY RECEIVE THE CARE OR MEDICATION, THEY ALSO LEARN TO BETTER MANAGE THEIR OWN HEALTH OR ACCESS COMPONENTS OF THE HEALTH SYSTEM OR ASSISTANCE PROGRAM. REFLECTION, TEACH-BACK, AND COMMUNICATION TECHNIQUES ARE UTILIZED TO EMPOWER THE PARTICIPANT TO MOVE BEYOND A ONE-TIME INTERACTION OR ASSISTANCE. FRANCISCAN ALLIANCE USES EVIDENCE-BASED PRACTICES IN PLANNING INTERVENTIONS WHENEVER POSSIBLE, AS THESE PROGRAMS HAVE BEEN THOROUGHLY TESTED AND HAVE PROVEN EFFICACY. WHEN EVIDENCE-BASED PROGRAMS ARE NOT AVAILABLE, BEST PRACTICES AND DOCUMENTED RESEARCH GUIDES THE DEVELOPMENT AND IMPLEMENTATION OF THE INTERVENTION. IMPLEMENTATION ACTIVITIES WILL BE EVALUATED TO THE FULLEST EXTENT. USING THE KIRKPATRICK MODEL (A STANDARDIZED EVALUATION SYSTEM BASED ON REACTION, LEARNING, BEHAVIOR, AND RESULTS) AS A GUIDE, EVALUATION OF NOT ONLY THE PROGRAM, BUT ITS IMPACT AND RESULTS WILL BE REVIEWED. THIS PROCESS ALLOWS FOR CHANGES TO BE MADE TO IMPROVE THE PROGRAM ON AN ONGOING BASIS. WHILE IT CAN BE DIFFICULT TO DETERMINE THE EXACT CAUSE OF INDIVIDUAL BEHAVIORAL CHANGE, BIOMETRICS, POST-FOLLOW UP SURVEYS, AND OTHER METHODS WERE USED TO CAPTURE QUALITATIVE AND QUANTITATIVE DATA. THE FRANCISCAN ALLIANCE HOSPITALS MADE THE FOLLOWING PROGRESS DURING 2018 IN ADDRESSING THE IDENTIFIED COMMUNITY HEALTH NEEDS FROM ITS MOST RECENT CHNA: FRANCISCAN HEALTH CARMEL: - PHYSICAL ACTIVITY - COMPLETED AS INDICATED. PROGRAM WILL END DUE TO TAX ID/STRUCTURE AT THIS HOSPITAL. - ACCESS TO HEALTH CARE - COMPLETED AND EXCEEDED DETERMINED GOALS. FRANCISCAN HEALTH CRAWFORDSVILLE: - PARAMEDICINE - COMPLETED AND EXCEEDED DETERMINED GOALS. DUE TO SUCCESS OF THIS PROGRAM, IT HAS BEEN EXPANDED AND WILL CONTINUE THROUGH A HOSPITAL-CITY PARTNERSHIP AND SUPPORT. - PHYSICAL ACTIVITY - COMPLETED AS INDICATED. THIS PROGRAM WILL END REDIRECTING RESOURCES TO OTHER PROGRAMS. FRANCISCAN HEALTH CROWN POINT: - STEPPING ON FALL PREVENTION - UNMET. ONLY 13 PEOPLE ATTENDED THE PROGRAM. HAD DIFFICULTY RECRUITING PARTICIPANTS. - DIABETES PREVENTION PROGRAM ("DPP") - COMPLETED. PROGRAM WILL CONTINUE AS A ONE-ON-ONE PRORGAM INSTEAD OF GROUP FORMAT TO BETTER MEET THE NEEDS OF THE PARTICIPANTS. - ACCESS TO HEALTH CARE FOR UNINSURED - COMPLETED, WITH SOME STRUCTURAL CHANGES DUE TO MOVING PROGRAMS TO FRANCISCAN PHYSICIAN NETWORK. NOW INTEGRATED AS STANDARD PRACTICE. FRANCISCAN HEALTH HAMMOND AND FRANCISCAN HEALTH DYER: - ADOLESCENTS COPING WITH DEPRESSION - COMPLETED AS INDICATED. PROGRAM WILL NOT CONTINUE. - ASTHMA SCHOOL PROGRAM - COMPLETED AS INDICATED. PROGRAM WILL NOT CONTINUE. - PERIOD OF PURPLE CRYING - COMPLETED AS INDICATED AND NOW INTEGRATED AS STANDARD PRACTICE. FRANCSICAN HEALTH INDIANAPOLIS AND MOORESVILLE: - MEDICATION ASSISTANCE - SHIFTED TO MEDI
LINES 15 AND 16: ALL FACILITIES	THROUGH FRANCISCAN ALLIANCE, INC. ("FRANCISCAN"), WE CONTINUE THE HEALING MINISTRY OF CHRIST IN A CATHOLIC HEALTH CARE SYSTEM THAT UPHOLDS THE MORAL VALUES AND TEACHINGS OF THE CATHOLIC CHURCH. CENTRAL CONCERNS OF THIS CORPORATE MINISTRY INCLUDE COMPASSION FOR THOSE IN NEED, RESPECT FOR LIFE AND THE DIGNITY OF PERSONS. FRANCISCAN BELIEVES IN THE DIGNITY, UNIQUENESS, AND WORTH OF EACH INDIVIDUAL AND, WITHIN THE LIMITS OF OUR RESOURCES, FRANCISCAN OFFERS A COMPREHENSIVE RANGE OF HEALTH CARE SERVICES TO ALL REGARDLESS OF RACE, CREED, COLOR, SEX, NATIONAL ORIGIN, HANDICAP OR AN INDIVIDUAL'S FINANCIAL CAPABILITY. IN LIGHT OF THIS BELIEF, WE CONSIDER OUR HEALTH CARE SERVICES TO BE REACHING OUT AND RESPONDING, IN A CHRIST-LIKE MANNER, TO THOSE WHO ARE PHYSICALLY, MATERIALLY, OR SPIRITUALLY IN NEED. FRANCISCAN IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE, IN THE FORM OF CHARITY CARE OR UNINSURED DISCOUNTS, TO PERSONS WHO ARE UNINSURED OR UNDERINSURED, WHO ARE INELIGIBLE FOR GOVERNMENTAL OR SOCIAL SERVICE PROGRAMS, AND WHO OTHERWISE ARE UNABLE TO PAY FOR EMERGENCY SERVICES OR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. CONSISTENT WITH OUR MISSION TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE AND TO ADVOCATE FOR THOSE WHO ARE POOR AND DISENFRANCHISED, FRANCISCAN STRIVES TO ENSURE THE FINANCIAL CAPACITY OF PEOPLE WHO NEED MEDICALLY NECESSARY HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING THAT CARE. FRANCISCAN'S FINANCIAL ASSISTANCE POLICY IS DESIGNED TO ALLOW RELIEF FROM ALL OR PART OF THE CHARGES RELATED TO EMERGENCY OR MEDICALLY NECESSARY HEALTH CARE SERVICES THAT EXCEED A PATIENT'S REASONABLE ABILITY TO PAY. IN ORDER TO ENSURE TRANSPARENCY, CONSISTENCY AND FAIRNESS, WE ASK PATIENTS TO COOPERATE BY PROVIDING NECESSARY INFORMATION TO DETERMINE THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. FOR PATIENTS NOT INITIALLY IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, FRANCISCAN COMMUNICATES THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY THROUGH THE FOLLOWING MEANS: 1. FRANCISCAN COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN APPROPRIATE CARE SETTINGS SUCH AS EMERGENCY DEPARTMENTS, ADMITTING/REGISTRATION AREAS, BILLING OFFICES, OUTPATIENT SERVICE SETTINGS, AND ON OUR HOSPITALS' WEBSITES. SIGNS/POSTINGS INFORM PATIENTS THAT FREE OR REDUCED COST CARE MAY BE AVAILABLE TO QUALIFYING PATIENTS WHO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. 2. BROCHURES SUMMARIZING OUR FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE THROUGHOUT EACH FRANCISCAN HOSPITAL. 3. FINANCIAL COUNSELORS AND BUSINESS OFFICE PERSONNEL ARE AVAILABLE TO HELP PATIENTS UNDERSTAND AND APPLY FOR LOCAL, STATE, FEDERAL HEALTH CARE, AND HEALTH INSURANCE EXCHANGE PROGRAMS AND FRANCISCAN'S FINANCIAL ASSISTANCE PROGRAMS. 4. ALL BILLS AND STATEMENTS FOR SERVICES INFORM UNINSURED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. 5. PATIENTS/GUARANTORS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE APPLICATION BY CALLING THE FRANCISCAN BILLING OFFICE OR DOWNLOADING A COPY AT NO COST FROM FRANCISCAN HOSPITAL'S WEBSITES. 6. PATIENTS/GUARANTORS CAN REQUEST FINANCIAL ASSISTANCE INFORMATION BY CALLING FRANCISCAN'S BILLING OFFICE PHONE LINE ON A 24-HOUR BASIS. 7. INDIVIDUALS OTHER THAN THE PATIENT, SUCH AS THE PATIENT'S PHYSICIAN, FAMILY MEMBERS, COMMUNITY OR RELIGIOUS GROUPS, SOCIAL SERVICES, OR HOSPITAL PERSONNEL MAY MAKE REQUESTS FOR FINANCIAL ASSISTANCE ON THE PATIENT'S BEHALF, SUBJECT TO APPLICABLE PRIVACY LAWS. 8. PRIOR TO TRANSFER TO A COLLECTION AGENCY, FRANCISCAN SENDS A MINIMUM OF 4 STATEMENTS AND MAKES 6 PHONE CALL ATTEMPTS TO CONTACT THE PATIENT/GUARANTOR AT THE ADDRESS AND PHONE NUMBER PROVIDED BY THE PATIENT/GUARANTOR. STATEMENTS AND COMMUNICATIONS INFORM THE PATIENT OF THE AMOUNT DUE AND IF THEY CANNOT PAY THEIR BALANCE THE AVAILABILITY OF FINANCIAL ASSISTANCE. A PATIENT'S QUALIFICATION FOR CHARITY CARE IS DETERMINED THROUGH A FINANCIAL ASSISTANCE APPLICATION AND SCREENING PROCESS. PATIENTS WHO MAY QUALIFY FOR MEDICAID OR ANY OTHER GOVERNMENTAL ASSISTANCE MUST BE DENIED COVERAGE OR ASSISTANCE FROM THOSE GOVERNMENTAL PROGRAMS PRIOR TO RECEIVING APPROVAL FOR CHARITY CARE. AS SUCH, FRANCISCAN OFFERS PATIENTS ASSISTANCE IN APPLYING OR ENROLLING IN SUCH PROGRAMS. A PATIENT WILL NEED TO FILL OUT, SIGN, AND SUBMIT THE FINANCIAL ASSISTANCE APPLICATION ALONG WITH ALL REQUESTED DOCUMENTATION OF INCOME, EXPENSES, ASSETS, AND LIABILITIES. FRANCISCAN'S BILLING OFFICE WILL PLACE THE PATIENT'S ACCOUNT ON HOLD ONCE A FINANCIAL ASSISTANCE APPLICATION HAS BEEN REQUESTED AND UNTIL A FINANCIAL ASSISTANCE DETERMINATION IS MADE. APPLICANTS ARE TREATED WITH DIGNITY AND RESPECT THROUGHOUT THE FINANCIAL ASSISTANCE PROCESS AND ALL INFORMATION/MATERIALS RECEIVED ARE CONFIDENTIALLY MAINTAINED. FRANCISCAN ALSO UTILIZES AN EXTERNAL VENDOR, SERVICE, OR DATA SOURCE THAT PROVIDES INFORMATION ON A PATIENT'S OR GUARANTOR'S ABILITY TO PAY (I.E. CREDIT SCORING). ELIGIBILITY FOR CHARITY CARE MAY BE DETERMINED AT ANY POINT IN THE COLLECTIONS CYCLE (I.E. PRIOR TO THE PROVISION OF SERVICES, DURING THE NORMAL COLLECTIONS CYCLE, OR MAY BE USED TO RE-CLASSIFY ACCOUNTS AFTER THEY HAVE BEEN DEEMED UNCOLLECTIBLE AND SUBSEQUENTLY RETURNED FROM A THIRD PARTY COLLECTION AGENCY). ONCE APPROVED, THE PATIENT WILL REMAIN ELIGIBLE FOR CHARITY CARE FOR A MAXIMUM OF FOUR MONTHS. THE ELIGIBILITY PERIOD WILL BEGIN FROM THE DATE OF THE PATIENT'S APPROVAL OF CHARITY CARE. CHARITY CARE DISCOUNTS WILL BE GIVEN FOR CURRENT OPEN ACCOUNTS AND THE FOLLOWING FOUR MONTHS OF EMERGENCY SERVICES OR MEDICALLY NECESSARY CARE. AFTER THE ELIGIBILITY PERIOD HAS ELAPSED, THE PATIENT MUST REAPPLY FOR FINANCIAL ASSISTANCE. LINES 16A, 16B, AND 16C: ALL FACILITIES THE FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT THE FOLLOWING ADDRESS: HTTPS://FRANCISCANHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-INSURANCE/FINAN CIAL-ASSISTANCE-AND-COUNSELING LINE 22: FRANCISCAN HEALTH CHICAGO HEIGHTS, FRANCISCAN HEALTH OLYMPIA FIELDS FRANCISCAN HEALTH CHICAGO HEIGHTS AND FRANCISCAN HEALTH OLYMPIA FIELDS COMPUTE THE MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS BASED ON THE ILLINOIS UNINSURED DISCOUNT ACT. UNDER THIS ACT, ILLINOIS FACILITIES CANNOT CHARGE GREATER THAN 135% OF COST. THIS METHOD RESULTS IN A LARGER DISCOUNT THAN THAT DETERMINED BY THE FEDERAL CALCULATION.

Schedule H (Form 990) 2018

Page 9

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?179
Name and address		Type of Facility (describe)
1	FRANCISCAN SURGERY CENTER 5255 E STOP 11 ROAD SUITE 100 INDIANAPOLIS,IN46237	AMBULATORY SURGERY CENTER
2	ST FRANCIS RADIATION THERAPY CENTERS 8111 S EMERSON AVENUE INDIANAPOLIS,IN46239	RADIATION THERAPY
3	INDIANA HEART PHYSICIANS 5330 E STOP 11 ROAD INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
4	IIMC 701 E COUNTY LINE ROAD SUITE 101 GREENWOOD,IN46143	PHYSICIAN PRACTICE
5	FRANCISCAN HAMMOND CLINIC 7905 CALUMET AVENUE MUNSTER,IN46321	SPECIALTY CENTER/URGENT CARE
6	FPN MC - ORTHOPEDIC HEALTH PARTNERS 1225 E COOLSPRING AVENUE MICHIGAN CITY,IN46360	PHYSICIAN PRACTICE
7	FRANCISCAN MEDICAL SPECIALISTS 761 45TH STREET MUNSTER,IN46321	PHYSICIAN PRACTICE
8	THE ENDOSCOPY CENTER AT ST FRANCIS 8051 S EMERSON AVENUE SUITE 150 INDIANAPOLIS,IN46237	ENDOSCOPY CENTER
9	FRANCISCAN HAMMOND CLINIC 9800 VALPARAISO DRIVE MUNSTER,IN46321	FAMILY WELLNESS CENTER
10	MOORESVILLE SURGERY CENTER 1215 HADLEY ROAD SUITE 100 MOORESVILLE,IN46260	AMBULATORY SURGERY CENTER
11	FRANCISCAN MEDICAL SPECIALISTS 919 MAIN STREET DYER,IN46311	PHYSICIAN PRACTICE
12	FPN OBSTETRICSGYNECOLOGY 3900 SAINT FRANCIS WAY LAFAYETTE,IN47905	PHYSICIAN PRACTICE
13	FRANCISCAN PHYSICIANS NETWORK - FMS 759 45TH STREET MUNSTER,IN46321	ORTHO/PT
14	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 3700 W 203RD STREET OLYMPIA FIELDS,IL60461	PHYSICIAN PRACTICE
15	ONCOLOGY AND HEMATOLOGY SPECIALISTS 8111 S EMERSON AVENUE SUITE 101 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
16	SPECIALTY PHYSICIANS OF ILLINOIS 20201 SOUTH CRAWFORD AVENUE OLYMPIA FIELDS,IL60461	PHYSICIAN PRACTICE
17	FPN - ST ANTHONY WOODLAND HEALTH CENTER 8865 W 400 NORTH MICHIGAN CITY,IN46360	PHYSICIAN PRACTICE
18	SPECIALTY PHYSICIANS OF ILLINOIS 3800 W 203RD STREET OLYMPIA FIELDS,IL60461	PHYSICIAN PRACTICE
19	ORTHOPEDIC SPECIALISTS 5255 E STOP 11 ROAD 300 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
20	SPECIALTY PHYSICIANS OF ILLINOIS 3700 W 203RD STREET OLYMPIA FIELDS,IL60461	PHYSICIAN PRACTICE
21	FRANCISCAN PHYSICIAN NETWORK - MC 1501 WABASH STREET MICHIGAN CITY,IN46360	PHYSICIAN PRACTICE
22	SOUTH EMERSON SURGERY CENTER 8141 S EMERSON AVENUE SUITE C INDIANAPOLIS,IN46237	AMBULATORY SURGERY CENTER
23	ST FRANCIS IMAGING CENTER 3147 WEST SMITH VALLEY ROAD GREENWOOD,IN46143	IMAGING
24	COOPERATIVE MANAGED CARE SERVICES 9045 RIVER ROAD SUITE 250 INDIANAPOLIS,IN46240	MANAGED CARE
25	INDY SOUTHSIDE SURGICAL 5255 E STOP 11 ROAD 450 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
26	FPN DERMATOLOGY FAMILY MEDICINE & PEDS 915 SAGAMORE PARKWAY WEST WEST LAFAYETTE,IN47906	PHYSICIAN PRACTICE
27	KENDRICK COLON & RECTAL CENTER 5255 E STOP 11 RD 250 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
28	MOORESVILLE ENDOSCOPY CENTER 1215 HADLEY ROAD SUITE 101 MOORESVILLE,IN46158	ENDOSCOPY CENTER
29	JOINT REPLACEMENT SURGEONS 1199 HADLEY ROAD MOORESVILLE,IN46158	PHYSICIAN PRACTICE
30	FPN CP CROWN POINT PEDIATRICS 1505 SOUTH COURT STREET CROWN POINT,IN46307	PHYSICIAN PRACTICE
31	FRANCISCAN HAMMOND CLINIC 11355 WEST 97TH LANE ST JOHN,IN46373	PRIMARY CARE
32	FRANCISCAN MEDICAL SPECIALISTS 2001 US 41 SCHERERVILLE,IN46375	PT/SPEC CENTER
33	FPN CP VALPARAISO CLINIC 2421 LAPORTE AVENUE VALPARAISO,IN46385	PHYSICIAN PRACTICE
34	GREENWOOD IMMEDIATE CARE 1001 N MADISON AVENUE GREENWOOD,IN46142	IMMEDIATE CARE CENTER
35	FPN NEPHROLOGY FPN PULMONARY 2708 FERRY STREET LAFAYETTE,IN47904	PHYSICIAN PRACTICE
36	FPN MEDICAL PAVILION SOUTH 2150 GETTLER STREET DYER,IN46311	MEDICAL PAVILION
37	FPN BROADWAY CLINIC 9470 BROADWAY CROWN POINT,IN46307	PHYSICIAN PRACTICE
38	FRANCISCAN IMMEDIATE CARE - THOMPSON 5210 E THOMPSON ROAD INDIANAPOLIS,IN46237	IMMEDIATE CARE
39	DIABETES AND ENDOCRINOLOGY SPECIALISTS 5230A E STOP 11 ROAD SUITE 150 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
40	FPN DYER FAMILY HEALTH CENTER 840 RICHARD ROAD DYER,IN46311	PHYSICIAN PRACTICE
41	PEDIATRIC ASSOCIATES OF GREENWOOD 900 AVERITT ROAD GREENWOOD,IN46143	PHYSICIAN PRACTICE
42	FPN CARDIOLOGY ELECTROPHYSIOLOGY 3900 SAINT FRANCIS WAY STE 200 LAFAYETTE,IN47905	PHYSICIAN PRACTICE
43	FRANCISCAN MEDICAL SPECIALISTS 757 45TH STREET MUNSTER,IN46321	HOME INFUSION
44	INDIANA SLEEP CENTER 701 E COUNTY LINE ROAD SUITE 207 GREENWOOD,IN46143	SLEEP CENTER
45	NEUROSURGICAL SPECIALISTS 8051 S EMERSON AVENUE SUITE 300 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
46	FRANCISCAN MEDICAL SPECIALISTS 300 W 80TH PLACE MERRILLVILLE,IN46410	PHYSICIAN PRACTICE
47	FPN CP WINFIELD CLINIC 11161 RANDOLPH STREET CROWN POINT,IN46307	PHYSICIAN PRACTICE
48	REHABILITATION SPECIALISTS 8051 S EMERSON AVENUE SUITE 250 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
49	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 211 DIXIE HIGHWAY CHICAGO HEIGHTS,IL60411	EXPRESS CARE CLINIC
50	MADISON AVE FAMILY MEDICINE 747 E COUNTY LINE ROAD SUITE D GREENWOOD,IN46143	PHYSICIAN PRACTICE
51	SOUTHPORT FP AND SPORTS MEDICINE 7825 MCFARLAND LANE A INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
52	IMPACT CENTER 1201 HADLEY ROAD MOORESVILLE,IN46158	PHYSICIAN PRACTICE
53	CENTER GROVE FAMILY MEDICINE 362 MERIDIAN PARKE LANE GREENWOOD,IN46142	PHYSICIAN PRACTICE
54	FPN CP SCHERERVILLE CHERRY CREEK CLINIC 7310 W LINCOLN HIGHWAY SCHERERVILLE,IN46307	PHYSICIAN PRACTICE
55	FPN CP - CHESTERTON NEURO 770 INDIAN BOUNDARY ROAD CHESTERTON,IN46304	PHYSICIAN PRACTICE
56	MOORESVILLE FAMILY CARE 1001 HADLEY ROAD SUITE 102 MOORESVILLE,IN46158	PHYSICIAN PRACTICE
57	SPECIALTY PHYSICIANS OF ILLINOIS 3900 W 203RD STREET OLYMPIA FIELDS,IL60461	PHYSICIAN PRACTICE
58	FPN NORTHSIDE FAMILY MEDICINE 1660 LAFAYETTE ROAD SUITE 170 CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
59	FPN FAMILY & GERIATRIC MEDICINE 3920 ST FRANCIS WAY SUITE 209 LAFAYETTE,IN47905	PHYSICIAN PRACTICE
60	COUNTY LINE PEDIATRICS 747 E COUNTY LINE ROAD G GREENWOOD,IN46143	PHYSICIAN PRACTICE
61	AMER HEALTH NETWORK - SLEEP (MUNCIE) 3631 N MORRISON ROAD MUNCIE,IN47304	SLEEP CENTER
62	FPN CP EXPRESS CARE 12800 MISSISSIPPI PARKWAY CROWN POINT,IN46307	PHYSICIAN PRACTICE
63	SPINE SPECIALISTS 8051 S EMERSON AVENUE SUITE 360 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
64	PSYCHIATRIC SPECIALISTS 610 E SOUTHPORT ROAD SUITE 200 INDIANAPOLIS,IN46227	PHYSICIAN PRACTICE
65	FPN CRAWFORDSVILLE FAMILY MEDICINE 308 W MARKET STREET CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
66	PLASTIC & RECONSTRUCTIVE SURGEONS 8051 S EMERSON AVENUE SUITE 450 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
67	HEARTLAND CROSSING PEDIATRICS 1001 HADLEY ROAD SUITE LL 100 MOORESVILLE,IN46158	PHYSICIAN PRACTICE
68	FRANCISCAN MEDICAL SPECIALISTS 5529 HOHMAN AVENUE HAMMOND,IN46320	PHYSICIAN PRACTICE
69	FPN CP LOWELL CLINIC 4500 W 181ST AVE LOWELL,IN46356	PHYSICIAN PRACTICE
70	COLUMBUS PRIMARY & SPECIALTY CARE 123 2ND STREET COLUMBUS,IN47201	PHYSICIAN PRACTICE
71	GYNECOLOGIC ONCOLOGY SPECIALISTS 8111 S EMERSON SUITE 204 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
72	OMNI REHABILITATION 810 MICHAEL DRIVE CHESTERTON,IN46304	PHYSICIAN PRACTICE
73	INDY SOUTHSIDE FAMILY MEDICINE 4018 E SOUTHPORT ROAD INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
74	FRANCISCAN PHYSICIAN NETWORK - MC 8955 W 400 NORTH MICHIGAN CITY,IN46360	PHYSICIAN PRACTICE CANCER CENTER
75	FRANCISCAN IMMEDIATE CARE - VILLAGE PARK 14641-1 THATCHER LANE CARMEL,IN46032	IMMEDIATE CARE
76	FRANCISCAN HEALTH MUNSTER 701 SUPERIOR DRIVE MUNSTER,IN46321	FPN ONCOLOGY
77	FRANKLIN TOWNSHIP FAMILY MEDICINE 8325 E SOUTHPORT ROAD SUITE 100 INDIANAPOLIS,IN46259	PHYSICIAN PRACTICE
78	FPN CP CARDIOLOGY 1205 S MAIN STREET SUITE 101 CROWN POINT,IN46307	PHYSICIAN PRACTICE
79	SOUTH 31 FAMILY CARE 610 E SOUTHPORT ROAD SUITE 205 INDIANAPOLIS,IN46227	PHYSICIAN PRACTICE
80	GREENWOOD PEDIATRICS 8849 SHELBY STREET B1 INDIANAPOLIS,IN46227	PHYSICIAN PRACTICE
81	FPN DYER SOUTH FAMILY HEALTH CENTER 2150 GETTLER STREET SUITE 255 DYER,IN46311	PHYSICIAN PRACTICE
82	MARTINSVILLE FAMILY & INTERNAL MEDICINE 49 BILLS BLVD MARTINSVILLE,IN46151	PHYSICIAN PRACTICE
83	FPN CP CEDAR LAKE CLINIC 6831 133RD AVENUED CEDAR LAKE,IN46303	FAMILY PRACTICE
84	BEECH GROVE FAMILY MEDICINE 2030 CHURCHMAN AVENUE A BEECH GROVE,IN46107	PHYSICIAN PRACTICE
85	GREENWOOD PARKE FAMILY MEDICINE 701 E COUNTY LINE ROAD SUITE 204 GREENWOOD,IN46143	PHYSICIAN PRACTICE
86	FPN CROWN POINT CLINIC 12800 MISSISSIPPI PARKWAY CROWN POINT,IN46307	PHYSICIAN PRACTICE
87	PLAINFIELD FAMILY MEDICINE 315 DAN JONES ROAD SUITE 150 PLAINFIELD,IN46168	PHYSICIAN PRACTICE
88	CENTRAL INDIANA DERMATOLOGY 5255 E STOP 11 ROAD 310 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
89	KENDRICK FAMILY MEDICINE 1001 HADLEY ROAD SUITE 101 MOORESVILLE,IN46158	PHYSICIAN PRACTICE
90	IRVINGTON FAMILY MEDICINE 5839 E WASHINGTON STREET INDIANAPOLIS,IN46219	PHYSICIAN PRACTICE
91	SOUTH INDY MRI AND REHAB 8141 S EMERSON AVENUE SUITE A INDIANAPOLIS,IN46237	RADIOLOGY AND PHYSICAL
92	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 20180 S LAGRANGE ROAD FRANKFORT,IL60423	EXPRESS CARE CLINIC
93	WEIGHT LOSS SPECIALISTS 5230A E STOP 11 ROAD SUITE 190 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
94	FPN CP SPECIALTY CENTER 1205 S MAIN STREET SUITE 201 CROWN POINT,IN46307	PHYSICIAN PRACTICE
95	FPN FAMILY MEDICINE KENSINGTON 3875 KENSINGTON DRIVE LAFAYETTE,IN47905	PHYSICIAN PRACTICE
96	HEARTLAND INTERNAL MEDICINE 10701 ALLIANCE DRIVE CAMBY,IN46113	PHYSICIAN PRACTICE
97	FPN CP NORTH POINT INTERNAL MEDICINE 2050 NORTH MAIN STREET CROWN POINT,IN46307	PHYSICIAN PRACTICE
98	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 20939 S CICERO AVENUE MATTESON,IL60443	PHYSICIAN PRACTICE
99	SOUTHEAST FAMILY MEDICINE 965 EMERSON PARKWAY SUITE J GREENWOOD,IN46143	PHYSICIAN PRACTICE
100	FPN NORTHRIDGE INTERNAL MEDICINE 1704 LAFAYETTE ROAD SUITE 8 CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
101	CARMEL FAMILY MEDICINE 12188 B NORTH MERIDIAN ST 280 CARMEL,IN46032	PHYSICIAN PRACTICE
102	FPN OBGYN HEALTH CENTER 1205 S MAIN STREET CROWN POINT,IN46321	PHYSICIAN PRACTICE
103	PULMONARY & SLEEP SPECIALISTS 1040 GREENWOOD SPRINGS BLVD GREENWOOD,IN46143	PHYSICIAN PRACTICE
104	FPN ST JOHN HEALTH CENTER 10860 MAPLE LANE ST JOHN,IN46373	PHYSICIAN PRACTICE
105	FRANCISCAN HEALTH OUTPATIENT CENTER 24 JOLIET STREET SUITE 101 DYER,IN46311	PHYSICIAN PRACTICE
106	MCFARLAND INTERNAL MEDICINE 7855 S EMERSON AVENUE P INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
107	FPN RENSSELAER MED CTR- FM & GEN SURGERY 118 W DREXEL PARKWAY RENSSELAER,IN47978	PHYSICIAN PRACTICE
108	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 1423 CHICAGO ROAD CHICAGO HEIGHTS,IL60411	PHYSICIAN PRACTICE
109	FPN CP DEMOTTE CLINIC 200 3RD COURT SE DEMOTTE,IN46310	PHYSICIAN PRACTICE
110	MONTICELLO MEDICAL CENTER 826 N 6TH STREET MONTICELLO,IN47960	MEDICAL PRACTICE
111	FPN EASTSIDE FAMILY MEDICINE 2056 LEBANON ROAD CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
112	FRANCISCAN PHYSICIAN NETWORK-LAKE RIDGE 1573 N CLINE AVENUE GRIFFITH,IN46319	PHYSICIAN PRACTICE
113	SPECIALTY PHYSICIANS OF ILLINOIS 3649 W 183RD STREET HAZEL CREST,IL60429	PHYSICIAN PRACTICE
114	MAJOR HOSPITAL CARDIAC DIAGNOSTICS 150 WEST WASHINGTON STREET SHELBYVILLE,IN46176	CARDIOVASCULAR TESTING
115	FPN OMNI FAMILY HEALTH CENTER 221 US HWY 41 SUITE I SCHERERVILLE,IN46375	PHYSICIAN PRACTICE
116	FRANCISCAN HEALTH PALLATIVE CARE 8111 S EMERSON AVENUE INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
117	SPECIALTY PHYSICIANS OF ILLINOIS 1423 CHICAGO ROAD CHICAGO HEIGHTS,IL60411	PHYSICIAN PRACTICE
118	FPN DYER SPECIALTY HEALTH CENTER 24 JOLIET STREET SUITE 101 DYER,IN46311	PHYSICIAN PRACTICE
119	FPN BREAST SPECIALISTS 8111 S EMERSON 104 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
120	FPN - HAMMOND SPECIALTY HEALTH CENTER 5454 HOHMAN AVENUE HAMMOND,IN46320	PHYSICIAN PRACTICE
121	RHEUMATOLOGY & OSTEOPOROSIS SPECIALISTS 5255 E STOP 11 ROAD SUITE 320 INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
122	FPN PHYSICAL MEDICINE & REHABILITATION 1012 N 14TH STREET LAFAYETTE,IN47904	PHYSICIAN PRACTICE
123	CENTER GROVE INTERNAL MEDICINE 107 N STATE ROAD 135 103 GREENWOOD,IN46142	PHYSICIAN PRACTICE
124	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 20201 SOUTH CRAWFORD AVENUE OLYMPIA FIELDS,IL60461	DIABETES CLINIC
125	FPN SURGICAL SPECIALISTS 1630 LAFAYETTE ROAD SUITE 300 CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
126	CITYWAY FAMILY & SPORTS MEDICINE 426 S ALABAMA STREET INDIANAPOLIS,IN46225	PHYSICIAN PRACTICE
127	FPN DYER SOUTH FAMILY HEALTH CENTER 14785 WEST 101ST AVENUE DYER,IN46311	PHYSICIAN PRACTICE
128	FPN CP RADIATION ONCOLOGY BURRELL CANCER CTR 1201 S MAIN STR CROWN POINT,IN46307	PHYSICIAN PRACTICE
129	FPN BEHAVIOR HEALTH 1501 HARTFORD ST LAFAYETTE,IN47905	PHYSICIAN PRACTICE
130	CENTRAL INDIANA PROCTOLOGY 49 BILLS BOULEVARD MARTINSVILLE,IN46151	PHYSICIAN PRACTICE
131	CENTRAL EXPRESS CARE 1501 HARTFORD STREET LAFAYETTE,IN47905	URGENT CARE
132	FPN CP MEDICAL ARTS INTERNAL MEDICINE 297 WEST FRANCISCAN LANE SUITE 104 CROWN POINT,IN46307	PHYSICIAN PRACTICE
133	FPN ORTHOPEDIC AND SPORTS MEDICINE 1702 LAFAYETTE ROAD CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
134	MOORESVILLE AFTER HOURS CLINIC 1001 HADLEY ROAD SUITE 101 MOORESVILLE,IN46158	PHYSICIAN PRACTICE
135	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 20180 S LAGRANGE ROAD FRANKFORT,IL60423	PHYSICIAN PRACTICE
136	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 18636 DIXIE HIGHWAY HOMEWOOD,IL60430	PHYSICIAN PRACTICE
137	EXPRESS CARE RENSSELAER 919 GRACE STREET RENSSELAER,IN47978	PHYSICIAN PRACTICE
138	AMER HEALTH NETWORK - KOKOMO 2330 S DIXON ROAD KOKOMO,IN46902	IMAGING
139	WOUND CARE SPECIALISTS 8111 S EMERSON AVENUE INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
140	FPN CARDIOLOGY LOGANSPORT 1201 MICHIGAN AVENUE SUITE 50 LOGANSPORT,IN46947	PHYSICIAN PRACTICE
141	BEECH GROVE INTERNAL MEDICINE 2030 CHURCHMAN AVENUE SUITE A BEECH GROVE,IN46107	physician practice
142	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 20121 SOUTH CRAWFORD AVENUE OLYMPIA FIELDS,IL60461	PHYSICIAN PRACTICE
143	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 344 VICTORY DRIVE PARK FOREST,IL60466	PHYSICIAN PRACTICE
144	AMER HEALTH NETWORK - SLEEP (CARMEL) 12425 OLD MERIDIAN STREET SUITE A- CARMEL,IN46032	SLEEP CENTER
145	FPN MICHIGAN CITY EXPRESS CARE 2590 MORTHDAND DRIVE STE I VALPARAISO,IN46383	PHYSICIAN PRACTICE
146	FPN GREENACRES FAMILY MEDICINE 1500 DARLINGTON AVENUE SUITE 300 CRAWFORDSVILLE,IN47933	PHYSICIAN PRACTICE
147	FPN CP MIDWIFE CENTER 297 WEST FRANCISCAN LANE SUITE 203 CROWN POINT,IN46307	PHYSICIAN PRACTICE
148	FPN MICHIGAN CITY EXPRESS CARE 3325 WILLOWCREEK ROAD PORTAGE,IN46368	PHYSICIAN PRACTICE
149	ORTHOPEDIC FOOT & ANKLE SURGEONS 1199 HADLEY ROAD SUITE 300 MOORESVILLE,IN46158	PHYSICIAN PRACTICE
150	FPN ST CLARE HEALTH CLINIC 1121 S INDIANA CROWN POINT,IN46307	PHYSICIAN PRACTICE
151	KENDRICK INTERNAL MEDICINE 1001 HADLEY ROAD LL050 MOORESVILLE,IN46158	PHYSICIAN PRACTICE
152	PLEASANT VIEW FAMILY MEDICINE 12524 SOUTHEASTERN AVENUE INDIANAPOLIS,IN46259	PHYSICIAN PRACTICE
153	FRANCISCAN PHYSICIAN NETWORK - MC 500 W BUFFALO STREET NEW BUFFALO,MI49117	PHYSICIAN PRACTICE
154	WOMEN'S SPECIALTY HEALTH CENTER - DYER 2150 GETTLER STREET SUITE 255 DYER,IN46311	PHYSICIAN PRACTICE
155	AMER HEALTH NETWORK - MUNCIE 3631 N MORRISON ROAD MUNCIE,IN47304	PT, IMAGING, SURGERY
156	FRANCISCAN HEALTH MATERNAL FETAL MED 8111 S EMERSON AVNUE INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
157	FRANCISCAN PHYSICIAN NETWORK OF ILLINOIS 30 E 15TH STREET CHICAGO HEIGHTS,IL60411	RESIDENCY CLINIC
158	AFTER HOURS CLINIC - INDY 7855 S Emerson P INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
159	CATHERINE MCAULEY CLINIC 5530 HOHMAN AVENUE HAMMOND,IN46320	PHYSICIAN PRACTICE
160	FMS MN SKILLED NURSING 1400 S LAKE PARK AVENUE HOBART,IN46342	SKILLED NURSING
161	FPN CP SKILLED NURSING 1205 S MAIN STREET CROWN POINT,IN46307	PHYSICIAN PRACTICE
162	SPECIALTY PHYSICIANS OF ILLINOIS 4932 W 95th Street OAK LAWN,IL60453	PHYSICIAN PRACTICE
163	SKILLED NURSING FACILITY 4904 WAR ADMIRAL DRIVE INDIANAPOLIS,IN46237	NURSING FACILITY
164	SPECIALTY PHYSICIANS OF ILLINOIS BEECHER 989 DIXIE HIGHWAY BEECHER,IL60401	PHYSICIAN PRACTICE
165	FPN DOUGLAS PARK HEALTH CARE 3831 HOHMAN AVENUE HAMMOND,IN46327	PHYSICIAN PRACTICE
166	FRANCISCAN PHYSICIAN NETWORK - MC 900 I STREET LAPORTE,IN46350	PHYSICIAN PRACTICE
167	FPN WOUND CARE 1501 HARTFORD STREET LAFAYETTE,IN47905	PHYSICIAN PRACTICE
168	FPN MICHIGAN CITY 2307 LAPORTE AVENUE SUITE B VALPARAISO,IN46383	PHYSICIAN PRACTICE
169	SPORTS MEDICINE SPECIALISTS 315 DAN JONES ROAD 120 PLAINFIELD,IN46168	PHYSICIAN PRACTICE
170	POST ACUTE TRANSITIONAL CARE 5330 E STOP 11 ROAD INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
171	MCFARLAND FAMILY MEDICINE 7855 S EMERSON AVENUE P INDIANAPOLIS,IN46237	PHYSICIAN PRACTICE
172	FPN CP CHESTERTON NEURO SURGERY 770 INDIAN BOUNDARY ROAD CHESTERTON,IN46304	PHYSICIAN PRACTICE
173	FPN ONCOLOGY HEMATOLOGY 1701 S CREASY LANE SUITE 1W93 LAFAYETTE,IN47905	PHYSICIAN PRACTICE
174	FPN CP MUNSTER NEUROSURGERY 759 45TH STREET MUNSTER,IN46321	PHYSICIAN PRACTICE
175	FPN HAMMOND FAMILY HEALTH CENTER 5500 HOHMAN AVENUE SUITE 2A HAMMOND,IN46320	physician practice
176	FRANCISCAN IMMEDIATE CARE - CASTLE KEY 4527 E 82ND STREET INDIANAPOLIS,IN46250	IMMEDIATE CARE
177	FRANCISCAN HEALTH FITNESS CENTERS CHICAGO HEIGHTS 100 197TH PLACE CHICAGO HEIGHTS,IL60411	FITNESS CENTER
178	FRANCISCAN HEALTH FITNESS CENTERS CHESTERTON 810 MICHAEL DRIVE CHESTERTON,IN46304	FITNESS CENTER
179	FRANCISCAN HEALTH FITNESS CENTERS SCHERERVILLE 221 US HIGHWAY 41 SU SCHERERVILLE,IN46375	FITNESS CENTER

Schedule H (Form 990) 2018

Page 10

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

SUPPLEMENTAL INFORMATION

SCHEDULE H, PART VI, ITEM 2 NEEDS ASSESSMENT FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") HOSPITALS ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE BY COLLABORATING WITH PUBLIC AND PRIVATE AGENCIES TO DETERMINE COMMUNITY HEALTH NEEDS AND HOW BEST TO ADDRESS THEM. FRANCISCAN'S CORPORATE COMMUNITY BENEFIT COMMITTEE, AS WELL AS COMMITTEES IN THE LOCAL FACILITIES, COMMITTED TO AN ONGOING ASSESSMENT OF COMMUNITY HEALTH NEEDS AND PRIORITIES BASED UPON HEALTH INITIATIVES OF THE MUNICIPAL, COUNTY, AND STATE HEALTH DEPARTMENTS, COMMUNITY-BASED ASSESSMENTS BY OTHER PUBLIC SECTOR PARTNERS, PROFESSIONAL RESEARCH CONSULTANT REPORTS, AND FAITH-BASED PARTNERS WITHIN THE COMMUNITIES SERVED. IN ADDITION, OUR HOSPITALS ADDRESS PUBLIC AGENCY AND COMMUNITY GROUP REQUESTS TO PROVIDE COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS THAT MEET CERTAIN SPECIALTY OR HYBRID NEEDS OR POPULATIONS. THE DETAILED CHNA ACTIVITIES FOR EACH OF FRANCISCAN'S HOSPITALS CAN BE FOUND IN PART V OF THIS SCHEDULE H. ------------------------------------------------------------------- SCHEDULE H, PART VI, ITEM 3 FINANCIAL ASSISTANCE POLICY FRANCISCAN'S HOSPITALS INFORM AND EDUCATE PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER FRANCISCAN'S FINANCIAL ASSISTANCE AND CHARITY CARE POLICY. FOR PATIENTS NOT INITIALLY IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, FRANCISCAN COMMUNICATES THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY THROUGH THE FOLLOWING MEANS: 1. FRANCISCAN COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN APPROPRIATE CARE SETTINGS SUCH AS EMERGENCY DEPARTMENTS, ADMITTING/REGISTRATION AREAS, BILLING OFFICES, OUTPATIENT SERVICE SETTINGS, AND ON OUR HOSPITALS' WEBSITES. SIGNS/POSTINGS INFORM PATIENTS THAT FREE OR REDUCED COST CARE MAY BE AVAILABLE TO QUALIFYING PATIENTS WHO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. 2. BROCHURES SUMMARIZING OUR FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE THROUGHOUT EACH FRANCISCAN HOSPITAL. 3. FINANCIAL COUNSELORS AND BUSINESS OFFICE PERSONNEL ARE AVAILABLE TO HELP PATIENTS UNDERSTAND AND APPLY FOR LOCAL, STATE, FEDERAL HEALTH CARE PROGRAMS; HEALTH INSURANCE EXCHANGES; AND FRANCISCAN'S FINANCIAL ASSISTANCE PROGRAMS. 4. ALL BILLS AND STATEMENTS FOR SERVICES INFORM UNINSURED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. 5. PATIENTS/GUARANTORS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE APPLICATION BY CALLING THE FRANCISCAN BILLING OFFICE OR DOWNLOADING A COPY AT NO COST FROM FRANCISCAN HOSPITAL'S WEBSITES. 6. INDIVIDUALS OTHER THAN THE PATIENT, SUCH AS THE PATIENT'S PHYSICIAN, FAMILY MEMBERS, COMMUNITY OR RELIGIOUS GROUPS, SOCIAL SERVICES, OR HOSPITAL PERSONNEL MAY MAKE REQUESTS FOR FINANCIAL ASSISTANCE ON THE PATIENT'S BEHALF, SUBJECT TO APPLICABLE PRIVACY LAWS. 7. FRANCISCAN SENDS 4 STATEMENTS AND MAKES 6 PHONE CALL ATTEMPTS TO CONTACT THE PATIENT/GUARANTOR AT THE ADDRESS AND PHONE NUMBER PROVIDED BY THE PATIENT/GUARANTOR. STATEMENTS AND COMMUNICATIONS INFORM THE PATIENT OF THE AMOUNT DUE AND IF THEY CANNOT PAY THEIR BALANCE THE AVAILABILITY OF FINANCIAL ASSISTANCE. ------------------------------------------------ SCHEDULE H, PART VI, ITEM 4 COMMUNITY INFORMATION THE FRANCISCAN ALLIANCE SERVES A LARGE GEOGRAPHIC AREA WHICH INCLUDES 18 COUNTIES IN INDIANA (BENTON, CARROLL, FOUNTAIN, HAMILTON, JASPER, JOHNSON, LAKE, LAPORTE, MARION, MONTGOMERY, MORGAN, NEWTON, PORTER, SHELBY, STARKE, TIPPACANOE, WARREN, AND WHITE) AND 3 COUNTIES IN ILLINOIS (COOK, KANKAKEE, AND WILL). THE POPULATION OF THE COMMUNITIES THAT WE SERVE WAS ESTIMATED CLOSE TO 3.9 MILLION PEOPLE WITH AN AVERAGE HOUSEHOLD INCOME ABOVE $59,000 IN 2018. FOR THESE COMMUNITIES, THE PERCENTAGE OF RESIDENTS BELOW THE FEDERAL POVERTY LEVEL WAS ESTIMATED AT 13.8%. THE PERCENTAGE OF INPATIENTS FROM THESE COMMUNITIES WHO WERE SERVED BY MEDICAID WAS 21.6%. AND THE PERCENTAGE OF INPATIENTS FROM THESE COMMUNITIES WHO WERE UNINSURED WAS APPROXIMATELY 3.1%. IN COMPARISON, THE PERCENTAGES OF MEDICAID AND UNINSURED INPATIENTS TREATED BY THE HOSPITALS OF THE FRANCISCAN ALLIANCE WERE 19.4% AND 2.1% RESPECTIVELY IN 2018. THERE ARE 58 OTHER HOSPITALS THAT SERVE WITHIN THESE COMMUNITIES AS WELL. ------------------------------------------------ SCHEDULE H, PART VI, ITEM 5 & PART I, LINE 6A OTHER INFORMATION WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH REFLECTS FRANCISCAN'S MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION." ALTHOUGH IT IS NOT ALL INCLUSIVE OF THE MANY BENEFITS PROVIDED BY FRANCISCAN IT DOES PORTRAY THE SIGNIFICANT BENEFITS THAT REFLECT OUR COMMITMENT TO HEALTHCARE AND THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. THE FOLLOWING IS A SUBSET OF THE MANY CLINICAL SERVICES AS WELL AS POPULATION HEALTH IMPROVEMENT AND COMMUNITY OUTREACH ACTIVITIES OFFERED BY ONE OR MORE OF FRANCISCAN'S HEALTHCARE FACILITIES: - INPATIENT HOSPITAL SERVICES INCLUDING: MEDICAL SERVICES, SURGICAL SERVICES, INTENSIVE CARE SERVICES, TELEMETRY SERVICES, OBSTETRICS SERVICES, PEDIATRICS SERVICES, NEONATAL INTENSIVE CARE SERVICES, ACUTE REHABILITATION SERVICES, ONCOLOGY SERVICES, BONE MARROW TRANSPLANT SERVICES, GENERAL SURGERY SERVICES, CARDIAC SURGERY SERVICES, VASCULAR SERVICES, PULMONARY SERVICES, INTERVENTIONAL RADIOLOGY, ORTHOPEDICS, JOINT AND SPINE CARE, GASTROINTESTINAL CARE, NEUROSCIENCES SERVICES, COLON AND RECTAL SERVICES, ANESTHESIA SERVICES, HOSPICE SERVICES, INPATIENT PSYCHIATRIC CARE, RESIDENTIAL TREATMENT PROGRAM FOR ADOLESCENTS, ETC. - EMERGENCY SERVICES INCLUDING: 24 HOUR EMERGENCY ROOM SERVICES, AMBULANCE SERVICES, IMMEDIATE CARE SERVICES, ADVANCED LIFE SUPPORT SERVICES, BASIC LIFE SUPPORT SERVICES, BEHAVIORAL HEALTH EMERGENCY CONSULTATION SERVICES, 24-HOUR CRISIS AND REFERRAL HOTLINE, TRAUMA SERVICES, ETC. - OUTPATIENT SERVICES INCLUDING: LABORATORY SERVICES, PHYSICAL THERAPY SERVICES, OCCUPATIONAL THERAPY SERVICES, SPEECH THERAPY SERVICES, GENERAL RADIOLOGY SERVICES, COMPUTED TOMOGRAPHY SERVICES, MAGNETIC RESONANCE IMAGING (MRI), NUCLEAR MEDICINE SERVICES, MAMMOGRAPHY SERVICES, ANGIOGRAPHY SERVICES, NEURODIAGNOSTICS SERVICES, GASTRO/INTESTINAL SERVICES, SLEEP LABORATORY, PULMONARY SERVICES, OUTPATIENT SURGERY, CARDIAC TESTING, ELECTROCARDIOGRAM (EKG) SERVICES, MEDICAL ONCOLOGY SERVICES, RADIATION ONCOLOGY SERVICES, PHARMACY, OCCUPATIONAL MEDICINE SERVICES, CARDIAC/PULMONARY REHABILITATION SERVICES, CONGESTIVE HEART FAILURE CLINIC, WOUND HEALING AND PREVENTION, NUTRITIONAL COUNSELING, DIABETES MANAGEMENT, BARIATRIC SERVICES, PAIN MANAGEMENT, SOCIAL SERVICES, PALLIATIVE CARE, SPORTS MEDICINE, BEHAVIORAL HEALTH, STROKE SERVICES, HOME HEALTH SERVICES, SKILLED NURSING SERVICES, SOCIAL SERVICES, DURABLE MEDICAL EQUIPMENT. - PRIMARY CARE AND SPECIALTY CARE PHYSICIAN CLINICS. SUBSIDIZED HEALTHCARE SERVICES OFFERED BY FRANCISCAN: - FRANCISCAN HAS NEIGHBORHOOD HEALTH CLINICS THAT OFFER FAMILY PRACTICE SERVICES DESIGNED FOR FAMILIES WITHOUT ACCESS TO AFFORDABLE HEALTH CARE. THE FOCUS IS ON PROVIDING PRIMARY AND PREVENTIVE CARE AS WELL AS HEALTH EDUCATION. THESE CLINICS OFFER FREE IMMUNIZATIONS. - FRANCISCAN'S SEXUAL ASSAULT CLINICS THAT PROVIDE MEDICAL AND FORENSIC ASSISTANCE THAT IS SENSITIVE TO THE SPECIAL NEEDS OF THE VICTIM AS WELL AS A VICTIM ADVOCATE PROGRAM AND CRISIS INTERVENTION COUNSELORS. - FRANCISCAN'S BLOOD AND MARROW TRANSPLANT PROGRAM IS ONLY ONE OF TWO PROGRAMS IN INDIANA OFFERING FULL SERVICE TRANSPLANT CARE AND SPECIALIZES IN THE TREATMENT OF PATIENTS WITH LEUKEMIA, HODGKIN'S OR NON-HODGKIN'S LYMPHOMA, MULTIPLE MYELOMA, AND MANY OTHER MALIGNANCIES AND BLOOD DISORDERS. - FRANCISCAN'S DIABETES EDUCATION CENTERS OFFER A NUMBER OF DIABETES CLASSES AND INDIVIDUALIZED SESSIONS TO HELP PATIENTS TAKE CONTROL OF THEIR HEALTH WITH A FOCUS ON NUTRITIONAL, EXERCISE, MEDICATIONS, CHRONIC CONDITIONS, PRECONCEPTION AND PREGNANCY, BLOOD GLUCOSE MONITORING, GOAL SETTING, PROBLEM SOLVING, PSYCHOSOCIAL ADJUSTMENT, DETECTION/TREATMENT OF HIGH AND LOW BLOOD SUGAR, AND INSULIN ADMINISTRATION. - FRANCISCAN'S WOMEN'S AND CHILDREN'S SERVICES INCLUDE PREVENTIVE MEDICAL CARE AND HEALTH SCREENINGS TO GYNECOLOGICAL CARE, MATERNITY, LACTATION CONSULTATION SERVICES, AND BEYOND WITH A FOCUS ON KEEPING WOMEN HEALTHY. - FRANCISCAN'S HOSPICE CARE SERVICES PROVIDE A SENSE OF DIGNITY AND COMPASSION TO BOTH THE PATIENT AND THEIR FAMILY IN CARING FOR PATIENTS WITH A LIFE EXPECTANCY OF SIX MONTHS OR LESS. OUR PROGRAMS AFFIRM AND CELEBRATE LIFE AND REGARD DYING AS A NATURAL PROCESS, RECOGNIZING THAT EVERY PERSON HAS THE RIGHT TO DIE WITH DIGNITY, PEACE, AND COMFORT REGARDLESS OF THEIR ETHNICITY, FAITH BACKGROUND, OR ABILITY TO PAY. - LEVEL III NICU - AMBULANCE SERVICE - PHYSICIAN SERVICES - INPATIENT PSYCHIATRIC UNITS - HEALTH AND WELLNESS CENTERS AND HEALTHY LIVING EDUCATION CENTERS - CLINICAL CARE COORDINATORS TO SUPPORT FRANCISCAN'S VARIOUS ACCOUNTABLE CARE ORGANIZATIONS WHICH ARE DESIGNED TO IMPROVE QUALITY AND REDUCE CO

SCHEDULE H, PART II

COMMUNITY BUILDING ACTIVITIES FOLLOWING NATIONAL GUIDANCE ON COMMUNITY BUILDING AS A CATEGORY REPRESENTING INVESTMENTS IN SOCIAL DETERMINANTS IN THE COMMUNITY, FRANCISCAN ALLIANCE REPORTS ACCURATE DOLLARS IN THIS CATEGORY. FRANCISCAN ALLIANCE HAS ENGAGED IN COMMUNITY BUILDING THROUGH SUPPORTING LOCAL PARTNERS IN THEIR WORK. FRANCISCAN ALLIANCE DOES ENGAGE IN REDUCING BARRIERS TO HEALTH CARE ACCESS. MOST ACTIVITIES IN THIS AREA ARE INCLUDED IN THE FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT CATEGORIES. EXAMPLES INCLUDE: FREE OR LOW COST HEALTH SCREENING IN SPECIFIC NEIGHBORHOODS, IMMUNIZATION SERVICES, PRESCRIPTION MEDICATION ASSISTANCE PROGRAMS, ENROLLMENT ASSISTANCE IN MEDICAID, FOOD ASSISTANCE, TRANSPORTATION ASSISTANCE, AND REFERRAL ASSISTANCE. ADDITIONALLY, SEVERAL OF OUR HOSPITALS HAVE BEEN IDENTIFIED BY THE FEDERAL GOVERNMENT AS DESIGNATED REGIONAL MEDICATION DISTRIBUTION SITES IN THE EVENT OF A NATIONAL DISASTER OR EPIDEMIC/PANDEMIC. RESPONDING TO FEDERAL, STATE, AND LOCAL NEEDS IN THE EVENT OF NATIONAL OR LOCAL DISASTERS OR EPIDEMIC/PANDEMICS, WE COLLABORATE AND COORDINATE OUR EFFORTS WITH MANY CIVIC AND OTHER AGENCIES TO ENSURE THAT THOSE NEEDS WILL BE MET SHOULD DISASTER STRIKE. ----------------------------------------- SCHEDULE H, PART III, LINE 2 THROUGHOUT THE YEAR, THE CORPORATION ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF ITS PATIENT ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE, AND OTHER RELEVANT FACTORS. THESE FACTORS INCLUDE CHANGES IN THE ECONOMY AND UNEMPLOYMENT RATES, WHICH HAS AN IMPACT ON THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, AS WELL AS TRENDS IN HEALTH CARE COVERAGE, SUCH AS THE INCREASED BURDEN OF DEDUCTIBLES, COPAYMENTS, AND COINSURANCE PAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED PROCEDURES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS AND CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE CORPORATION. ----------------------------------------- SCHEDULE H, PART III, LINE 3 THE CORPORATION HAS A SYSTEM-WIDE CHARITY CARE AND UNINSURED DISCOUNT POLICY; HAS DETAILED ADMINISTRATIVE PROCEDURES ESTABLISHED FOR QUALIFYING AND ENROLLING PATIENTS FOR CHARITY CARE OR UNINSURED/UNDERINSURED DISCOUNTS; USES VARIOUS ANALYTICAL PROGRAMS INCLUDING SOFT CREDIT INQUIRIES THAT DO NOT AFFECT CREDIT SCORES TO HELP ASSESS A PATIENT'S ABILITY TO PAY; AND UTILIZES NUMEROUS MECHANISMS TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE WHICH ARE DETAILED UNDER SCHEDULE H, PART VI, ITEM 3. DESPITE THESE RIGOROUS EFFORTS, PATIENTS WHO NEED SUBSIDIZED CARE MAY NOT SEEK THIS ASSISTANCE NOR CHOOSE TO ENROLL IN THE STATE'S MEDICAID PROGRAM. ALSO, AS FURTHER DESCRIBED IN HFMA STATEMENT NO. 15, THE APPROPRIATE CLASSIFICATION OF CHARITY CARE AND BAD DEBT IS OFTEN DIFFICULT. THE URGENCY OF SOME TREATMENTS, AS WELL AS CERTAIN FEDERAL REGULATIONS, OFTEN REQUIRES THE PROVISION OF SERVICE WITHOUT CONSIDERATION OF THE PATIENT'S ABILITY TO PAY. SOME PATIENTS HAVE COMPLEX MEDICAL CONDITIONS WITH UNPREDICTABLE TREATMENT NEEDS. FOR THESE AND OTHER REASONS, FRANCISCAN BELIEVES, A PORTION OF ITS BAD DEBT EXPENSE AS REPORTED ON LINE 2 OF PART III REPRESENTS CHARITY CARE DELIVERED TO INDIVIDUALS IN THE COMMUNITIES IT SERVES CONSISTENT WITH ITS CHARITABLE HEALTHCARE MISSION. -------------------------------------- SCHEDULE H, PART III, LINE 4 THE CORPORATION'S UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS FOOTNOTE FROM ITS AUDITED FINANCIAL STATEMENTS IS AS FOLLOWS: THE CORPORATION ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE TO PATIENTS WHICH IS NOT REPORTED IN THE SUMMARY OF QUANTIFIABLE COMMUNITY BENEFITS. EFFECTIVE JANUARY 1, 2018, THE CORPORATION ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARD UPDATE ("ASU") 2014-9, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) WHICH REQUIRES REVENUE TO BE RECOGNIZED IN AN AMOUNT THAT REFLECTS THE CONSIDERATION THE ENTITY EXPECTS TO BE ENTITLED TO IN AN EXCHANGE FOR GOODS OR SERVICES. ADOPTION OF THIS ASU DOES NOT ALLOW THE SEPARATE REPORTING OF THE UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS; HOWEVER, THE IDENTIFICATION OF THIS AMOUNT IS NEEDED FOR OTHER PURPOSES INCLUDING GOVERNMENTAL REPORTING AND REIMBURSEMENT CALCULATIONS. THE CORPORATION HAS A SYSTEM-WIDE CHARITY CARE AND UNINSURED DISCOUNT POLICY THAT INCLUDES ADMINISTRATIVE PROCEDURES FOR QUALIFYING AND ENROLLING PATIENTS FOR CHARITY CARE OR UNINSURED/UNDERINSURED DISCOUNTS. THE CORPORATION ALSO USES VARIOUS ANALYTICAL PROGRAMS TO ASSESS A PATIENTS ABILITY TO PAY AND IT UTILIZES NUMEROUS MECHANISMS TO INFORM AND EDUCATE PATIENTS ABOUT FINANCIAL ASSISTANCE. DESPITE THESE RIGOROUS EFFORTS, PATIENTS WHO NEED SUBSIDIZED CARE MAY NOT SEEK THIS ASSISTANCE NOR CHOOSE TO ENROLL IN MEDICAID OR OTHER FINANCIAL ASSISTANCE PROGRAMS. FOR THESE AND OTHER REASONS, THE CORPORATION BELIEVES A PORTION OF ITS UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS REPRESENTS CHARITY CARE DELIVERED TO INDIVIDUALS IN THE COMMUNITIES IT SERVES CONSISTENT WITH ITS CHARITABLE HEALTH CARE MISSION. DURING THE YEARS ENDED DECEMBER 31, 2018 AND 2017, THE CORPORATION INCURRED APPROXIMATELY $50.4 MILLION AND $34.6 MILLION, RESPECTIVELY, AS UNCOLLECTIBLE AMOUNTS DUE FROM PATIENTS BASED ON ACCUMULATED CHARGES. ------------------------------------------------ SCHEDULE H, PART III, LINE 8 CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF FRANCISCAN AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545 AND THE REQUIREMENTS OF IRC SECTION 501(R), FRANCISCAN PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE AT FRANCISCAN. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY FRANCISCAN TO PROVIDE SUCH SERVICES. LIKE MEDICAID, PAYMENT RATES FOR MEDICARE ARE SET BY LAW RATHER THAN THROUGH A NEGOTIATION PROCESS AS WITH PRIVATE INSURERS. THESE PAYMENT RATES ARE CURRENTLY SET BELOW THE COSTS OF PROVIDING CARE RESULTING IN UNDERPAYMENTS. MEDICARE RATES ARE DETERMINED WITHIN THE CONTEXT OF ALL THE BUDGETARY NEEDS OF THE FEDERAL GOVERNMENT AND MEDICARE PAYMENTS HAVE HISTORICALLY BEEN SET BELOW THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS THOUGH HOW FAR BELOW VARIES OVER TIME AND BY SERVICE. EACH YEAR MEDICARE IS SUPPOSED TO PROVIDE HOSPITALS AN INCREASE IN BOTH INPATIENT AND OUTPATIENT PAYMENTS TO ACCOUNT FOR INFLATION IN THE PRICES FOR GOODS AND SERVICES HOSPITALS MUST PURCHASE IN ORDER TO PROVIDE PATIENT CARE. HOWEVER INPATIENT UPDATES HAVE BEEN SET BELOW THE RATE OF INFLATION AND ACTUALLY NEGATIVE IN RECENT YEARS RESULTING IN A SHORTFALL THAT HAS GROWN OVER TIME. THE COMPOUNDING ISSUE THAT OCCURS IS THAT THIS SHORTFALL JEOPARDIZES HOSPITALS' ABILITY TO SERVE THEIR COMMUNITIES BECAUSE THEY ARE NOT REIMBURSED THEIR INCURRED COSTS. PROVIDERS MAKE THE DECISION TO ELIMINATE OR SIGNIFICANTLY REDUCE NECESSARY CLINICAL SERVICES WITHIN THE MARKETPLACE PLACING THE MEDICARE SHORTFALL BURDEN ON OTHERS THAT DO, SUCH AS FRANCISCAN. GIVEN THAT FRANCISCAN PROVIDES SUCH SERVICES TO MEDICARE PATIENTS KNOWING THAT THEY WILL RESULT IN A LOSS, AND GIVEN THAT FRANCISCAN BELIEVES THAT IT PROVIDES THESE SERVICES IN AN EFFICIENT AND COST EFFECTIVE MANNER, THE SHORTFALL REPORTED ON LINE 7 OF PART III SHOULD BE VIEWED AS COMMUNITY BENEFIT PROVIDED BY FRANCISCAN. ------------------------------------------------ SCHEDULE H, PART III, LINE 9B FRANCISCAN ALLIANCE, INC.'S WRITTEN CHARITY CARE AND UNINSURED PATIENT DISCOUNT POLICY AND PATIENT COLLECTION PROCEDURE INCLUDE VARIOUS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE CERTAIN COLLECTION PRACTICES DO NOT APPLY. ------------------------------------------------ SCHEDULE H, PART IV NAME OF ENTITY: MOORESVILLE ENDOSCOPY CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: ENDOSCOPY SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 50.00000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 50.00000 NAME OF ENTITY: INDIANA SLEEP CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: SLEEP CENTER ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 50.00000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 50.00000 NAME OF ENTITY: FRANCISCAN SURGERY CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: SURGICAL SERVICES ORGANIZATION'S PROFIT % OR STOCK OWNERSHIP %: 50.44000 OFFICERS, DIRECTORS, TRUSTEES. ETC. PROFIT % OR STOCK OWNERSHIP %: 0 PHYSICIANS' PROFIT % OR STOCK OWNERSHIP %: 49.56000 NAME OF ENTITY: SOUTH EMERSON SURGERY CENTER LLC DESCRIPTION OF PRIMARY ACTIVITY OF ENTITY: SURGICAL SERVICES ORGANIZATION'S PRO

Schedule H (Form 990) 2018

Additional Data

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

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? .........

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 nonfixed
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) 2018

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)
1KEVIN D LEAHY PRESIDENT AND TRUSTEE	(i) (ii)	1,825,836 ------------- 0	0 ------------- 0	108,616 ------------- 0	-17,664 ------------- 0	24,996 ------------- 0	1,941,784 ------------- 0	0 ------------- 0
2EUGENE C DIAMOND SR VP/COO INPATIENT SERVICES	(i) (ii)	1,022,775 ------------- 0	0 ------------- 0	56,383 ------------- 0	-208,495 ------------- 0	32,263 ------------- 0	902,926 ------------- 0	0 ------------- 0
3ROBERT J BRODY SR VP/COO AMBULATORY SERVICES	(i) (ii)	1,021,775 ------------- 0	0 ------------- 0	50,321 ------------- 0	-36,227 ------------- 0	30,929 ------------- 0	1,066,798 ------------- 0	0 ------------- 0
4JENNIFER P MARION SENIOR VP FINANCE, CFO	(i) (ii)	902,542 ------------- 0	0 ------------- 0	294,544 ------------- 0	-186,132 ------------- 0	31,663 ------------- 0	1,042,617 ------------- 0	0 ------------- 0
5JAIRO CRUZ MD PHYSICIAN (UNPAID TRUSTEE)	(i) (ii)	232,547 ------------- 0	0 ------------- 0	23,539 ------------- 0	0 ------------- 0	15,794 ------------- 0	271,880 ------------- 0	0 ------------- 0
6ARNOLD KIMMEL FMR PRES/CEO - OLYMPIA FIELDS	(i) (ii)	0 ------------- 0	0 ------------- 0	314,417 ------------- 0	-8,745 ------------- 0	1,166 ------------- 0	306,838 ------------- 0	0 ------------- 0
7THOMAS GRYZBEK SR VP OF POST ACUTE SRVCS DIV	(i) (ii)	627,783 ------------- 0	0 ------------- 0	50,884 ------------- 0	-201,975 ------------- 0	21,812 ------------- 0	498,504 ------------- 0	0 ------------- 0
8ROWLAND O MBAOMA PHYSICIAN	(i) (ii)	1,826,784 ------------- 0	0 ------------- 0	12,735 ------------- 0	6,652 ------------- 0	22,035 ------------- 0	1,868,206 ------------- 0	0 ------------- 0
9NADEEM IKHLAQUE PHYSICIAN	(i) (ii)	1,406,571 ------------- 0	0 ------------- 0	13,613 ------------- 0	1,390 ------------- 0	22,054 ------------- 0	1,443,628 ------------- 0	0 ------------- 0
10TERRENCE E WILSON PRESIDENT/CEO - LAFAYETTE	(i) (ii)	797,942 ------------- 0	0 ------------- 0	466,707 ------------- 0	-114,277 ------------- 0	29,355 ------------- 0	1,179,727 ------------- 0	0 ------------- 0
11JAMES J SIEGERT PHYSICIAN	(i) (ii)	1,100,281 ------------- 0	0 ------------- 0	26,405 ------------- 0	0 ------------- 0	23,310 ------------- 0	1,149,996 ------------- 0	0 ------------- 0
12NEEL JAIN PHYSICIAN	(i) (ii)	1,066,348 ------------- 0	35,000 ------------- 0	24,155 ------------- 0	-1,272 ------------- 0	23,115 ------------- 0	1,147,346 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
SCHEDULE J, PART II, COLUMN (C)	Deferred compensation reported in this column includes change in present value of the qualified defined benefit plan. Changes in the amount reflected between years is primarily a function of the fluctuation in the actuarial discount rate used to measure this future liability.

Schedule J (Form 990) 2018

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
FRANCISCAN ALLIANCE INC

Employer identification number
35-1330472

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDIANA FINANCE AUTHORITY (08C)	35-1602316	45470YAX9	09-15-2008	291,837,375	REFUND PRIOR ISSUE DATED 5/2/06	X			X		X
B	INDIANA FINANCE AUTHORITY (08F)	35-1602316	45470YBE0	10-10-2008	279,345,000	REFUND PRIOR ISSUE DATED 11/20/03		X		X		X
C	INDIANA FINANCE AUTHORITY (O8IJ)	35-1602316	45470YBL4	11-20-2008	81,850,000	REFUND PRIOR ISSUE DATED 5/16/06		X		X		X
D	INDIANA FINANCE AUTHORITY (09A)	35-1602316	45470YCF6	11-05-2009	221,309,385	REFUNDING AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (12AB)	35-1602316		05-25-2012	82,620,000	REFUND PRIOR ISSUES DATED '01&'08		X		X		X
	INDIANA FINANCE AUTHORITY (14A)	35-1602316		06-02-2014	50,000,000	REFUND PRIOR ISSUES DATED '08		X		X		X
	INDIANA FINANCE AUTHORITY (16AB)	35-1602316	45470YCJ8	02-04-2016	295,426,956	REFUNDING AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (16CDE)	35-1602316		10-19-2016	223,085,000	REFUNDING PRIOR ISSUE		X		X		X
	INDIANA FINANCE AUTHORIY (17A)	35-1602316		10-31-2017	45,250,000	REFUND 2008G BONDS		X		X		X
	INDIANA FINANCE AUTHORITY (17BC)	35-1602316	45470YET4	12-28-2017	385,659,962	REFUND 2009A AND NEW PROJECTS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	66,942,375		234,145,000		9,870,000		217,999,385
2 Amount of bonds legally defeased ..............	192,625,000		0		0		0
3 Total proceeds of issue ..................	290,462,634		278,919,324		81,693,875		219,392,897
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	1,505,785		503,876		1,120,800		792,500
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		124,873,123		0		218,600,397
11 Other spent proceeds .............	288,956,849		151,542,325		80,573,075		0
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............			2011		2012		2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0.840 %		0.100 %		1.200 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.030 %		0.030 %		0.020 %		0.130 %
6 Total of lines 4 and 5 .............	0.870 %		0.870 %		0.120 %		1.330 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............	X		X		X			X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X	X			X	X
c No rebate due? .........	X			X	X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X		X			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?	X			X	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference

Explanation

SCHEDULE K, PART II, LINE 13

FOR THE INDIANA FINANCE AUTHORITY 2008C, INDIANA FINANCE AUTHORITY 2012A/B, INDIANA FINANCE AUTHORITY 2014A, INDIANA FINANCE AUTHORITY 2016C/D/E, AND INDIANA FINANCE AUTHORITY 2017A BONDS, THESE BONDS SOLELY REFUNDED PRIOR ISSUES, SO THE YEAR OF SUBSTANTIAL COMPLETION HAS NOT BEEN ENTERED. SCHEDULE K, PART III FOR THE INDIANA FINANCE AUTHORITY 2008C BONDS, PART III IS NOT COMPLETED SINCE ALL BOND PROCEEDS WERE USED TO REFUND BONDS ISSUED BEFORE JANUARY 1, 2003. SCHEDULE K, PART III, LINE 8B FOR THE INDIANA FINANCE AUTHORITY 2008F, 2008I/J, AND 2012A/B BONDS, DURING 2012, THE DISPOSITION PROCEEDS FOR THE DISPOSED OF BOND-FINANCED PROPERTY WAS $1.00, WHICH WAS WELL BELOW A TENTH OF A PERCENT OF EACH ISSUE. SCHEDULE K, PART III, LINE 8C FRANCISCAN ALLIANCE, THE INDIANA FINANCE AUTHORITY, AND THE IRS ENTERED INTO A CLOSING AGREEMENT TO ADDRESS THE REQUIRED REMEDIAL ACTION UNDER REGULATIONS SECTION 1.142-12 AND 1.145-2. SCHEDULE K, PART IV, LINE 2C FOR EACH OF THE FOLLOWING BONDS, THE REBATE COMPUTATION WAS PERFORMED: SERIES 2008C - JANUARY 2011 AND SERIES 2008I/J - FEBRUARY 2011.

SCHEDULE K, PART IV, LINE 5

FOR THE INDIANA FINANCE AUTHORITY 2008C AND INDIANA FINANCE AUTHORITY 2008I/J ISSUES, ONLY SMALL AMOUNTS OF PROCEEDS RELATED TO THE COST OF ISSUANCE WERE NOT EXPENDED AT THE END OF THE TEMPORARY PERIODS.

Schedule K (Form 990) 2018

Additional Data

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
FRANCISCAN ALLIANCE INC

Employer identification number
35-1330472

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDIANA FINANCE AUTHORITY (08C)	35-1602316	45470YAX9	09-15-2008	291,837,375	REFUND PRIOR ISSUE DATED 5/2/06	X			X		X
B	INDIANA FINANCE AUTHORITY (08F)	35-1602316	45470YBE0	10-10-2008	279,345,000	REFUND PRIOR ISSUE DATED 11/20/03		X		X		X
C	INDIANA FINANCE AUTHORITY (O8IJ)	35-1602316	45470YBL4	11-20-2008	81,850,000	REFUND PRIOR ISSUE DATED 5/16/06		X		X		X
D	INDIANA FINANCE AUTHORITY (09A)	35-1602316	45470YCF6	11-05-2009	221,309,385	REFUNDING AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (12AB)	35-1602316		05-25-2012	82,620,000	REFUND PRIOR ISSUES DATED '01&'08		X		X		X
	INDIANA FINANCE AUTHORITY (14A)	35-1602316		06-02-2014	50,000,000	REFUND PRIOR ISSUES DATED '08		X		X		X
	INDIANA FINANCE AUTHORITY (16AB)	35-1602316	45470YCJ8	02-04-2016	295,426,956	REFUNDING AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (16CDE)	35-1602316		10-19-2016	223,085,000	REFUNDING PRIOR ISSUE		X		X		X
	INDIANA FINANCE AUTHORIY (17A)	35-1602316		10-31-2017	45,250,000	REFUND 2008G BONDS		X		X		X
	INDIANA FINANCE AUTHORITY (17BC)	35-1602316	45470YET4	12-28-2017	385,659,962	REFUND 2009A AND NEW PROJECTS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	66,942,375		234,145,000		9,870,000		217,999,385
2 Amount of bonds legally defeased ..............	192,625,000		0		0		0
3 Total proceeds of issue ..................	290,462,634		278,919,324		81,693,875		219,392,897
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	1,505,785		503,876		1,120,800		792,500
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		124,873,123		0		218,600,397
11 Other spent proceeds .............	288,956,849		151,542,325		80,573,075		0
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............			2011		2012		2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0.840 %		0.100 %		1.200 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.030 %		0.030 %		0.020 %		0.130 %
6 Total of lines 4 and 5 .............	0.870 %		0.870 %		0.120 %		1.330 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............	X		X		X			X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X	X			X	X
c No rebate due? .........	X			X	X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X		X			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?	X			X	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference

Explanation

SCHEDULE K, PART II, LINE 13

SCHEDULE K, PART IV, LINE 5

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
FRANCISCAN ALLIANCE INC

Employer identification number
35-1330472

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	INDIANA FINANCE AUTHORITY (08C)	35-1602316	45470YAX9	09-15-2008	291,837,375	REFUND PRIOR ISSUE DATED 5/2/06	X			X		X
B	INDIANA FINANCE AUTHORITY (08F)	35-1602316	45470YBE0	10-10-2008	279,345,000	REFUND PRIOR ISSUE DATED 11/20/03		X		X		X
C	INDIANA FINANCE AUTHORITY (O8IJ)	35-1602316	45470YBL4	11-20-2008	81,850,000	REFUND PRIOR ISSUE DATED 5/16/06		X		X		X
D	INDIANA FINANCE AUTHORITY (09A)	35-1602316	45470YCF6	11-05-2009	221,309,385	REFUNDING AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (12AB)	35-1602316		05-25-2012	82,620,000	REFUND PRIOR ISSUES DATED '01&'08		X		X		X
	INDIANA FINANCE AUTHORITY (14A)	35-1602316		06-02-2014	50,000,000	REFUND PRIOR ISSUES DATED '08		X		X		X
	INDIANA FINANCE AUTHORITY (16AB)	35-1602316	45470YCJ8	02-04-2016	295,426,956	REFUNDING AND NEW PROJECTS		X		X		X
	INDIANA FINANCE AUTHORITY (16CDE)	35-1602316		10-19-2016	223,085,000	REFUNDING PRIOR ISSUE		X		X		X
	INDIANA FINANCE AUTHORIY (17A)	35-1602316		10-31-2017	45,250,000	REFUND 2008G BONDS		X		X		X
	INDIANA FINANCE AUTHORITY (17BC)	35-1602316	45470YET4	12-28-2017	385,659,962	REFUND 2009A AND NEW PROJECTS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	66,942,375		234,145,000		9,870,000		217,999,385
2 Amount of bonds legally defeased ..............	192,625,000		0		0		0
3 Total proceeds of issue ..................	290,462,634		278,919,324		81,693,875		219,392,897
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	1,505,785		503,876		1,120,800		792,500
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		124,873,123		0		218,600,397
11 Other spent proceeds .............	288,956,849		151,542,325		80,573,075		0
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............			2011		2012		2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X		X		X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0.840 %		0.100 %		1.200 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.030 %		0.030 %		0.020 %		0.130 %
6 Total of lines 4 and 5 .............	0.870 %		0.870 %		0.120 %		1.330 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............	X		X		X			X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X	X			X	X
c No rebate due? .........	X			X	X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X		X			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?	X			X	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference

Explanation

SCHEDULE K, PART II, LINE 13

SCHEDULE K, PART IV, LINE 5

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- 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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Return Reference	Explanation
FORM 990, HEADING, BOX B	FRANCISCAN ALLIANCE, INC. IS FILING THIS AMENDED RETURN TO INCORPORATE INFORMATION REPORTED ON SCHEDULES K-1 THAT WERE RECEIVED AFTER THE FILING OF ITS ORIGINAL RETURN. THIS INFORMATION IMPACTED FORM 990, PART VIII, SCHEDULE F, SCHEDULE H, PART IV, AND SCHEDULE R, PARTS III AND V. FRANCISCAN ALLIANCE, INC. IS ALSO FILING THIS AMENDED RETURN TO MORE ACCURATELY REFLECT THE ALLOCATION OF AN EMPLOYEE'S BASE AND OTHER REPORTABLE COMPENSATION ON SCHEDULE J, PART II. THE REPORTED TOTAL COMPENSATION FOR THE EMPLOYEE HAS NOT CHANGED. FORM 990, PART I, LINE 1 FRANCISCAN ALLIANCE, INC.'S ("FRANCISCAN") PURPOSE IS TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND IN PARTNERSHIP WITH OTHERS TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ACTIVITIES DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN. PLEASE VIEW WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH WHICH REFLECTS OUR MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION." FORM 990, PART V, LINE 4B ADDITIONAL FOREIGN COUNTRIES (CONTINUATION OF ATTACHMENT 3) - DENMARK, EGYPT, EUROPEAN UNION, FINLAND, FRANCE, GERMANY, GREECE, HONG KONG, HUNGARY, INDIA, INDONESIA, ISRAEL, ITALY, JAPAN, REPUBLIC OF KOREA (SOUTH KOREA), MALAYSIA, MEXICO, NETHERLANDS, NEW ZEALAND, NORWAY, PERU, PHILIPPINES, POLAND, PORTUGAL, QATAR, RUSSIAN FEDERATION, SINGAPORE, SOUTH AFRICA, SPAIN, SWEDEN, SWITZERLAND, TAIWAN, THAILAND, TURKEY, UNITED ARAB EMIRATES, UNITED KINGDOM. FORM 990, PART VI, SECTION A, LINE 7A THE ENTIRE BOARD OF TRUSTEES SHALL CONSIST OF NO MORE THAN TWENTY (20), AND NO FEWER THAN NINE (9), SEVEN (7) OF WHOM SHALL BE SISTERS OF THE EASTERN PROVINCE ("PROVINCE") OF THE SISTERS OF ST. FRANCIS OF PERPETUAL ADORATION, A RELIGIOUS CONGREGATION OF WOMEN OF THE ROMAN CATHOLIC CHURCH ("CONGREGATION"). THE TRUSTEES OF THE BOARD SHALL INCLUDE THE FOLLOWING PERSONS: (A) THREE TRUSTEES SHALL BE MEMBERS OF THE PROVINCIAL LEADERSHIP OF THE PROVINCE, ONE OF WHOM SHALL BE THE PROVINCIAL, OR HER DESIGNEE, AND THE REMAINING TWO SHALL BE APPOINTED BY THE PROVINCIAL LEADERSHIP; (B) THE MEMBER OF THE CORPORATION SERVING AS TREASURER OF THE PROVINCE WHO MAY ALSO BE ONE OF THE PROVINCIAL LEADERSHIP REPRESENTATIVES AS DESCRIBED IN (A); (C) THE MEMBER OF THE CORPORATION SERVING AS SPONSOR LIAISON FOR HEALTHCARE OF THE PROVINCE WHO MAY ALSO BE ONE OF THE PROVINCIAL LEADERSHIP REPRESENTATIVES AS DESCRIBED IN (A); (D) THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION; AND (E) THE TRUSTEES ELECTED BY THE MEMBERS TO FILL THE REMAINING POSITIONS.
FORM 990, PART VI, SECTION A, LINE 7B	NO ACTION ON THE PART OF THE BOARD OF TRUSTEES IN RESPECT OF ANY OF THE FOLLOWING MATTERS SHALL BE EFFECTIVE UNLESS THE ACTION HAS BEEN APPROVED BY A MAJORITY OF THE MEMBERS; NAMELY: (A) CORPORATE MISSION AND PHILOSOPHY; (B) APPOINTMENT OR REMOVAL OF THE CHAIRPERSON, PRESIDENT, SECRETARY, OR TREASURER OF THE CORPORATION; (C) ALIENATION OF PROPERTY AS DEFINED IN CANON LAW; OR (D) ENCUMBRANCE OF DEBT AS DEFINED BY CANON LAW.
FORM 990, PART VI, SECTION B, LINE 11B	THE INFORMATION TO PREPARE THE FORM 990 OF FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") IS GATHERED BY FINANCE STAFF AND MISSION REPRESENTATIVES AND PROVIDED TO ITS ACCOUNTING FIRM WHO PREPARES THE RETURN. SENIOR MANAGEMENT THEN REVIEWS THE RETURN PRIOR TO FILING. THE FORM 990 IS ALSO MADE AVAILABLE TO FRANCISCAN'S BOARD OF TRUSTEES PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	The Corporation requires annual conflict of interest statements from each director, principal officer, members of committees with board designated powers, key employees, and executive leadership committee members which affirms that they have received, read, and understand the conflict of interest policy and have agreed to comply with the policy. In connection with any actual or possible conflict of interest, a director, principal officer or member of a committee with board designated powers must disclose the existence and nature of the financial interest to the directors and members of committees with board delegated powers considering the proposed transaction or arrangements. After disclosure of the financial interest, the director, principal or committee member shall leave the board or committee meeting while the financial interest is discussed and vote taken. In addition, ongoing reviews and assessments are made to make certain that the Corporation operates in a manner consistent with its charitable purposes. In conducting the ongoing reviews and assessments, the Corporation uses internal and external advisors. Reviews include compensation arrangements, acquisitions, partnerships, joint venture arrangements, and agreements to provide health care products/services, etc.
FORM 990, PART VI, SECTION B, LINE 15	Franciscan Alliance, Inc.'s ("Franciscan") process for determining compensation for the organization's President/CEO, officers and key employees consists of periodic external reviews completed by national independent compensation consultants. The Executive Committee of the Board of Trustees approves the proposed compensation and benefits at an annual compensation review meeting held each year. The organization's President/CEO recuses himself from the vote on executive compensation. FORM 990, PART VII, SECTION A, COLUMN (F) Deferred compensation reported in this column includes change in present value of the qualified defined benefit plan. Changes in the amount reflected between years is primarily a function of the fluctuation in the actuarial discount rate used to measure this future liability. FORM 990, PART X, LINES 27 AND 29 DURING 2018, FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") ADOPTED THE NEW FINANCIAL ACCOUNTING STANDARDS BOARD ACCOUNTING STANDARD UPDATE THAT MODIFIED THE PRESENTATION OF NOT-FOR-PROFIT FINANCIAL STATMENTS. AS SUCH THE ADOPTION OF THIS STANDARD REQUIRED A CHANGE TO THE AMOUNTS OF THE BEGINNING BALANCE OF ITS NET ASSETS. HOWEVER, THE TOTAL NET ASSETS FOR THE BEGINNING OF THE YEAR REMAINS UNCHANGED. LINE 27 REPORTS NET ASSETS WITHOUT DONOR RESTRICTIONS AND LINE 29 REPORTS NET ASSETS WITH DONOR RESTRICTIONS, AS PROVIDED IN THE FORM 990 INSTRUCTIONS.
FORM 990, PART XI, LINE 9	EQUITY IN EARNINGS OF AFFILIATES 40,935,506 MINORITY INTEREST IN AFFILIATES 185,200 EQUITY TRANSFERS TO/FROM AFFILIATES (10,220,980) UNREALIZED GAIN ON SWAP CONTRACTS 4,226,575 UNREALIZED LOSS - HILLS (16,354,339) CHANGE IN NONCONTROLLING INTEREST IN SUBS (5,185,200) CHANGE IN DONOR RESTRICTED NET ASSETS 51,573 DIVIDENDS RECEIVED FROM AFFILIATES 3,897,409 OTHER COMPREHENSIVE INCOME (25,934,196) OTHER CHANGES IN NET ASSETS (404,837) ------------- TOTAL OTHER CHANGES IN NET ASSETS (8,653,815)

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

FRANCISCAN ALLIANCE INC

Employer identification number

35-1330472

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) ST FRANCIS INSURANCE SERVICES LLC 1600 ALBANY STREET BEECH GROVE,IN46107 20-0048077	INSURANCE	IN	874,038	0	FRANCISCAN
(2) SPECIALTY PHYSICIANS OF ILLINOIS LLC 333 DIXIE HIGHWAY CHICAGO HEIGHTS,IL60411 05-0540914	PHYSICIAN	IL	20,308,000	5,500,000	FRANCISCAN
(3) FAITH HOPE AND LOVE CANCER CENTER LLC 1250 SOUTH CREASY LN STE A LAFAYETTE,IN47905 68-0612977	MEDICAL SRVCS	IN	0	0	FRANCISCAN
(4) ST FRANCIS MEDICAL GROUP LLC 5330 E STOP 11 RD INDIANAPOLIS,IN46237 26-3877295	MEDICAL SRVCS	IN	0	0	FRANCISCAN
(5) FRANCISCAN PHO CENTRAL INDIANA LLC 1515 DRAGOON TRAIL MISHAWAKA,IN46544 82-2534628	ACCOUNT. CARE	IN	0	0	FRANCISCAN
(6) FRANCISCAN PHO NORTHERN INDIANA LLC 1515 DRAGOON TRAIL MISHAWAKA,IN46544 82-2537889	ACCOUNT. CARE	IN	0	0	FRANCISCAN

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)HILLS INSURANCE COMPANY INC 1515 DRAGOON TRAIL MISHAWAKA,IN46544 03-0372512	CAPTIVE INS	VT	501(C)(3)	12-TYPE 1	FRANCISCAN	Yes
(2)SISTERS OF ST FRANCIS OF PERPETUAL ADOR PO BOX 766 MISHAWAKA,IN46546 35-1328145	RELIGIOUS	IN	501(C)(3)	1	NA		No
(3)ST ALEXIS HOSPITAL ASSOCIATION PO BOX 1290 MISHAWAKA,IN46546 34-0714485	SUPPORT ALEXA	OH	501(C)(3)	3	FRANCISCAN	Yes
(4)FRANCISCAN HEALTH FOUNDATION INC 1515 DRAGOON TRAIL MISHAWAKA,IN46544 35-1955283	FUNDRAISING	IN	501(C)(3)	7	FRANCISCAN	Yes
(5)FRANCISCAN VNS HOME CARE INC 4701 N KEYSTONE AVE S418 INDIANAPOLIS,IN46205 35-0868199	HOME HEALTH	IN	501(C)(3)	10	FRANCISCAN	Yes
(6)FRANCISCAN PERSONAL CARE INC 4701 N KEYSTONE AVE S418 INDIANAPOLIS,IN46205 35-2107306	HEALTHCARE	IN	501(C)(3)	10	FRANCISCAN	Yes
(7)FRANCISCAN HEALTH RENSSELAER INC 1104 E GRACE ST RENSSELAER,IN47978 47-3825106	HEALTH SRVCS	IN	501(C)(3)	3	FRANCISCAN	Yes
(8)FRANCISCAN ACO INC 700 E SOUTHPORT ROAD INDIANAPOLIS,IN46227 35-1904455	HEALTHCARE	IN	501(C)(3)	12-TYPE 1	FRANCISCAN	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

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) FRANCISCAN SURGERY CENTER LLC 421 N EMERSON AVE BEECH GROVE,IN46143 35-2128334	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	10,131,638	6,868,385		No	0		No	50.440 %
(2) LAFAYETTE HEART PROGRAM HOLDINGS LLC 1501 HARTFORD STREET LAFAYETTE,IN47904 38-3750811	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	3,101,987	14,397,410			0			51.000 %
(3) ST FRANCIS MOORESVILLE SURGERY CTR LLC 1215 HADLEY ROAD SUITE 100 MOORESVILLE,IN46158 20-2256900	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	1,735,993	1,633,036	Yes		0		No	52.590 %
(4) ST FRANCIS RADIATION THERAPY CENTERS LLC 421 N EMERSON AVE GREENWOOD,IN46143 77-0663631	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	5,092,713	6,286,219		No	0		No	88.950 %
(5) ST FRANCIS IMAGING CTR (GREENWOOD) LLC 421 N EMERSON AVE GREENWOOD,IN46143 20-4607426	IMAGING SERVI	IN	FRANCISCAN	RELATED	634,390	516,058		No	0		No	60.000 %
(6) TONN & BLANK CONSTRUCTION LLC 1623 GREENWOOD AVENUE MICHIGAN CITY,IN46360 26-3919039	CONSTRUCTION	IN	FHC	RELATED	9,226,975	57,880,538		No	128,871		No	75.570 %
(7) MAJOR HOSP CARDIAC DIAGNOSTICS LLC 2451 INTELLIPLEX DR SHELBYVILLE,IN46176 20-8715441	MEDICAL SERVICES	IN	FRANCISCAN	RELATED	529,338	263,245		No	0		No	53.600 %

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) FRANCISCAN HOLDING CORPORATION 1515 DRAGOON TRAIL MISHAWAKA,IN46544 36-3593505	HOLDING CO.	IN	FRANCISCAN	C CORP	3,053,002	83,103,569	100.000 %	Yes
(2) ST JAMES PHO INC 30 E 11TH ST SUITE 402 CHICAGO HEIGHTS,IL60411 36-3945083	MANAGED CARE	IL	FRANCISCAN	C CORP	0	0	0 %	Yes

Schedule R (Form 990) 2018

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) ............................

Yes

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

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

Yes

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) ......................

Yes

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) .................

Yes

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

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

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

Yes

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

Yes

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
(1) FRANCISCAN HEALTH FOUNDATION INC	C	4,620,754	FMV
(2) LAFAYETTE HEART PROGRAM HOLDINGS LLC	C	3,101,987	FMV
(3) FRANCISCAN SURGERY CENTER LLC	C	9,319,500	FMV
(4) MAJOR HOSPITAL CARDIAC DIAGNOSTICS LLC	C	400,000	FMV
(5) ST FRANCIS IMAGING CENTER (GREENWOOD) LLC	C	636,060	FMV
(6) ST FRANCIS MOORESVILLE SURGERY CENTER LLC	B	297,260	FMV
(7) ST FRANCIS MOORESVILLE SURGERY CENTER LLC	C	1,726,200	FMV
(8) ST FRANCIS RADIATION THERAPY CENTERS LLC	C	5,646,235	FMV
(9) THE ENDOSCOPY CENTER AT ST FRANCIS LLC	C	4,316,473	FMV
(10) TONN AND BLANK CONSTRUCTION LLC	C	3,897,408	FMV

Schedule R (Form 990) 2018

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) 2018

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) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	22,482
6	Total number of volunteers (estimate if necessary) .............	6	1,568
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	7,551,802
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	6,086,262	4,976,529
9	Program service revenue (Part VIII, line 2g) .........	2,779,324,389	2,964,191,691
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	151,830,351	171,789,418
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,052,408	5,118,774
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,943,293,410	3,146,076,412
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	1,387,129,094	1,418,623,960
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,407,001,145	1,470,618,953
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,794,130,239	2,889,242,913
19	Revenue less expenses. Subtract line 18 from line 12.......	149,163,171	256,833,499
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	5,192,782,915	5,106,168,565
21	Total liabilities (Part X, line 26).............	2,032,064,049	1,970,061,989
22	Net assets or fund balances. Subtract line 21 from line 20.....	3,160,718,866	3,136,106,576

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 2,387,098,083 including grants of $ 0 ) (Revenue $ 2,955,959,031 )
	FOR OVER 140 YEARS, FRANCISCAN ALLIANCE, INC. ("FRANCISCAN") HAS ENDEAVORED TO STAY TRUE TO OUR FOUNDING MISSION OF CARING FOR PATIENTS WHO COME THROUGH OUR DOORS AND WE CONTINUE TO LOOK FOR OPPORTUNITIES TO SERVE OUR COMMUNITIES THROUGH THE VERY BEST IN MEDICAL CARE AND SERVICE TO THE LESS FORTUNATE AMONG US. FRANCISCAN'S PURPOSE IS TO CONTINUE THE HEALING MINISTRY OF CHRIST IN ACCORDANCE WITH THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH AND IN PARTNERSHIP WITH OTHERS TO PROVIDE A FULL CONTINUUM OF HEALTH CARE SERVICES; TO CARRY ON EDUCATIONAL ACTIVITIES RELATED TO THE PROMOTION OF HEALTH; TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO HEALTH CARE; AND TO PARTICIPATE IN ACTIVITIES DESIGNED AND CONDUCTED TO PROMOTE THE GENERAL HEALTH OF THOSE SERVED BY FRANCISCAN. FRANCISCAN DIRECTLY OR INDIRECTLY OPERATES 12 HOSPITAL CAMPUSES (ONE IN ILLINOIS AND ELEVEN IN INDIANA) ALONG WITH NUMEROUS PHYSICIAN CLINICS AND ANCILLARY SERVICES CENTERS AND OFFERS NUMEROUS COMMUNITY HEALTH IMPROVEMENT PROGRAMS THAT ARE FURTHER DESCRIBED BELOW. IN 2018, FRANCISCAN SERVED OVER 2.3 MILLION PERSONS AND PROVIDED OVER $721 MILLION IN CHARITY CARE AND OTHER COMMUNITY BENEFITS. FRANCISCAN PROVIDES SIGNIFICANT BENEFITS THAT REFLECT THE ORGANIZATION'S COMMITMENT TO HEALTHCARE AND THE COMMUNITIES IT IS PRIVILEGED TO SERVE. IN 2018, FRANCISCAN PROVIDED COMMUNITY BENEFITS WHICH INCLUDED: UNREIMBURSED COSTS OF MEDICAID AND OTHER INDIGENT CARE PROGRAMS $131,803,000 COST OF CHARITY CARE PROVIDED $ 96,426,000 OTHER BENEFITS FOR THE POOR AND UNDERSERVED $ 6,256,000 SUBSIDIZED HEALTH SERVICES $ 40,091,000 HEALTH PROFESSIONS EDUCATION $ 14,657,000 COMMUNITY HEALTH IMPROVEMENT SERVICES $ 5,508,000 FINANCIAL AND IN-KIND CONTRIBUTIONS $ 1,408,000 RESEARCH $ 1,639,000 COMMUNITY BUILDING ACTIVITIES $ 1,783,000 COMMUNITY BENEFIT OPERATIONS $ 315,000 UNREIMBURSED COSTS OF MEDICARE $421,646,000 _______________ TOTAL $721,532,000 WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH REFLECTS FRANCISCAN'S MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION." ALTHOUGH IT IS NOT ALL INCLUSIVE OF THE MANY BENEFITS PROVIDED BY FRANCISCAN IT DOES PORTRAY THE SIGNIFICANT BENEFITS THAT REFLECT OUR COMMITMENT TO HEALTHCARE AND THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. WWW.FRANCISCANHEALTH.ORG/COMMUNITYHEALTH REFLECTS FRANCISCAN'S MISSION OF "CONTINUING CHRIST'S MINISTRY IN OUR FRANCISCAN TRADITION." ALTHOUGH IT IS NOT ALL INCLUSIVE OF THE MANY BENEFITS PROVIDED BY FRANCISCAN IT DOES PORTRAY THE SIGNIFICANT BENEFITS THAT REFLECT OUR COMMITMENT TO HEALTHCARE AND THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. THE FOLLOWING IS A SUBSET OF THE MANY CLINICAL SERVICES AS WELL AS POPULATION HEALTH IMPROVEMENT AND COMMUNITY OUTREACH ACTIVITIES OFFERED BY ONE OR MORE OF FRANCISCAN'S HEALTHCARE FACILITIES: - INPATIENT HOSPITAL SERVICES INCLUDING: MEDICAL SERVICES, SURGICAL SERVICES, INTENSIVE CARE SERVICES, TELEMETRY SERVICES, OBSTETRICS SERVICES, PEDIATRICS SERVICES, NEONATAL INTENSIVE CARE SERVICES, ACUTE REHABILITATION SERVICES, ONCOLOGY SERVICES, BONE MARROW TRANSPLANT SERVICES, GENERAL SURGERY SERVICES, CARDIAC SURGERY SERVICES, VASCULAR SERVICES, PULMONARY SERVICES, INTERVENTIONAL RADIOLOGY, ORTHOPEDICS, JOINT AND SPINE CARE, GASTROINTESTINAL CARE, NEUROSCIENCES SERVICES, COLON AND RECTAL SERVICES, ANESTHESIA SERVICES, HOSPICE SERVICES, INPATIENT PSYCHIATRIC CARE, RESIDENTIAL TREATMENT PROGRAM FOR ADOLESCENTS, ETC. - EMERGENCY SERVICES INCLUDING: 24 HOUR EMERGENCY ROOM SERVICES, AMBULANCE SERVICES, IMMEDIATE CARE SERVICES, ADVANCED LIFE SUPPORT SERVICES, BASIC LIFE SUPPORT SERVICES, BEHAVIORAL HEALTH EMERGENCY CONSULTATION SERVICES, 24-HOUR CRISIS AND REFERRAL HOTLINE, TRAUMA SERVICES, ETC. - OUTPATIENT SERVICES INCLUDING: LABORATORY SERVICES, PHYSICAL THERAPY SERVICES, OCCUPATIONAL THERAPY SERVICES, SPEECH THERAPY SERVICES, GENERAL RADIOLOGY SERVICES, COMPUTED TOMOGRAPHY SERVICES, MAGNETIC RESONANCE IMAGING (MRI), NUCLEAR MEDICINE SERVICES, MAMMOGRAPHY SERVICES, ANGIOGRAPHY SERVICES, NEURODIAGNOSTICS SERVICES, GASTRO/INTESTINAL SERVICES, SLEEP LABORATORY, PULMONARY SERVICES, OUTPATIENT SURGERY, CARDIAC TESTING, ELECTROCARDIOGRAM (EKG) SERVICES, MEDICAL ONCOLOGY SERVICES, RADIATION ONCOLOGY SERVICES, PHARMACY, OCCUPATIONAL MEDICINE SERVICES, CARDIAC/PULMONARY REHABILITATION SERVICES, CONGESTIVE HEART FAILURE CLINIC, WOUND HEALING AND PREVENTION, NUTRITIONAL COUNSELING, DIABETES MANAGEMENT, BARIATRIC SERVICES, PAIN MANAGEMENT, SOCIAL SERVICES, PALLIATIVE CARE, SPORTS MEDICINE, BEHAVIORAL HEALTH, STROKE SERVICES, HOME HEALTH SERVICES, SKILLED NURSING SERVICES, SOCIAL SERVICES, DURABLE MEDICAL EQUIPMENT. - PRIMARY CARE AND SPECIALTY CARE PHYSICIAN CLINICS. SUBSIDIZED HEALTHCARE SERVICES OFFERED BY FRANCISCAN: - FRANCISCAN HAS NEIGHBORHOOD HEALTH CLINICS THAT OFFER FAMILY PRACTICE SERVICES DESIGNED FOR FAMILIES WITHOUT ACCESS TO AFFORDABLE HEALTH CARE. THE FOCUS IS ON PROVIDING PRIMARY AND PREVENTIVE CARE AS WELL AS HEALTH EDUCATION. THESE CLINICS OFFER FREE IMMUNIZATIONS. - FRANCISCAN'S SEXUAL ASSAULT CLINICS THAT PROVIDE MEDICAL AND FORENSIC ASSISTANCE THAT IS SENSITIVE TO THE SPECIAL NEEDS OF THE VICTIM AS WELL AS A VICTIM ADVOCATE PROGRAM AND CRISIS INTERVENTION COUNSELORS. - FRANCISCAN'S BLOOD AND MARROW TRANSPLANT PROGRAM IS ONLY ONE OF TWO PROGRAMS IN INDIANA OFFERING FULL SERVICE TRANSPLANT CARE AND SPECIALIZES IN THE TREATMENT OF PATIENTS WITH LEUKEMIA, HODGKIN'S OR NON-HODGKIN'S LYMPHOMA, MULTIPLE MYELOMA, AND MANY OTHER MALIGNANCIES AND BLOOD DISORDERS. - FRANCISCAN'S DIABETES EDUCATION CENTERS OFFER A NUMBER OF DIABETES CLASSES AND INDIVIDUALIZED SESSIONS TO HELP PATIENTS TAKE CONTROL OF THEIR HEALTH WITH A FOCUS ON NUTRITIONAL, EXERCISE, MEDICATIONS, CHRONIC CONDITIONS, PRECONCEPTION AND PREGNANCY, BLOOD GLUCOSE MONITORING, GOAL SETTING, PROBLEM SOLVING, PSYCHOSOCIAL ADJUSTMENT, DETECTION/TREATMENT OF HIGH AND LOW BLOOD SUGAR, AND INSULIN ADMINISTRATION. - FRANCISCAN'S WOMEN'S AND CHILDREN'S SERVICES INCLUDE PREVENTIVE MEDICAL CARE AND HEALTH SCREENINGS TO GYNECOLOGICAL CARE, MATERNITY, LACTATION CONSULTATION SERVICES, AND BEYOND WITH A FOCUS ON KEEPING WOMEN HEALTHY. - FRANCISCAN'S HOSPICE CARE SERVICES PROVIDE A SENSE OF DIGNITY AND COMPASSION TO BOTH THE PATIENT AND THEIR FAMILY IN CARING FOR PATIENTS WITH A LIFE EXPECTANCY OF SIX MONTHS OR LESS. OUR PROGRAMS AFFIRM AND CELEBRATE LIFE AND REGARD DYING AS A NATURAL PROCESS, RECOGNIZING THAT EVERY PERSON HAS THE RIGHT TO DIE WITH DIGNITY, PEACE, AND COMFORT REGARDLESS OF THEIR ETHNICITY, FAITH BACKGROUND, OR ABILITY TO PAY. - LEVEL III NICU - AMBULANCE SERVICE - PHYSICIAN SERVICES - INPATIENT PSYCHIATRIC UNITS - HEALTH AND WELLNESS CENTERS AND HEALTHY LIVING EDUCATION CENTERS - CLINICAL CARE COORDINATORS TO SUPPORT FRANCISCAN'S VARIOUS ACCOUNTABLE CARE ORGANIZATIONS WHICH ARE DESIGNED TO IMPROVE QUALITY AND REDUCE COST. - FRANCISCAN SENIOR HEALTH & WELLNESS IS A COMPLETE HEALTH CARE SOLUTION FOR SENIORS WHO WANT TO REMAIN AT HOME. OUR PROGRAM ENABLES SENIORS TO LIVE AS INDEPENDENTLY AS POSSIBLE BY PROVIDING TRULY ALL-INCLUSIVE SERVICES. FRANCISCAN SENIOR HEALTH & WELLNESS IS A PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE), A COMMUNITY-BASED HEALTHCARE PROGRAM CREATED FOR PEOPLE 55 OR OLDER WHO ARE ELIGIBLE FOR NURSING-HOME LEVEL CARE BUT PREFER TO RECEIVE THEIR CARE IN THEIR OWN FAMILIAR SURROUNDINGS. THE FRANCISCAN SENIOR HEALTH & WELLNESS - PACE PROGRAM DELIVERS ALL THE SERVICES NEEDED TO KEEP PEOPLE HEALTHY, SAFE AND COMFORTABLE IN THE PLACE THEY CALL HOME. COVERED BENEFITS INCLUDE: - PRIMARY MEDICAL AND NURSING CARE - OCCUPATIONAL, PHYSICAL, AND SPEECH THERAPY - MEDICATIONS AND DURABLE MEDICAL EQUIPMENT - LABORATORY AND DIAGNOSTIC SERVICES - ALL NECESSARY PRESCRIPTION DRUGS - SKILLED HOME CARE AND PERSONAL CARE AIDES - HOSPITALIZATION AND SKILLED NURSING FACILITY CARE - CARE FROM MEDICAL SPECIALISTS IN CARDIOLOGY, NEPHROLOGY, OPHTHALMOLOGY, DERMATOLOGY, ORTHOPEDICS, SURGERY, PODIATRY, AND MORE - MEDICALLY NECESSARY TRANSPORTATION OUR BROAD RANGE OF SERVICE PROVIDERS, INCLUDING DOCTORS, NURSES, PHARMACISTS, THERAPISTS AND PERSONAL CARE AIDES ARE READILY ACCESSIBLE. THROUGH THESE MEDICAL SERVICES, WE CAN MANAGE THE CARE OF AN AGING LOVED ONE, AND HELP AVOID THE ILLNESSES AND HOSPITALIZATIONS THAT SENIORS OFTEN FACE. IN ADDITION TO ADDRESSING EACH PARTICIPANT'S UNIQUE MEDICAL NEEDS, FRANCISCAN SENIOR HEALTH & WELLNESS ALSO HELPS WITH THE SOCIAL, EMOTIONAL, AND PRACTICAL CHALLENGES THAT OLDER ADULTS OFTEN FACE. THROUGH INTERACTIONS WITH PEERS, STIMULATIVE ACTIVITIES AND OTHER SUPPORTIVE SERVICES, PARTICIPANTS WILL ENJOY A BETTER QUALITY OF LIFE. - BEHAVIORAL HEALTH SERVICES AT FRANCISCAN HEALTH DYER TOUCHES ALL FACETS OF EMOTIONAL, MENTAL HEALTH, BEHAVIORAL HEALTH AND CHEMICAL DEPENDENCY PROBLEMS. WE OFFER TREATMENTS IN PSYCHIATRIC DISORDERS, SUBSTANCE ABUSE AND ADDICTION, FAMILY CONFLICTS, AND EMOTIONAL DISORDERS, INCLUDING TESTING FOR PSYCHOLOGICAL DISORDERS AND CONSULTATIONS. OUR BEHAVIORAL HEALTH SERVICES AND P

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses2,387,098,083

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	13,308,503	0	-488,253

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	4,620,754
e	Government grants (contributions)		1e	100,000

f	All other contributions, gifts, grants, and similar amounts not included above		1f	255,775

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		4,976,529

		Business Code
2a	PATIENT SERVICE AND OTHER REVENUES	900099	2,941,565,464	2,939,537,436	2,028,028
b	PREMIUM REVENUE	900099	16,547,879	16,547,879
c	CAFETERIA	722310	5,594,774		1,982	5,592,792
d	LAUNDRY	812332	483,574	-126,284	609,858
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		2,964,191,691

3 Investment income (including dividends, interest, and othersimilar amounts) ......			172,229,065		2,022,777	170,206,288
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		8,312,118
b	Less: rental expenses		5,965,432
c	Rental income or (loss)	0	2,346,686
d	Net rental income or (loss)......			2,346,686			2,346,686
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	8,215,011
b	Less: cost or other basis and sales expenses	8,654,658
c	Gain or (loss)	-439,647
d	Net gain or (loss).....			-439,647			-439,647
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a		187,759
b	Less: cost of goods sold ..b		304,828
c	Net income or (loss) from sales of inventory..			-117,069			-117,069
Business Code			Miscellaneous Revenue
11a	OTHER OPERATING REVENUE		900099	2,889,157		2,889,157
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,889,157
12	Total revenue. See Instructions......			3,146,076,412	2,955,959,031	7,551,802	177,589,050

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	17,777,026	9,716,040	8,060,986
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	1,104,145,322	842,175,992	261,969,330
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	55,578,568	48,239,448	7,339,120	0
9	Other employee benefits .......	163,522,289	120,112,301	43,409,988
10	Payroll taxes ...........	77,600,755	61,546,242	16,054,513
11	Fees for services (non-employees):
a	Management ......	10,905,952	10,264,949	641,003
b	Legal .........	5,200,636		5,200,636
c	Accounting ...........	1,680,894		1,680,894
d	Lobbying ...........	501,838	1,261	500,577
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	62,439,666	54,450,889	7,988,777
12	Advertising and promotion ....	14,281,811	758,643	13,523,168
13	Office expenses .......	12,909,219	8,810,457	4,098,762
14	Information technology ......	147,390,080	147,390,080
15	Royalties ..	0
16	Occupancy ...........	33,800,122	32,283,621	1,516,501
17	Travel ............	4,035,565	2,422,709	1,612,856
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	1,202,637	746,239	456,398
20	Interest ...........	21,237,775	21,237,775
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	154,967,351	130,482,510	24,484,841
23	Insurance ...	33,773,602	27,538,244	6,235,358
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES/DRUGS	405,689,459	405,689,459
b	PURCHASED SERVICES	291,685,129	239,030,266	52,654,863
c	HAF	91,590,397	91,590,397
d	FEDERAL AND STATE UBTI TAXES	14,211		14,211
e	All other expenses	177,312,609	132,610,561	44,702,048
25	Total functional expenses. Add lines 1 through 24e	2,889,242,913	2,387,098,083	502,144,830	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 ........			0	1	0
2	Savings and temporary cash investments .........			79,777,507	2	90,000,958
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			364,596,438	4	371,182,857
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
				0	6	0
7	Notes and loans receivable, net ....			20,900,616	7	21,700,319
8	Inventories for sale or use ........			49,117,437	8	48,958,085
9	Prepaid expenses and deferred charges ......			0	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	3,553,087,122
b	Less: accumulated depreciation	10b	1,603,589,461	1,826,071,713	10c	1,949,497,661
11	Investments—publicly traded securities .			2,459,434,855	11	2,207,656,756
12	Investments—other securities. See Part IV, line 11 .....			167,740,645	12	170,153,475
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			19,735,823	14	19,195,355
15	Other assets. See Part IV, line 11 ...........			205,407,881	15	227,823,099
16	Total assets. Add lines 1 through 15 (must equal line 34)...			5,192,782,915	16	5,106,168,565

17	Accounts payable and accrued expenses .....	249,624,347	17	234,991,327
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	1,208,186,545	20	1,184,011,960
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	574,253,157	25	551,058,702
26	Total liabilities. Add lines 17 through 25..	2,032,064,049	26	1,970,061,989

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	3,153,166,150	27	3,128,502,287
28	Temporarily restricted net assets ...........	0	28	0
29	Permanently restricted net assets	7,552,716	29	7,604,289
	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 ...........	3,160,718,866	33	3,136,106,576
34	Total liabilities and net assets/fund balances ........	5,192,782,915	34	5,106,168,565

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No