TY 2018 Form 990

- TIN:

Form990

Department of the TreasuryInternal Revenue Service

Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)

Do not enter social security numbers on this form as it may be made public.

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

OMB No. 1545-0047

2018

Open to Public Inspection

A For the 2019 calendar year, or tax year beginning 07-01-2018 , and ending 06-30-2019

BCheck if applicable: Address change Name change Initial return Final return/terminated Amended return Application pending

CName of organization
Christus Health

% KIM REYNOLDS

Doing business as
SEE SCHEDULE O

Number and street (or P.O. box if mail is not delivered to street address)
919 Hidden Ridge Drive

Room/suite

City or town, state or province, country, and ZIP or foreign postal code
Irving, TX75038

D Employer identification number

76-0590551

E Telephone number

G Gross receipts $ 2,043,841,256

F Name and address of principal officer:
ERNIE SADAU
919 HIDDEN RIDGE DRIVE
IRVING,TX75038

Tax-exempt status: 501(c)(3) 501(c) ( ) LeftBullet

(insert no.) 4947(a)(1) or 527

Website:

www.christushealth.org

H(a)

Is this a group return for
subordinates? Yes No

H(b)

Are all subordinates
included?

Yes No

If "No," attach a list. (see instructions)

H(c)

Group exemption number MediumBullet

0928

K Form of organization: Corporation Trust Association Other MediumBullet

L Year of formation: 1999

M State of legal domicile: TX

Part I

Summary

1	Briefly describe the organization’s mission or most significant activities: SUPPORTING THE HEALTH CARE MINISTRIES OF THE SPONSORING CONGREGATIONS IN EXTENDING THE HEALING MINISTRY OF JESUS CHRIST IN CONFORMITY WITH THE ROMAN CATHOLIC CHURCH.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	18
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	3,503
6	Total number of volunteers (estimate if necessary) .............	6	5
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	701,392
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	573,001

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	841,199,248	652,479,799
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	119,676,011	61,929,868
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	26,642,277	22,117,309
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	987,517,536	736,526,976
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	5,364,075	3,829,820
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)	444,097,063	305,824,160
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)....	556,903,948	467,947,165
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,006,365,086	777,601,145
19	Revenue less expenses. Subtract line 18 from line 12.......	-18,847,550	-41,074,169
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,644,038,414	2,854,146,211
21	Total liabilities (Part X, line 26).............	1,538,747,391	2,211,818,635
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,105,291,023	642,327,576

Part II

Signature Block

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title

Paid Preparer Use Only

Print/Type preparer's name

Preparer's signature

Date

Check if
self-employed

PTIN

Firm's name MediumBullet

Firm's EIN MediumBullet

Firm's address MediumBullet

Phone no.

May the IRS discuss this return with the preparer shown above? (see instructions) ..........YesNo

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y Form 990 (2018)

Form 990 (2018)

Page 2

Part III

Statement of Program Service Accomplishments

Check if Schedule O contains a response or note to any line in this Part III..............

Briefly describe the organization’s mission: THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, EDUCATIONAL AND RELIGIOUS PURPOSES OF ADVANCING, PROMOTING AND SUPPORTING THE HEALTH CARE MINISTRIES OF THE SPONSORING CONGREGATIONS WHICH OPERATE AND ARE CONTROLLED IN CONFORMITY WITH THE ETHICAL AND MORAL TEACHINGS OF THE ROMAN CATHOLIC CHURCH, AND PROMOTING EFFICIENT GOVERNANCE AND MANAGEMENT, COOPERATIVE PLANNING AND THE SHARING OF RESOURCES AMONG SUCH HEALTH CARE MINISTRIES. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE CORPORATION'S MISSION SHALL BE TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, AND CONSISTENT THEREWITH, SHALL OPERATE ACCORDING TO THE DOCTRINES, RESOLUTIONS, DECREES AND ETHICAL PRINCIPLES OF THE SPONSORING CONGREGATIONS, AND THE ETHICAL AND RELIGIOUS DIRECTORS FOR CATHOLIC HEALTH CARE SERVICES AS PROMULGATED OR AMENDED FROM TIME TO TIME BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS. IT IS ALSO A PURPOSE OF THE CORPORATION TO AID, LEND FINANCIAL SUPPORT AND AS

Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ..................... Yes No

If "Yes," describe these new services on Schedule O.

Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ........................... Yes No

If "Yes," describe these changes on Schedule O.

Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.


4a	(Code: ) (Expenses $ 336,723,471 including grants of $ 0 ) (Revenue $ 517,055,548 )
	COMMITMENT TO BENEFITING OUR COMMUNITIES CHRISTUS HEALTH WAS FORMED IN 1999 WHEN THE SISTERS OF CHARITY HEALTH SYSTEM, SPONSORED BY THE SISTERS OF CHARITY OF THE INCARNATE WORD OF HOUSTON, AND THE INCARNATE WORD HEALTH CARE SYSTEM, SPONSORED BY THE SISTERS OF CHARITY OF THE INCARNATE WORD OF SAN ANTONIO, BROUGHT THEIR HEALTH MINISTRIES TOGETHER. THE 2016 AFFILIATION WITH TRINITY MOTHER FRANCES HEALTH SYSTEM RESULTED IN A THIRD SPONSORING CONGREGATION OF CHRISTUS HEALTH, THE SISTERS OF THE HOLY FAMILY OF NAZARETH. THE VISION OF CHRISTUS HEALTH AS A CATHOLIC, FAITH-BASED MINISTRY, IS TO BE A LEADER, A PARTNER AND ADVOCATE IN THE CREATION OF INNOVATIVE HEALTH AND WELLNESS SOLUTIONS THAT IMPROVE THE LIVES OF INDIVIDUALS AND COMMUNITIES SO THAT ALL MAY EXPERIENCE GOD'S HEALING PRESENCE AND LOVE. CHRISTUS HEALTH RESPONDS TO HEALTH CARE NEEDS THROUGH SERVICES PROVIDED IN 350 FACILITIES, INCLUDING 60 HOSPITALS AND LONG-TERM CARE FACILITIES, 175 CLINICS AND OUTPATIENT CENTERS AND DOZENS OF OTHER HEALTH MINISTRIES AND VENTURES. CHRISTUS SERVICES ARE FOUND IN 60 CITIES IN TEXAS, ARKANSAS, IOWA, LOUISIANA, GEORGIA AND NEW MEXICO IN THE U.S., CHIHUAHUA, COAHUILA, NUEVO LEN, PUEBLA, SAN LUIS, POTOSI AND TAMAULIPAS IN MEXICO AND IN CHILE. WHILE SPECIFIC PROGRAMS AND SERVICES DIFFER FROM FACILITY TO FACILITY TO MEET COMMUNITY NEEDS, EACH OF OUR HEALTH CARE ENTITIES HAS THE SAME OBJECTIVE -- TO FULFILL OUR MISSION OF EXTENDING THE HEALING MINISTRY OF JESUS CHRIST, WHICH INCLUDES LEADING THE WAY TO A HEALTHIER COMMUNITY. CHRISTUS HEALTH PROVIDES VARIOUS ADMINISTRATIVE SERVICES TO THE CHRISTUS REGIONS, INCLUDING EMPLOYEE BENEFITS, WELFARE BENEFITS, COLLECTION SERVICES, COMPUTER SERVICES, INSURANCE, EQUIPMENT MAINTENANCE AND OTHER BUSINESS OFFICE SERVICES. COMBINED, THE CHRISTUS HEALTH SERVICE AREA COMPRISES A POPULATION OF APPROXIMATELY 8,735,000. IN FISCAL YEAR 2019 ALONE, WE WERE PRIVILEGED TO SERVE MANY MEMBERS OF OUR COMMUNITIES IN VARIOUS WAYS, INCLUDING 970,091 VISITS TO OUR EMERGENCY DEPARTMENTS; 46,697 INPATIENT SURGERY PROCEDURES; 133,887 OUTPATIENT SURGERY PROCEDURES; 184,267 PATIENTS ADMITTED TO OUR HOSPITALS FOR CARE; AND 3,049,934 PATIENTS WHO RECEIVED OUTPATIENT CARE AT OUR FACILITIES. TOUCHING THE LIVES OF THE PEOPLE AROUND US IS WHAT MAKES CHRISTUS HEALTH STAND APART. ALLOWING OTHERS TO TOUCH US GIVES CHRISTUS HEALTH A VISION FOR THE MEDICALLY NEEDY IN EACH OF THE COMMUNITIES WE SERVE. WHETHER IT IS THE LIFE OF A CHILD EXPECTING A FUTURE FILLED WITH MIRACLES, THE LIFE OF A MAN IN NEED OF A CRITICAL HEART SURGERY, OR THE LIFE OF A WOMAN ABOUT TO GIVE BIRTH, CHRISTUS HEALTH'S HOSPITALS, CLINICS AND VARIOUS OTHER HEALTH CARE SERVICES PROVIDE THE BEST CARE POSSIBLE REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. BY COLLABORATING WITH COMMUNITIES, CHURCHES, BUSINESSES AND OTHER HEALTH CARE ORGANIZATIONS, CHRISTUS HEALTH'S VARIOUS ENTITIES HAVE STRENGTHENED THEIR ROLES AS MAJOR PROVIDERS OF COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES. THESE PARTNERSHIPS WITHIN THE COMMUNITY HAVE BEEN A BLESSING BY HELPING CHRISTUS CARE FOR THOSE IN NEED. FURTHERMORE, INVESTMENT IN COMMUNITY SERVICES WOULD NOT BE POSSIBLE WITHOUT OUR DEDICATED EMPLOYEES AND VOLUNTEERS. THEY HELP TO BUILD STRONG RELATIONSHIPS BETWEEN THE HOSPITALS AND OTHER HEALTH CARE MINISTRIES AND THE COMMUNITIES, NURTURING CHRISTUS' MISSION TO MEET THE NEEDS OF AND MAKE A DIFFERENCE IN THE LIVES OF OTHERS. OUR EMPLOYEES WORK BOTH INSIDE AND OUTSIDE THE WALLS OF OUR HEALTH CARE FACILITIES AND ARE COMMITTED TO REACHING BEYOND THE TRADITIONAL HOSPITAL WALLS TO HELP OUR COMMUNITIES MAINTAIN GOOD HEALTH. UNDERSTANDING THE NEED TO PROVIDE ACCESS TO HEALTH CARE TO AS MUCH OF OUR PUBLIC AS POSSIBLE, CHRISTUS HEALTH PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS INCLUDING MEDICAID, MEDICARE, CHAMPUS, TRICARE AND OTHERS. IN ADDITION, WE OFFER SPECIFIC PROGRAMS TO PROVIDE A DISCOUNT ON IMPORTANT SERVICES PROVIDED TO THOSE IN NEED WHO DO NOT HAVE MEDICAL INSURANCE OR WHO DO NOT PARTICIPATE IN GOVERNMENT-SPONSORED PROGRAMS. CHRISTUS HEALTH PROVIDES A RANGE OF INPATIENT AND OUTPATIENT SERVICES TO MEET THE NEEDS OF THE COMMUNITIES WE SERVE. WE CONDUCT OUR ACTIVITIES AND PROVIDE HEALTH CARE WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. PARTICULAR HEALTH CARE SERVICES VARY BY MARKET AND ARE BASED ON THE NEEDS OF EACH PARTICULAR COMMUNITY. OUR SERVICES RANGE FROM THE MOST SOPHISTICATED RESEARCH AND BREAKTHROUGH MEDICAL TECHNOLOGY SERVICES TO MUCH-NEEDED PRIMARY CARE. EACH OF OUR ACUTE CARE HOSPITALS PROVIDES AN EMERGENCY ROOM THAT IS OPEN TO SERVE ALL THOSE IN NEED OF EMERGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY. CHRISTUS ALSO SUPPORTS MANY LOCAL COMMUNITY HEALTH SERVICES. CLINICAL TRIALS TO ADVANCE CARE AND PROVIDE CURES FOR CERTAIN DISEASES, AND SOME CHRISTUS HOSPITALS HOST GRADUATE MEDICAL EDUCATION PROGRAMS THAT TRAIN FUTURE HEALTH CARE PROVIDERS AND LEADERS INCLUDING NURSES, PHYSICIANS AND VARIOUS ALLIED HEALTH PROFESSIONALS. AS A NOT-FOR-PROFIT ORGANIZATION, A GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT PROFESSIONALS WHO HELP SHAPE THE STRATEGIES AND POLICIES OF OUR HEALTH SYSTEM GUIDES CHRISTUS HEALTH. IN ADDITION, A BOARD OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE AREA WE SERVE GOVERNS EACH OF OUR HEALTH CARE ENTITIES. WE ARE PRIVILEGED TO HAVE OPEN MEDICAL STAFFS IN EACH OF OUR HOSPITALS AND CLINICS COMPRISED OF QUALIFIED PHYSICIANS WHO WORK WITH US TO PROVIDE CARE TO OUR COMMUNITIES. ALL QUALIFIED PHYSICIANS WHO ARE GRANTED PRIVILEGES TO SERVE IN OUR HOSPITALS MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING PROCESS.

4b	(Code: ) (Expenses $ 123,721,164 including grants of $ 0 ) (Revenue $ 135,424,251 )
	OTHER GOVERNMENT SERVICES IN ADDITION TO THE PROVISION OF CHARITY CARE AND OTHER COMMUNITY SERVICES, CHRISTUS HEALTH PROVIDES SERVICES TO PERSONS COVERED UNDER GOVERNMENT-SPONSORED PROGRAMS INCLUDING MEDICARE, DEPARTMENT OF DEFENSE (DOD) AND TRICARE. THE UNREIMBURSED COSTS OF THESE SERVICES ARE REPORTED TO THE STATE OF TEXAS BUT ARE NOT INCLUDED IN REPORTS PREPARED FOLLOWING CATHOLIC HEALTH ASSOCIATION GUIDELINES. CHRISTUS HEALTH PROVIDES SERVICES TO PERSONS COVERED UNDER THE FEDERAL MEDICARE PROGRAM, AND IN FACT, THIS IS THE LARGEST SINGLE PAYOR CLASSIFICATION OF PATIENTS SERVED BY THIS HEALTH SYSTEM. THE PAYMENT RATE FOR INPATIENT SERVICES IS ON A PER-CASE RATE, CALCULATED BASED ON THE DIAGNOSTIC-RELATED GROUP (DRG) INTO WHICH THE PATIENT IS CATEGORIZED. OUTPATIENT SERVICES ARE REIMBURSED BY MEDICARE BASED ON THEIR FEE SCHEDULE. CHRISTUS HEALTH DBA US FAMILY HEALTH PLAN ALSO PROVIDES THE UNIFORM MEDICAL BENEFIT FOR APPROXIMATELY 15,000 MILITARY FAMILY MEMBERS UNDER CONTRACT WITH THE DOD. UNDER THIS PROGRAM, COMPREHENSIVE MEDICAL SERVICES ARE PROVIDED TO FAMILIES OF ACTIVE DUTY MILITARY PERSONNEL AND TO RETIREES AND THEIR FAMILIES IN ALL AGE CATEGORIES INCLUDING THOSE OVER AGE 65. CHRISTUS HEALTH ALSO PARTICIPATES IN THE TRICARE STANDARD PROGRAM, AND MANY OF OUR HOSPITALS CONTRACT WITH THE MANAGED CARE SUPPORT CONTRACTOR FOR THE SOUTH REGION TO PROVIDE SERVICES UNDER THE PROVISION OF TRICARE PRIME.

4c	(Code: ) (Expenses $ 1,898,755 including grants of $ 0 ) (Revenue $ 0 )
	COMMUNITY SERVICES FOR THE BROADER COMMUNITY THE GREATEST SHARE OF THESE EXPENSES IS FOR EDUCATING HEALTH PROFESSIONALS. HELPING TO PREPARE FUTURE HEALTH CARE PROFESSIONALS IS A DISTINGUISHING CHARACTERISTIC OF NOT-FOR-PROFIT HEALTH CARE AND CONSTITUTES A SIGNIFICANT COMMUNITY BENEFIT. CHRISTUS HEALTH ALSO USED CASH DONATIONS AS A VEHICLE TO HELP OUR COMMUNITIES. WE MADE CASH DONATIONS IN ADDITION TO GRANTS AWARDED THROUGH THE CHRISTUS FUND TO SUPPORT CAUSES LIKE THE FIGHT AGAINST CANCER, PROVISION OF A CONTINUUM OF CARE FOR THE ELDERLY AND THOSE WITH HIV/AIDS, FEDERALLY QUALIFIED HEALTH CENTERS, RURAL HEALTH SERVICE ORGANIZATIONS, WHICH DISTRIBUTED THE DONATIONS TO RURAL HEALTH PROVIDERS ACROSS EAST AND NORTHEAST TEXAS AND FOR MANY OTHER EQUALLY WORTHY PURPOSES. DURING FY 2019, CHRISTUS HEALTH ADVOCATED FOR IMPROVING PUBLIC POLICIES, WORKING TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTH CARE SERVICES FOR THE CONSTITUENTS WE SERVE.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 256,221 including grants of $ 3,829,820 ) (Revenue $ 0 )
4e	Total program service expenses462,599,611

Form 990 (2018)

Page 3

Part IV

Checklist of Required Schedules

Yes

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A Click to see attachment

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

Yes

Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...

Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I Click to see attachment

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

Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II Click to see attachment

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

Yes

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III Click to see attachment

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

Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I Click to see attachment

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

Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II Click to see attachment

...

Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment

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

Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV Click to see attachment

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

Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V Click to see attachment

......

If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.

Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI. Click to see attachment

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

11a

Yes

Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII Click to see attachment

.......

11b

Yes

Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII Click to see attachment

.......

11c

Yes

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX Click to see attachment

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

11d

Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X Click to see attachment

11e

Yes

Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X Click to see attachment

11f

Yes

12a

Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment

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

12a

Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment

12b

Yes

Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E

14a

Did the organization maintain an office, employees, or agents outside of the United States? .....

14a

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment

14b

Yes

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV..... Click to see attachment

Yes

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment

Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....

Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................

20a

Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....

20a

If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?

20b

Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..... Click to see attachment

Yes

Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment

Form 990 (2018)

Page 4

Part IV

Checklist of Required Schedules (continued)

Yes

Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment

Yes

24a

Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a............... Click to see list of attachments

24a

Yes

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...

24b

Yes

Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............

24c

Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...

24d

25a

Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............ Click to see attachment

25a

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment

25b

Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment

Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):

A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV........................ Click to see attachment

28a

A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV..................... Click to see attachment

28b

Yes

An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment

28c

Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..

Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............

Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...........

Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment

Yes

Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1......................... Click to see attachment

Yes

35a

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

35a

Yes

If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ... Click to see attachment

35b

Yes

Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment

Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI Click to see attachment

Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............

Yes

Part V

Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........

Yes

Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..

2,445

Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................

Yes

Form 990 (2018)

Page 5

Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................

3,503

If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)

Yes

Did the organization have unrelated business gross income of $1,000 or more during the year?...

Yes

If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...

Yes

At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..

Yes

If "Yes," enter the name of the foreign country: MediumBullet

CI , CJ , MX , CO
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............

Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...

If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................

Organizations that may receive deductible contributions under section 170(c).

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................

If "Yes," did the organization notify the donor of the value of the goods or services provided? .....

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................

If "Yes," indicate the number of Forms 8282 filed during the year ....

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................

Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................

Did the sponsoring organization make any taxable distributions under section 4966?...

Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on Part VIII, line 12 ...

10a

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities

10b

Section 501(c)(12) organizations. Enter:

Gross income from members or shareholders .........

11a

Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........

11b

12a

Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?

12a

If "Yes," enter the amount of tax-exempt interest received or accrued during the year.

12b

Section 501(c)(29) qualified nonprofit health insurance issuers.

Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.

13a

Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....

13b

Enter the amount of reserves on hand ............

13c

14a

Did the organization receive any payments for indoor tanning services during the tax year?.....

14a

If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..

14b

Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....

Yes

Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................

Form 990 (2018)

Page 6

Part VI

Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Check if Schedule O contains a response or note to any line in this Part VI..............

Section A. Governing Body and Management

Yes

Enter the number of voting members of the governing body at the end of the tax year

If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.

Enter the number of voting members included in line 1a, above, who are independent

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................

Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .

Did the organization become aware during the year of a significant diversion of the organization’s assets? .

Did the organization have members or stockholders? ................

Yes

Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................

Yes

Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................

Yes

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body? .......................

Yes

Each committee with authority to act on behalf of the governing body? ............

Yes

Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......

Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)

Yes

10a

Did the organization have local chapters, branches, or affiliates? ............

10a

If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?

10b

11a

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................

11a

Yes

Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....

12a

Did the organization have a written conflict of interest policy? If "No," go to line 13.......

12a

Yes

Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................

12b

Yes

Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................

12c

Yes

Did the organization have a written whistleblower policy? ...............

Yes

Did the organization have a written document retention and destruction policy? .........

Yes

Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization’s CEO, Executive Director, or top management official ...........

15a

Yes

Other officers or key employees of the organization ................

15b

Yes

If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).

16a

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................

16a

Yes

If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............

16b

Yes

Section C. Disclosure

List the States with which a copy of this Form 990 is required to be filed MediumBullet

Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.

Own website Another's website Upon request Other (explain in Schedule O)

Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.

State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBullet

KIM REYNOLDS919 HIDDEN RIDGE DRIVE IRVING,TX75038 (469) 282-2000

Form 990 (2018)

Page 7

Part VII

Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors

Check if Schedule O contains a response or note to any line in this Part VII..............

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet

List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

List all of the organization’s current key employees, if any. See instructions for definition of "key employee."

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.

Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) GEORGE BO-LINN MD...................................................................... Director	1.0 ................. 0.0	X		6,857	0	0
(2) J LYNN BRITTON...................................................................... Director	1.0 ................. 0.0	X		10,907	0	0
(3) PATRICIO DONOSO IBANEZ...................................................................... Director	1.0 ................. 0.0	X		12,057	0	0
(4) MARICELA SIEWCZYNSKI MOORE...................................................................... BOARD VICE-CHAIR	1.0 ................. 0.0	X	X	18,600	0	0
(5) ARTHUR SOUTHAM MD...................................................................... Director/CHAIR	1.0 ................. 0.0	X	X	4,660	0	0
(6) CLARENCE R WILLIAMS...................................................................... Director	1.0 ................. 0.0	X		12,407	0	0
(7) BILL CHEN...................................................................... DIRECTOR	1.0 ................. 0.0	X		13,407	0	0
(8) J LINDSEY BRADLEY JR...................................................................... DIRECTOR (TERM 6/2019)	1.0 ................. 0.0	X		858,693	0	0
(9) STEVEN KEUER MD...................................................................... TMF CMO	1.0 ................. 39.0	X		959,193	0	184,416
(10) SISTER LORETTA FELICI...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0	0
(11) DAVID STRONG...................................................................... DIRECTOR	1.0 ................. 0.0	X		9,732	0	0
(12) FATHER STEPHEN WORSLEY...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0	0
(13) SISTER YOLANDA TARANGO...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0	0
(14) Ernie W Sadau...................................................................... PRESIDENT/CEO	40.0 ................. 0.0	X	X	7,184,800	0	1,159,673
(15) SISTER CHRISTINA MURPHY...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0	0
(16) CHERYL ALSTON...................................................................... Director	1.0 ................. 0.0	X		11,109	0	0
(17) ALIDE CHASE...................................................................... BOARD DIRECTOR	1.0 ................. 0.0	X		13,359	0	0

Form 990 (2018)

Page 8

Part VII

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)					(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) KEVIN J ROY DBA........................................................................ DIRECTOR (EFF 7/2018)	1.0 .......................0.0	X					1,850	0	0
(19) SISTER HANNAH O'DONOGHUE CCVI........................................................................ DIRECTOR (TERM 12/2018)	1.0 .......................0.0	X					0	0	0
(20) KELLY KLIBERT........................................................................ Dir. of Governance	32.0 .......................8.0		X				127,403	0	21,018
(21) Randolph W Safady........................................................................ EVP/CFO	40.0 .......................0.0		X				4,641,179	0	176,925
(22) KAREN OLIVER........................................................................ ASST. CORP SEC (EFF 7/2018)	40.0 .......................0.0		X				71,662	0	9,690
(23) George S Conklin........................................................................ SVP-CIO	39.0 .......................1.0			X			1,683,750	0	59,409
(24) Dominic J Dominguez........................................................................ SVP-GROUP OPERATIONS SO TX	39.0 .......................1.0			X			1,108,350	0	191,803
(25) Paul D Generale........................................................................ EVP/CHIEF STRATEGY OFFICER	39.0 .......................1.0			X			3,007,416	0	502,346
(26) John A Gillean........................................................................ EVP/CHIEF MEDICAL OFFICER	39.0 .......................1.0			X			2,458,644	0	73,712
(27) Gerard F Heeley........................................................................ SVP-MISSION AND ETHICS	39.0 .......................1.0			X			1,464,780	0	254,355
(28) Christopher karam........................................................................ SVP-Group Operations LA	39.0 .......................1.0			X			1,252,076	0	274,560
(29) Marty F Margetts........................................................................ EVP/CORP SERVICES	39.0 .......................1.0			X			2,825,188	0	482,873
(30) Linda K McClung........................................................................ EVP/CAO	39.0 .......................1.0			X			3,824,848	0	146,885
(31) Jeffrey M Puckett........................................................................ EVP/COO	39.0 .......................1.0			X			3,969,895	0	709,272
(32) M Shannon Stansbury........................................................................ SVP-POPULATION HEALTH	40.0 .......................0.0			X			781,187	0	160,661
(33) Stephen F Wright........................................................................ PRES/CEO-LA MINS (TIL 10/2018)	39.0 .......................1.0			X			1,727,752	0	138,925
(34) J Chris Glenney........................................................................ SVP GROUP OPERATIONS NETX	40.0 .......................0.0			X			1,666,029	0	315,046
(35) JEANNIE FREY........................................................................ SVP CHF LGL OFFCR (EFF 7/2018)	40.0 .......................0.0			X			538,670	0	82,621
(36) SAM BAGCHI MD........................................................................ SVP, Chief Medical Officer	40.0 .......................0.0			X			1,039,033	0	193,744
(37) DEBRA PASLEY........................................................................ SVP, CNO	40.0 .......................0.0			X			681,928	0	116,372
(38) ALEJANDRO CANAVATI........................................................................ CEO - CHILE OPDERATIONS	40.0 .......................0.0				X		1,084,034	0	162,952
(39) Patrick B Carrier........................................................................ PRESIDENT - SANTA FE MINISTRY	40.0 .......................0.0				X		1,502,606	0	56,259
(40) N TODD HANCOCK........................................................................ CEO GSHS	40.0 .......................0.0				X		1,171,176	0	204,302
(41) SCOTT SMITH........................................................................ SVP TRINITY CLINIC	40.0 .......................0.0				X		983,696	0	155,426
(42) MARIA ESTELA CHAPA........................................................................ CCTO SPOHN	40.0 .......................0.0				X		831,629	0	62,649
(43) ALEX J VALDEZ........................................................................ CEO-Clinica San Carlos de Apoq	0.0 .......................0.0					X	100,517	0	3,334
(44) Joseph S Barcie........................................................................ SVP INTL Ops (tERM 10/2017)	0.0 .......................0.0					X	484,796	0	1,282
(45) Nancy C Legros til 102017........................................................................ SVP-CHIEF Lgl CNSL	0.0 .......................0.0					X	287,436	0	1,627
(46) Peter J Plantes........................................................................ CEO CPG (term 11/2017)	0.0 .......................0.0					X	596,052	0	1,095

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	49,029,363	0	5,903,232

Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet

582

Yes

Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............

Yes

For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................

Yes

Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........

Section B. Independent Contractors

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.

(A) Name and business address	(B) Description of services	(C) Compensation
HHS ENVIRONMENTAL SERVICES LLC, 12495 Silver Creek Road DRIPPING SPRINGS,TX78620	ENVIRONMENTAL SRVCS	39,948,784
GRIFFIN CAPITAL CORPORATION, 18191 VON KARMAN AVE STE 300 IRVINE,CA92612	RENTAL SERVICES	6,390,578
DE LAGE LANDEN FINANCIAL, 1111 OLD EAGLE SCHOOL RD WAYNE,PA19087	RENTAL SERVICES	5,720,884
DELL FINANCIAL SERVICES LLC, 1 DELL WAY ROUND ROCK,TX78682	RENTAL SERVICES	4,822,231
OPTUM360 LLC, 11000 OPTUM CIRCLE EDEN PRAIRIE,MN55344	MANAGEMENT SERVICES	4,296,330
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 167

Form 990 (2018)

Page 9

Part VIII

Statement of Revenue

Check if Schedule O contains a response or note to any line in this Part VIII.............

(A)
Total revenue

(B)
Related or
exempt
function
revenue

(D)
Revenue
excluded from
tax under sections
512 - 514

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

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

g	Noncash contributions included in lines 1a - 1f:$ 0
h Total. Add lines 1a-1f.......		0

		Business Code
2a	SERVICE FEE INCOME	541900	287,275,802	286,574,410	701,392	0
b	CAPITATION REVENUE	621400	137,906,107	137,906,107	0	0
c	SYSTEM OFFICE FEES AND MGMT SERVICES	561000	106,087,238	106,087,238	0	0
d	PREMIUM REVENUE	900099	97,920,463	97,920,463	0	0
e	TLRA FEES	900099	16,771,337	16,771,337	0	0
f	All other program service revenue.		6,518,852	6,518,852		0
g	Total. Add lines 2a–2f ....		652,479,799

3 Investment income (including dividends, interest, and othersimilar amounts) ......			46,143,248			46,143,248
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			358,195			358,195
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		1,321,356,646
b	Less: cost or other basis and sales expenses		1,305,570,026
c	Gain or (loss)		15,786,620
d	Net gain or (loss).....			15,786,620			15,786,620
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		3,178,662
b	Less: cost of goods sold ..b		1,744,254
c	Net income or (loss) from sales of inventory..			1,434,408			1,434,408
Business Code			Miscellaneous Revenue
11a	MANAGED CARE REVENUE		900099	5,592,409	0	0	5,592,409
b	COBRA INSURANCE - EMPLOYERS		900099	1,189,448	0	0	1,189,448
c	METHODIST REVENUE		900099	1,141,102	0	0	1,141,102
d	All other revenue ....			12,401,747	0	0	12,401,747
e	Total. Add lines 11a–11d ......			20,324,706
12	Total revenue. See Instructions......			736,526,976	651,778,407	701,392	84,047,177

Form 990 (2018)

Page 10

Part IX

Statement of Functional Expenses

Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.		(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	3,829,820	3,829,820
2	Grants and other assistance to domestic individuals. See Part IV, line 22	0	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	47,112,406	14,657,070	32,455,336	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	1,476,139	459,239	1,016,900	0
7	Other salaries and wages	176,658,629	54,960,000	121,698,629	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	-4,271,798	-2,188,892	-2,082,906	0
9	Other employee benefits .......	70,233,470	65,096,173	5,137,297	0
10	Payroll taxes ...........	14,615,314	4,618,845	9,996,469	0
11	Fees for services (non-employees):
a	Management ......	0	0	0	0
b	Legal .........	2,497,089	21,468	2,475,621	0
c	Accounting ...........	-1,907,829	0	-1,907,829	0
d	Lobbying ...........	1,111,134	0	1,111,134	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	1,494,148	0	1,494,148	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	239,963,499	214,653,339	25,310,160	0
12	Advertising and promotion ....	0	0	0	0
13	Office expenses .......	68,845,256	38,575,561	30,269,695	0
14	Information technology ......	11,523,000	685,220	10,837,780	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	10,568,620	9,759,031	809,589	0
17	Travel ............	10,326,153	2,141,660	8,184,493	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	5,665,504	532,677	5,132,827	0
20	Interest ...........	37,832,212	356,665	37,475,547	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	5,449,627	990,979	4,458,648	0
23	Insurance ...	52,108,036	52,086,069	21,967	0
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	SWAP FINANCING COST	6,731,462	0	6,731,462	0
b	SALES TAX AND OTHER TAX	4,119,697	152,830	3,966,867	0
c	RECRUITMENT/PLACEMENT FEE	3,241,114	42,000	3,199,114	0
d	MEDICAL EXPENSE	41,921	17,756	24,165	0
e	All other expenses	8,336,522	1,152,101	7,184,421
25	Total functional expenses. Add lines 1 through 24e	777,601,145	462,599,611	315,001,534	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).	0

Form 990 (2018)

Page 11

Part X

Balance Sheet

Check if Schedule O contains a response or note to any line in this Part IX..............

				(A) Beginning of year		(B) End of year

1	Cash–non-interest-bearing ........			87,473,254	1	199,876,193
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			35,089,861	4	46,547,681
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 ....			7,208,230	7	35,029,271
8	Inventories for sale or use ........			1,293,128	8	1,441,608
9	Prepaid expenses and deferred charges ......			46,207,569	9	48,595,718
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	272,366,481
b	Less: accumulated depreciation	10b	150,621,459	126,403,391	10c	121,745,022
11	Investments—publicly traded securities .			629,455,485	11	771,260,310
12	Investments—other securities. See Part IV, line 11 .....			244,264,768	12	210,466,456
13	Investments—program-related. See Part IV, line 11 ..			1,336,966,076	13	559,537,021
14	Intangible assets ...............			19,296,630	14	19,296,630
15	Other assets. See Part IV, line 11 ...........			110,380,022	15	840,350,301
16	Total assets. Add lines 1 through 15 (must equal line 34)...			2,644,038,414	16	2,854,146,211

17	Accounts payable and accrued expenses .....	225,121,777	17	256,315,554
18	Grants payable ...	0	18	0
19	Deferred revenue .........	291,330	19	23,491,630
20	Tax-exempt bond liabilities .........	986,421,547	20	1,592,949,542
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	326,912,737	25	339,061,909
26	Total liabilities. Add lines 17 through 25..	1,538,747,391	26	2,211,818,635

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	1,089,844,571	27	626,329,518
28	Temporarily restricted net assets ...........	11,840,047	28	12,391,653
29	Permanently restricted net assets	3,606,405	29	3,606,405
	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 ...........	1,105,291,023	33	642,327,576
34	Total liabilities and net assets/fund balances ........	2,644,038,414	34	2,854,146,211

Form 990 (2018)

Page 12

Part XI

Reconcilliation of Net Assets

Check if Schedule O contains a response or note to any line in this Part XI..............

Total revenue (must equal Part VIII, column (A), line 12) ............

736,526,976

Total expenses (must equal Part IX, column (A), line 25) ............

777,601,145

Revenue less expenses. Subtract line 2 from line 1 ..............

-41,074,169

Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..

1,105,291,023

Net unrealized gains (losses) on investments ...............

Donated services and use of facilities .................

Investment expenses .....................

Prior period adjustments .....................

-18,367,620

Other changes in net assets or fund balances (explain in Schedule O) ........

-403,521,658

Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))

642,327,576

Part XII

Financial Statements and Reporting

Check if Schedule O contains a response or note to any line in this Part XII.............

Yes

Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.

Were the organization’s financial statements compiled or reviewed by an independent accountant?

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

Were the organization’s financial statements audited by an independent accountant?

Yes

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?

Yes

If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?

Yes

If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.

Yes

Form 990 (2018)

Additional Data

Software ID:
Software Version:

Form 990, Special Condition Description:

Special Condition Description

- 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

Christus Health

Employer identification number

76-0590551

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.") .	0	0	0	0	0	0
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	149,803,902	73,618,886	105,965,033	277,953,335	138,308,764	745,649,920
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....	6,219,408	3,469,032	3,247,953	3,199,276	1,449,781	17,585,450
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...						0
5	The value of services or facilities furnished by a governmental unit to the organization without charge						0
6	Total. Add lines 1 through 5	156,023,310	77,087,918	109,212,986	281,152,611	139,758,545	763,235,370
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons						0
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.						0
c	Add lines 7a and 7b..						0
8	Public support. (Subtract line 7c from line 6.)						763,235,370

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...	156,023,310	77,087,918	109,212,986	281,152,611	139,758,545	763,235,370
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	17,161,269	4,301,669	61,875,646	96,385,207	46,501,443	226,225,234
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.	4,783,879	2,974,103	569,668	595,523	574,014	9,497,187
c	Add lines 10a and 10b.	21,945,148	7,275,772	62,445,314	96,980,730	47,075,457	235,722,421
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.						0
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..	4,538,968	22,666,640	6,572,390	17,499,291	9,720,698	60,997,987
13	Total support. (Add lines 9, 10c, 11, and 12.)..	182,507,426	107,030,330	178,230,690	395,632,632	196,554,700	1,059,955,778

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)) .........

72.006 %

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

74.860 %

Section D. Computation of Investment Income Percentage

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

22.239 %

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

19.920 %

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 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

Christus Health

Employer identification number

76-0590551

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)? ........

Yes

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

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

Yes

2,123

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

120,691

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

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

Yes

988,320

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

1,111,134

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
LOBBYING DESCRIPTION	Part 1(b): Paid staff and management: with approximately five paid staff members for the CHRISTUS Health system that serve the Advocacy and Public and Policy department. The department represents the organization before state and federal legislative bodies and regulatory agencies. Part 1(d) Mailings to members and legislators through system-wide action alert for issues related to: Please Act Now to Support Rural Hospitals 7/10/2018; Support Preservation of 340B Drug Discount Program; 3185 letters sent, 594 advocates took action, 1 minute per letter Part 1 (g) Direct contact with legislators, their staffs, government officials and legislative bodies for issues related to: emails, letters and direct contact to members of congressional and state lawmakers in TX, LA, NM, and AR to discuss: sole community provider program, tax reform, disproportionate share hospital funding, critical access hospital funding, rural hospital issues, 1115 waiver Medicaid proposals, uniform hospital rate increase program, Medicaid managed care, health Information technology and interoperability, Affordable Care Act, federal emergency preparedness, 340B Drug Pricing Program, school based health clinics, Medicaid program, military health, palliative care, hospital provider fees, hospital-related tax issues, trauma funding, pediatric hospital issues, ACE Kids Act, graduate medical education, maternal health care, opioid abuse, advance directives legislation, behavioral health issues, maintenance of certification for physicians, public Information act and transparency legislation, medical malpractice caps and tort reform, foster care reform, balance billing and insurance reform, Medicaid managed care, state hospital reforms, and VA unreimbursed claims. Part 1 (i) Other Activity includes: Annual fee to CapWiz to administer action alert server hosting fee. Lobbying fees as portion to dues for trade associations including: 340B Health, ACCC, AHA, Arkansas Hospital Association, CHA(Childrens), CHA Children's CHGME, CHAUSA, Childrens Hospital of Texas, Health Plan Alliance, LALA, LHA, LNHA, NMHA Personal Connect, Picard Group (alliance), Texas Association Business, Texas Association Voluntary Hospital, Texas E-Health Alliance, Texas Hospital Association, Teaching Hospital of Texas, US Family Health . In addition, paid lobbyists and consultants to support the issues described above. Total Hours 40 Hours Executive/730 Hours Director/40 Hours Administrative

Return Reference

Explanation

LOBBYING DESCRIPTION

Part 1(b): Paid staff and management: with approximately five paid staff members for the CHRISTUS Health system that serve the Advocacy and Public and Policy department. The department represents the organization before state and federal legislative bodies and regulatory agencies. Part 1(d) Mailings to members and legislators through system-wide action alert for issues related to: Please Act Now to Support Rural Hospitals 7/10/2018; Support Preservation of 340B Drug Discount Program; 3185 letters sent, 594 advocates took action, 1 minute per letter Part 1 (g) Direct contact with legislators, their staffs, government officials and legislative bodies for issues related to: emails, letters and direct contact to members of congressional and state lawmakers in TX, LA, NM, and AR to discuss: sole community provider program, tax reform, disproportionate share hospital funding, critical access hospital funding, rural hospital issues, 1115 waiver Medicaid proposals, uniform hospital rate increase program, Medicaid managed care, health Information technology and interoperability, Affordable Care Act, federal emergency preparedness, 340B Drug Pricing Program, school based health clinics, Medicaid program, military health, palliative care, hospital provider fees, hospital-related tax issues, trauma funding, pediatric hospital issues, ACE Kids Act, graduate medical education, maternal health care, opioid abuse, advance directives legislation, behavioral health issues, maintenance of certification for physicians, public Information act and transparency legislation, medical malpractice caps and tort reform, foster care reform, balance billing and insurance reform, Medicaid managed care, state hospital reforms, and VA unreimbursed claims. Part 1 (i) Other Activity includes: Annual fee to CapWiz to administer action alert server hosting fee. Lobbying fees as portion to dues for trade associations including: 340B Health, ACCC, AHA, Arkansas Hospital Association, CHA(Childrens), CHA Children's CHGME, CHAUSA, Childrens Hospital of Texas, Health Plan Alliance, LALA, LHA, LNHA, NMHA Personal Connect, Picard Group (alliance), Texas Association Business, Texas Association Voluntary Hospital, Texas E-Health Alliance, Texas Hospital Association, Teaching Hospital of Texas, US Family Health . In addition, paid lobbyists and consultants to support the issues described above. Total Hours 40 Hours Executive/730 Hours Director/40 Hours Administrative

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

Christus Health

Employer identification number

76-0590551

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 ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

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

1a	Land .....	21,107,018		21,107,018
b	Buildings ....	99,308,522	47,900,837	51,407,685
c	Leasehold improvements	16,735,258	9,665,264	7,069,994
d	Equipment ....	73,433,208	43,141,473	30,291,735
e	Other .....	61,782,475	49,913,885	11,868,590
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				121,745,022

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) HEDGE FUNDS	210,466,456	F
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	210,466,456

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)INVESTMENT IN CONSOL SUBS	1,366,966,076	C
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	1,366,966,076

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
LT PENSION LIABILITY	182,979,585
LT OBLIGATION SELF FUNDED	93,108,522
BOND ISSUE COSTS	52,461,133
CAPITAL LEASE LIABILITY	3,835,245
TAXES PAYABLE	3,451,188
CCVI PAYABLE	3,346,359
CURRENT PORTION PENSION FUNDING	14,905
COLLECTIONS PAYABLE	-135,028
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	339,061,909
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	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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

Part XIII

Supplemental Information

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

Return Reference

Explanation

CASH - NON-INTEREST BEARING & SAVINGS & TEMPORARY CASH INVESTMENTS

FORM 990, PART X, LINE 1 AND 2 OTHER ASSETS, FORM 990, PART X, LINE 15 CHRISTUS HEALTH SYSTEM MAINTAINS A CENTRALIZED CASH MANAGEMENT SYSTEM. THIS CASH MANAGEMENT SYSTEM (CMS) INCLUDES A CONCENTRATION ACCOUNT WHEREIN DEPOSITS AND DISBURSEMENTS FOR RELATED CHRISTUS EXEMPT ORGANIZATIONS FLOW THROUGH THIS ACCOUNT AND OVER TO THE MANAGED INVESTMENT ACCOUNTS. EACH PARTICIPATING ORGANIZATION REPORTS A BALANCE IN THE CMS REFLECTIVE OF ITS CUMULATIVE CASH ACTIVITY. CASH BALANCES FOR EACH CHRISTUS ORGANIZATION ARE REPORTED ON FORM 990 IN ACCORDANCE WITH FINANCIAL STATEMENT REPORTING. CMS OWNERSHIP IS MAINTAINED BY CHRISTUS HEALTH (EIN 76-0590551) AND ALL ASSOCIATED INVESTMENT INCOME IS PROPERLY REPORTED ON THE CHRISTUS HEALTH FORM 990.

UNCERTAIN TAX POSITIONS UNDER ASC 740

FORM 990, SCHEDULE D, PART X, LINE 2 PER FOOTNOTE 3 IN THE CONSOLIDATED FINANCIAL STATEMENTS THERE ARE NO MATERIAL UNRECORDED TAX LIABILITIES AS OF JUNE 30, 2019 AND 2018.

Schedule D (Form 990) 2018

Additional Data

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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
Christus Health

Employer identification number

76-0590551

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)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	South America	Program Services	Program/Bus Travel	295,408
	North America	Program Services	Program/Bus Travel	121,746
	Europe (Including Iceland and Greenland)	Program Services	Program/Bus Travel	29,322
	Central America and the Caribbean	Program Services	Program/Bus Travel	3,595
	East Asia and the Pacific	Program Services	Program/Bus Travel	3,713
	Central America and the Caribbean	Program Services	INVESTMENTS-BOOK VALUE	152,667,304
	Central America and the Caribbean	Program Services	INVESTMENTS-CAP CONTR	37,063,335
	North America	Program Services	INVESTMENTS-BOOK VALUE	118,286,816
	North America	Program Services	INVESTMENTS-CAP CONTR	2,000,000








3a	Sub-total .....			310,471,239
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)			310,471,239

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
ORGANIZATION'S PROCEDURES FOR MONITORING USE OF GRANT FUNDS OUTSIDE THE US	FORM 990, SCHEDULE F, PART I, LINE 2 THE ORGANIZATION FOLLOWS CHRISTUS HEALTH MANAGEMENT DIRECTIVE NO. 0006, "CONTRIBUTIONS/DONATIONS TO OTHER ORGANIZATIONS". BEFORE ANY DONATION IS MADE, TWO CRITERIA ARE ADDRESSED: (1) ORGANIZATION TEST AND (2) IRS TEST. THE ORGANIZATION TEST ENSURES THAT DONATIONS ARE EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, EDUCATIONAL, AND RELIGIOUS PURPOSES, AND IN FURTHERANCE OF OUR PURPOSE OF SUPPORTING THE HEALING MINISTRY OF JESUS CHRIST AND ADVANCING, PROMOTING, AND SUPPORTING THE HEALTHCARE MINISTRIES OF THE SPONSORING CONGREGATIONS. CONTRIBUTIONS CAN BE MADE TO SUPPORT CHRISTUS SYSTEM MEMBERS AND TO OTHER QUALIFYING TAX-EXEMPT ORGANIZATIONS, PARTICULARLY THOSE DESIGNED TO SUPPORT AND BENEFIT THE POOR AND UNDERSERVED. THE ORGANIZATION CONSIDERED FOR DONATIONS MUST BE AN IRS SECTION 501(C)(3) ORGANIZATION AND DOCUMENTATION TO THAT EFFECT OBTAINED. TO SATISFY THE IRS TEST CONTRIBUTIONS GIVEN MUST BE DEDICATED TO ACHIEVING CHARITABLE PURPOSES NOT FOR PERSONAL BENEFIT BUT FOR PUBLIC BENEFIT. CONTRIBUTIONS ARE PROHIBITED TO ORGANIZATIONS THAT CONTRIBUTE TO POLITICAL CAMPAIGNS, CANDIDATES FOR OFFICE, OR CONDUCT MORE THAN INCIDENTAL LOBBYING. DOCUMENTATION MUST SUPPORT HOW THE DONATION MEETS ORGANIZATIONAL PURPOSES AND FURTHERANCE OF MISSION. DONATIONS SHOULD BE MODEST IN SCOPE.

Schedule F (Form 990) 2018

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Christus Health

Employer identification number
76-0590551

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) CORPUS CHRISTI HOPE HOUSE INC 658 Robinston Street Corpus Christi,TX78404	74-2480299	501(c)(3)	15,000	PROGRAM SUPPORT
(2) YWCA CORPUS CHRISTI 4601 Corona Drive Corpus Christi,TX78411	74-1157366	501(C)(3)	71,128	THERAPEUTIC RECREATION PROGRAM
(3) MARYS HOUSE OF LOUISIANA INC 906 Margaret Place Shreveport,LA71101	47-2593937	501(C)(3)	37,500	PREGNANCY CARE CENTER PROGRAMS
(4) SLEW WELLNESS CENTER 12521 Nacogdoches Road Suite 101 San Antonio,TX78217	42-1580967	501(C)(3)	75,000	LOW INCOME WOMEN WITH CANCER
(5) DALLAS AREA INTERFAITH SPONSORING COMMITTEE 1104 Lupo Drive Dallas,TX752015208	75-2409130	501(C)(3)	40,000	CHRISTUS MEDICAL MISSION FUND
(6) CATHOLIC CHARITIES OF DALLAS INC 1421 W Mockingbird Lane DALLAS,TX75247	75-2745221	501(C)(3)	62,500	PROVIDING MENTAL HEALTH SERVICES
(7) VISITATION HOUSE MINISTRIES 945 W HAUISACHE SAN ANTONIO,TX78201	74-2447137	501(C)(3)	17,500	SUMMER SOJOURN SPONSOR
(8) UNIVERSITY OF THE INCARNATE WORD 4301 BROADWAY 309 SAN ANTONIO,TX78209	74-1109661	501(C)(3)	81,229	EXPANDING WELLNESS SERVICES FOR WOMEN
(9) PROJECT MEND INC 5727 West IH 10 SAN ANTONIO,TX78201	74-2647324	501(C)(3)	30,000	PROVIDING MEDICAL EQUIPMENT
(10) Anayat House Inc PO BOX 5934 Beaumont,TX77726	76-0441913	501(C)(3)	20,000	PROVIDING MEDICAL HOSPITALITY
(11) Pregnancy Center for the Coastal Bend 4730 Everhart Rd Corpus Christi,TX78411	74-2541210	501(C)(3)	15,000	PROVIDING PREGNANCY SUPPORT AND EDUCATION
(12) YWCA San Antonio 6756 Montgomery DR San Antonio,TX78239	74-1143135	501(C)(3)	20,000	POSITIVE YOUTH DVLPMNT PROGRAM ENHANCEMENT
(13) Women's Global Connection of San Antonio 4503 Broadway St San Antonio,TX78209	42-1619919	501(C)(3)	20,000	PROVIDING INSTALLATION OF WATER FILTRATION SYSTEMS
(14) Villa Therese Catholic Clinic 219 Cathedral Place Sant Fe,NM87501	85-0229019	501(C)(3)	112,500	INCREASING HEALTH ACCESS
(15) Volunteers for Youth Justice 900 Jordan St Suite 102 Shreveport,LA71101	72-1057695	501(C)(3)	100,000	TRUANCY ASSESSMENT SERVICE CENTER
(16) HOPE CONNECTIONS INC PO box 37148 Shreveport,LA71133	72-1476208	501(C)(3)	107,000	DAY SHELTER
(17) Jewish Family Service of Dallas Inc 5402 Arapaho Rd Dallas,TX75248	75-1992728	501(C)(3)	25,000	MENTAL HEALTH SVCS SUPPORT
(18) The Visiting Nurse Association of Texas 1600 Viceroy Dr Suite 400 DALLAS,TX75235	75-0800692	501(C)(3)	100,000	MEALS ON WHEELS
(19) Guide Dogs of Texas Inc 1503 Allena Drive SAN ANTONIO,TX78213	74-2530268	501(C)(3)	62,050	MOBILITY FOR TXNS BLINDNESS
(20) Mary McLeod Bethune Early Child Development Nurser 900 Kinney St Corpus Christi,TX78401	74-1238426	501(C)(3)	25,000	CHILD CASE SRVCS FOR HOMELESS
(21) Nueces County Family Drug Treatment court Advisory 710 Buffalo Street suite 507 Corpus Christi,TX78401	81-4022909	501(C)(3)	59,812	SUPPT SUBST ABUSE TRTMT PROGRAMMING
(22) Women Called Moses Coalition and Outreach Inc 7800 North Stemmons Freeway suite Dallas,TX75247	20-0442818	501(C)(3)	100,000	SUPPORT TO DOMESTIC VIOLENCE VICTIMS
(23) Clarity Child Guidance Center 8535 Tom Slick Dr San Antonio,TX78229	74-1153067	501(C)(3)	100,000	MENTAL HEALTH SRVCS FOR HEALTHCARE
(24) Mission of Mercy Inc 2421 Ayers Street Corpus Christi,TX78404	86-0704883	501(C)(3)	75,000	TEXAS MEDICAL PROGRAM
(25) The Food Bank of Central Louisiana Inc 3223 Baldwin Ave Alexandria,LA71301	72-1154072	501(C)(3)	38,886	THE GOOD FOOD PROJECT
(26) Youth 180 Inc 7777 Forest Lane Suite C-140 Dallas,TX75230	27-0016585	501(C)(3)	68,300	TEEN & FAMILY COUNSELING PRGRM
(27) Shreveport-Bossier Rescue Mission 901 McNeil St Shreveport,LA71101	46-2460128	501(C)(3)	10,000	OPERATION HEALTHY HOMELESS
(28) Big Brothers Big Sisters of SW Louisiana 4135 Common St Lake Charles,LA70607	72-1009565	501(C)(3)	20,000	MENTORING
(29) St Peter-St Joseph Children's Home 919 Mission Rd San Antonio,TX78210	74-1143129	501(C)(3)	37,500	TRAUMA RECOVERY PROGRAM
(30) New Mexico Suicide Intervention Project PO box 6004 Sant Fe,NM87502	85-0427990	501(C)(3)	60,000	WELLNESS AND RESILIENCE
(31) Re-Entry Solutions Inc 1617 Branch St Alexandria,LA71302		501(C)(3)	75,000	PROVIDING MEDICAID ENROLLMENT SRVCS
(32) Stable-Spirit 295 Flamingo St Rose City,TX77662	27-0084459	501(C)(3)	33,200	EQUINE THERAPY SERVICES
(33) The Purple Door PO Box 3368 Corpus Christi,TX78463	74-1943398	501(C)(3)	20,000	SHELTER AND SUPPORT SRVCS
(34) Central LA Cltn to Prevent Homelessness INC 1515 Jackson St Alexandria,LA71301	72-1247718	501(C)(3)	30,000	HEALTHCARE SRVCS FOR HOMELESS
(35) Neighbor for Neighbor Inc 505 East 36th Street North Tulsa,OK74106	84-0630214	501(C)(3)	75,000	Providing support to homeless
(36) Runnin W J Therapeutic Center Inc 4802 South Kings Highway Texarkana,TX75501	75-2897949	501(C)(3)	30,000	THERAPEUTIC RIDING FOR SPCL NDS CHLDRN
(37) Sant Fe Community Services Inc 440 Cerrillos Rd 4 Sant Fe,NM87501	56-2491916	501(C)(3)	33,750	Overdose Prevention Training
(38) Martin Luther King Health Center & Pharmacy 865 Olive St Shreveport,LA71104	72-1079721	501(C)(3)	37,500	PROMOTING HEALTH BEHAVIORS
(39) Capland Speech Therapy Center 2660 Aero Drive Port Arthur,TX77640	74-6012298	501(C)(3)	25,000	INC SPEECH THERAPY SRVCS TO UNINSURED
(40) CASA of Central Texas Inc 1619 E Common St Suite 301 New Braunfels,TX78130	74-2403373	501(C)(3)	25,000	ADVOCACY FOR ABUSED & NEGLECTED CHILDREN
(41) Charlie's Place Recovery Center 11931 Wickchester Lane Suite 300 Houston,TX77043	74-1595867	501(C)(3)	75,000	FUNDING FOR NURSE PRTNR SRVCS
(42) Coming Home Connection 418 Cerrillos Rd Suite 27 Sant Fe,NM87501	74-2853467	501(C)(3)	35,000	Free and Affordable Home Care for Seniors
(43) Family and Youth Counseling Agency Inc 220 Louie Street Lake Charles,LA70601	72-0688561	501(C)(3)	75,000	COUNSELING & SRVCS TO WOMEN & MOTHERS
(44) Family Counseling Services 3833 S Staples Suite S203 Corpus Christi,TX78411	74-1321308	501(C)(3)	18,750	Therapy Services TO Uninsured
(45) Haven Homes PO Box 5345 Texarkana,TX75505	71-0429793	501(C)(3)	100,000	Housing & support for homeless
(46) Successfully Preparing Our Teens International 6402 Dianne St Shreveport,LA71119	82-1402961	501(C)(3)	79,500	Providing substance use education
(47) Coastal Bend Food Bank 826 Krill St Corpus Christi,TX78408	74-2234089	501(C)(3)	37,500	DIABETES EDUCATION
(48) Las Cumbres Community Services 102 N Coronado Ave Espanola,NM87532	23-7144268	501(C)(3)	40,350	TRAUMA-FOCUSED BEHAVIROAL HEALTH
(49) Coastal Bend Neighborhood Empowerment 4833 Saratoga Blvd suite 136 Corpus Christi,TX78413	82-5033516	501(C)(3)	65,000	COMMUNITY DVLPMT PROGRAM
(50) Campti Community Development Center 208 Edenborn st Campti,LA71411	43-2008828	501(C)(3)	30,000	EDU TO SUPP HLTHY FOOD CHCS
(51) New Braunfels Christian Ministries 1659 State Highway 46 West suite 115-405 New Braunfels,TX78132	26-2221231	501(C)(3)	50,000	SERVICES FOR CLIENTS INELIGIBLE FOR MEDICAID
(52) Refuge International Inc PO box 3586 Longview,TX75606	45-3161988	501(C)(3)	7,950	MEDICAL MISSION TO GUATEMALA
(53) Sisters of Charity of the Incarnate Word 4503 Broadway St San Antonio,TX78209	74-1676917	501(C)(3)	62,500	IMPLEMENTATION NEW PHARMACY SYSTEM
(54) CHRISTUS ST MICHAEL FOUNDATION 2600 St Michael Dr Texarkana,TX75503	47-1655865	501(c)(3)	10,000	DONATION
(55) COMMONWEAL FOUNDATION 475 Riverside Dr 405 NEW YORK,NY10115	13-3174407	501(c)(3)	25,000	DONATION
(56) AQUINAS INSTITUTE OF THEOLOGY 23 S Spring Ave St Louis,MO63108	43-1233793	501(c)(3)	75,000	DONATION
(57) CBRE 2100 McKinney Ave Ste 700 DALLAS,TX75201	51-0439609	501(c)(3)	10,000	DONATION
(58) CENTURION MILITARY ALLIANCE 18226 Stockton Springs Dr Spring,TX77379	46-1956681	501(c)(3)	10,000	DONATION
(59) CHRISTUS CABRINI FOUNDATION 3330 Masonic Dr Alexandria,LA71301	72-0998302	501(c)(3)	10,000	GOLD SPONSOR ANNUAL BALL
(60) CHRISTUS FOUNDATION FOR HEALTHCARE PO BOX 1919 Houston,TX77251	74-6074210	501(c)(3)	20,000	DONATION
(61) CHRISTUS GOOD SHEPHERD FDN - LONGVIEW 700 East Marshall Ave Longview,TX75601	75-2056700	501(c)(3)	7,500	DONATION
(62) CHRISTUS HEALTH FOUNDATION 2830 Calder Beaumont,TX77702	61-1500100	501(c)(3)	15,000	DONATION
(63) CHRISTUS MOTHER FRANCES FOUNDATION 100 E Ferguson St STE 800 Tyler,TX75702	75-2028241	501(c)(3)	20,000	DONATION
(64) CHRISTUS SPOHN FOUNDATION 613 Elizabeth ST 605 Corpus Christi,TX78404	74-1906005	501(c)(3)	83,000	HEALTH PLAN DONATION
(65) FRIENDS OF CHRISTUS SANTA ROSA FOUNDATION 100 NE Loop 410 STE 706 SAN ANTONIO,TX78216	74-2723391	501(c)(3)	7,500	DONATION
(66) HOPKINS COUNTY MEMORIAL HOSPITAL 115 Airport Rd Sulphur Springs,TX75482	75-6001812	501(c)(3)	20,000	DONATION
(67) INTERFAITH COMMUNITY SHELTER GROUP INC PO box 22653 Sant Fe,NM87502	27-0736366	501(c)(3)	56,250	SERVICES TO VICTIMS
(68) IRVING CARES INC 440 S Nursery Rd 101 Irving,TX75060	75-1436937	501(c)(3)	25,000	FINANCIAL STABILITY
(69) LEADERSHIP CONFERENCE OF WOMEN 8808 Cameron St Silver Spring,MD20910	43-6033728	501(c)(3)	10,000	DONATION
(70) QUIJOTES OF SAN ANTONIO (AMBASSADOR OF HEALTH) 13730 Wilderness PT San Antonio,TX78231	30-0786140	501(c)(3)	10,000	DONATIONS
(71) RISE AGAINST HUNGER INC 3733 National Dr Ste 200 Raleigh,NC27612	16-1541024	501(c)(3)	6,830	DONATIONS
(72) St Benedict's Prep 520 Dr Martin Luther King Jr Blvd Newark,NJ07102	22-1861903	501(c)(3)	15,000	DONATION
(73) St Vincent Hospital Foundation 440 St Michaels Dr Santa Fe,NM87505	85-0282847	501(c)(3)	25,000	DONATION
(74) Texas Hospital Association 1108 Lavaca st 700 Austin,TX78701	74-1362741	501(c)(3)	56,565	THA COMPASS PROGRAM
(75) The Catholic Health Association 4455 Woodson Rd St Louis,MO63134	43-0653271	501(c)(3)	56,500	SPONSORSHIPS
(76) The University Of Dallas 1845 E Northgate Dr Irving,TX75062	75-0926755	501(c)(3)	10,000	DONATION
(77) Wheelchairs For Warriors PO BOX 2911 League City,TX77575	81-4602791	501(c)(3)	7,313	CUSTOM BUILT WHEELCHAIR

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

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

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference

Explanation

Description of Organization's Procedures for Monitoring the Use of Grants

FORM 990, SCHEDULE I, PART I, LINE 2 THE ORGANIZATION FOLLOWS CHRISTUS HEALTH MANAGEMENT DIRECTIVE NO. 0006, "CONTRIBUTIONS/DONATIONS TO OTHER ORGANIZATIONS". BEFORE ANY DONATION IS MADE, TWO CRITERIA ARE ADDRESSED: (1) ORGANIZATION TEST AND (2) IRS TEST. THE ORGANIZATION TEST ENSURES THAT DONATIONS ARE EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, EDUCATIONAL, AND RELIGIOUS PURPOSES, AND IN FURTHERANCE OF OUR PURPOSE OF SUPPORTING THE HEALING MINISTRY OF JESUS CHRIST AND ADVANCING, PROMOTING, AND SUPPORTING THE HEALTHCARE MINISTRIES OF THE SPONSORING CONGREGATIONS. CONTRIBUTIONS CAN BE MADE TO SUPPORT CHRISTUS SYSTEM MEMBERS AND TO OTHER QUALIFYING TAX-EXEMPT ORGANIZATIONS, PARTICULARLY THOSE DESIGNED TO SUPPORT AND BENEFIT THE POOR AND UNDERSERVED. THE ORGANIZATION CONSIDERED FOR DONATIONS MUST BE AN IRS SECTION 501(C)(3) ORGANIZATION AND DOCUMENTATION TO THAT EFFECT OBTAINED. TO SATISFY THE IRS TEST CONTRIBUTIONS GIVEN MUST BE DEDICATED TO ACHIEVING CHARITABLE PURPOSES NOT FOR PERSONAL BENEFIT BUT FOR PUBLIC BENEFIT. CONTRIBUTIONS ARE PROHIBITED TO ORGANIZATIONS THAT CONTRIBUTE TO POLITICAL CAMPAIGNS, CANDIDATES FOR OFFICE, OR CONDUCT MORE THAN INCIDENTAL LOBBYING. DOCUMENTATION MUST SUPPORT HOW THE DONATION MEETS ORGANIZATIONAL PURPOSES AND FURTHERANCE OF MISSION. DONATIONS SHOULD BE MODEST IN SCOPE.

Schedule I (Form 990) 2018

Additional Data

Software ID:
Software Version:

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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

Christus Health

Employer identification number

76-0590551

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 .........

Yes

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? ..

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any 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)
1J LINDSEY BRADLEY JR DIRECTOR (TERM 6/2019)	(i) (ii)	0 ------------- 0	0 ------------- 0	858,693 ------------- 0	0 ------------- 0	0 ------------- 0	858,693 ------------- 0	0 ------------- 0
2STEVEN KEUER MD TMF CMO	(i) (ii)	598,914 ------------- 0	334,779 ------------- 0	25,500 ------------- 0	172,760 ------------- 0	11,656 ------------- 0	1,143,609 ------------- 0	0 ------------- 0
3ALEX J VALDEZ CEO-Clinica San Carlos de Apoq	(i) (ii)	0 ------------- 0	0 ------------- 0	100,517 ------------- 0	3,334 ------------- 0	0 ------------- 0	103,851 ------------- 0	0 ------------- 0
4ALEJANDRO CANAVATI CEO - CHILE OPDERATIONS	(i) (ii)	519,295 ------------- 0	418,000 ------------- 0	146,739 ------------- 0	145,712 ------------- 0	17,240 ------------- 0	1,246,986 ------------- 0	0 ------------- 0
5Joseph S Barcie SVP INTL Ops (tERM 10/2017)	(i) (ii)	0 ------------- 0	0 ------------- 0	484,796 ------------- 0	1,282 ------------- 0	0 ------------- 0	486,078 ------------- 0	0 ------------- 0
6Patrick B Carrier PRESIDENT - SANTA FE MINISTRY	(i) (ii)	507,454 ------------- 0	361,063 ------------- 0	634,089 ------------- 0	43,149 ------------- 0	13,110 ------------- 0	1,558,865 ------------- 0	0 ------------- 0
7George S Conklin SVP-CIO	(i) (ii)	788,891 ------------- 0	603,952 ------------- 0	290,907 ------------- 0	41,847 ------------- 0	17,562 ------------- 0	1,743,159 ------------- 0	0 ------------- 0
8Dominic J Dominguez SVP-GROUP OPERATIONS SO TX	(i) (ii)	655,631 ------------- 0	431,626 ------------- 0	21,093 ------------- 0	179,134 ------------- 0	12,669 ------------- 0	1,300,153 ------------- 0	0 ------------- 0
9Paul D Generale EVP/CHIEF STRATEGY OFFICER	(i) (ii)	1,864,660 ------------- 0	1,090,468 ------------- 0	52,288 ------------- 0	484,517 ------------- 0	17,829 ------------- 0	3,509,762 ------------- 0	0 ------------- 0
10John A Gillean EVP/CHIEF MEDICAL OFFICER	(i) (ii)	1,037,092 ------------- 0	1,000,595 ------------- 0	420,957 ------------- 0	43,096 ------------- 0	30,616 ------------- 0	2,532,356 ------------- 0	0 ------------- 0
11Gerard F Heeley SVP-MISSION AND ETHICS	(i) (ii)	683,161 ------------- 0	522,466 ------------- 0	259,153 ------------- 0	245,172 ------------- 0	9,183 ------------- 0	1,719,135 ------------- 0	0 ------------- 0
12Christopher karam SVP-Group Operations LA	(i) (ii)	724,486 ------------- 0	435,363 ------------- 0	92,227 ------------- 0	254,291 ------------- 0	20,269 ------------- 0	1,526,636 ------------- 0	0 ------------- 0
13Nancy C Legros til 102017 SVP-CHIEF Lgl CNSL	(i) (ii)	0 ------------- 0	0 ------------- 0	287,436 ------------- 0	1,627 ------------- 0	0 ------------- 0	289,063 ------------- 0	0 ------------- 0
14Marty F Margetts EVP/CORP SERVICES	(i) (ii)	1,517,379 ------------- 0	1,004,190 ------------- 0	303,619 ------------- 0	446,320 ------------- 0	36,553 ------------- 0	3,308,061 ------------- 0	0 ------------- 0
15Linda K McClung EVP/CAO	(i) (ii)	2,103,377 ------------- 0	976,628 ------------- 0	744,843 ------------- 0	132,227 ------------- 0	14,658 ------------- 0	3,971,733 ------------- 0	81,699 ------------- 0
16Peter J Plantes CEO CPG (term 11/2017)	(i) (ii)	0 ------------- 0	0 ------------- 0	596,052 ------------- 0	1,095 ------------- 0	0 ------------- 0	597,147 ------------- 0	0 ------------- 0
17Jeffrey M Puckett EVP/COO	(i) (ii)	2,482,445 ------------- 0	1,378,064 ------------- 0	109,386 ------------- 0	690,019 ------------- 0	19,253 ------------- 0	4,679,167 ------------- 0	0 ------------- 0
18Ernie W Sadau PRESIDENT/CEO	(i) (ii)	4,351,450 ------------- 0	2,666,867 ------------- 0	166,483 ------------- 0	1,140,874 ------------- 0	18,799 ------------- 0	8,344,473 ------------- 0	0 ------------- 0
19Randolph W Safady EVP/CFO	(i) (ii)	3,032,412 ------------- 0	1,282,199 ------------- 0	326,568 ------------- 0	147,590 ------------- 0	29,335 ------------- 0	4,818,104 ------------- 0	109,445 ------------- 0
20M Shannon Stansbury SVP-POPULATION HEALTH	(i) (ii)	421,397 ------------- 0	251,394 ------------- 0	108,396 ------------- 0	137,149 ------------- 0	23,512 ------------- 0	941,848 ------------- 0	0 ------------- 0
21Stephen F Wright PRES/CEO-LA MINS (TIL 10/2018)	(i) (ii)	1,175,006 ------------- 0	217,562 ------------- 0	335,184 ------------- 0	121,744 ------------- 0	17,181 ------------- 0	1,866,677 ------------- 0	73,765 ------------- 0
22J Chris Glenney SVP GROUP OPERATIONS NETX	(i) (ii)	639,604 ------------- 0	1,013,387 ------------- 0	13,038 ------------- 0	294,769 ------------- 0	20,277 ------------- 0	1,981,075 ------------- 0	0 ------------- 0
23JEANNIE FREY SVP CHF LGL OFFCR (EFF 7/2018)	(i) (ii)	436,753 ------------- 0	0 ------------- 0	101,917 ------------- 0	76,464 ------------- 0	6,157 ------------- 0	621,291 ------------- 0	0 ------------- 0
24SAM BAGCHI MD SVP, Chief Medical Officer	(i) (ii)	641,172 ------------- 0	377,091 ------------- 0	20,770 ------------- 0	172,970 ------------- 0	20,774 ------------- 0	1,232,777 ------------- 0	0 ------------- 0
25DEBRA PASLEY SVP, CNO	(i) (ii)	379,726 ------------- 0	217,875 ------------- 0	84,327 ------------- 0	105,418 ------------- 0	10,954 ------------- 0	798,300 ------------- 0	0 ------------- 0
26N TODD HANCOCK CEO GSHS	(i) (ii)	433,569 ------------- 0	712,364 ------------- 0	25,243 ------------- 0	180,254 ------------- 0	24,048 ------------- 0	1,375,478 ------------- 0	0 ------------- 0
27SCOTT SMITH SVP TRINITY CLINIC	(i) (ii)	596,969 ------------- 0	361,727 ------------- 0	25,000 ------------- 0	129,079 ------------- 0	26,347 ------------- 0	1,139,122 ------------- 0	0 ------------- 0
28MARIA ESTELA CHAPA CCTO SPOHN	(i) (ii)	599,647 ------------- 0	156,987 ------------- 0	74,995 ------------- 0	49,935 ------------- 0	12,714 ------------- 0	894,278 ------------- 0	29,857 ------------- 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
SUPPLEMENTAL COMPENSATION INFORMATION	FORM 990, PART VII, QUESTION 1A & SCHEDULE J, PART II DIRECTORS AND EX-OFFICIO DIRECTORS PROVIDE THEIR SERVICES AS MEMBERS OF THE BOARD WITHOUT COMPENSATION OR BENEFITS. ANY COMPENSATION AND BENEFITS DISCLOSED FOR SUCH PERSONS IS EARNED IN THE RESPECTIVE INDIVIDUAL'S ROLE AS AN OFFICER OR EMPLOYEE OF THE ORGANIZATION, NOT FOR THE INDIVIDUAL'S ROLE AS A BOARD MEMBER OR DIRECTOR. OFFICERS, KEY EMPLOYEES AND HIGHEST PAID EMPLOYEES ARE FULL-TIME EMPLOYEES. BOARD MEMBERS SPEND TIME AS NEEDED FOR BOARD MEETINGS AND FUNCTIONS.
FIRST CLASS TRAVEL	FFORM 990, SCHEDULE J, PART I, LINE 1A CERTAIN EXECUTIVES AND BOARD MEMBERS WERE REIMBURSED UNDER AN ACCOUNTABLE PLAN FOR FIRST CLASS TRAVEL. COMPANION TRAVEL FORM 990, SCHEDULE J, PART I, LINE 1A TAXABLE COMPENSATION WAS REPORTED TO VARIOUS OFFICERS AND BOARD MEMBERS RELATED TO COMPANION TRAVEL TO CHRISTUS MEETINGS. DETERMINATION OF CEO/EXECUTIVE DIRECTOR'S COMPENSATION FORM 990, SCHEDULE J, PART I, LINE 3 CHRISTUS HEALTH USES AN EXECUTIVE COMPENSATION COMMITTEE TO ESTABLISH AND APPROVE THE COMPENSATION OF THE FILING ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. THIS COMMITTEE USES AN INDEPENDENT COMPENSATION CONSULTANT WHO PERFORMS A BI-ANNUAL COMPENSATION SURVEY. THE CEO HAS A WRITTEN EMPLOYMENT CONTRACT WITH THE FILING ORGANIZATION. SEVERANCE PAYMENTS FORM 990, SCHEDULE J, PART I, QUESTION 4A THE FOLLOWING INDIVIDUAL(S) RECEIVED A SEVERANCE PAYMENT: J. LINDSEY BRADLEY - $843,286 ALEX J. VALDEZ - $59,703 JOSEPH S. BARCIE - $469,196 PATRICK B. CARRIER - $89,854 PETER J. PLANTES - $580,426 STEPHEN F. WRIGHT - $154,308 NANCY LEGROS - $285,061
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN	FORM 990, SCHEDULE J, PART I, QUESTION 4B DEFERRED COMPENSATION INCLUDES EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, AND PENSION RESTORATION PLAN. ESTIMATED PENSION BENEFITS WERE CALCULATED BASED ON THE PROVISIONS OF THE CURRENT PENSION RESTORATION PLAN AT 6% OF PENSIONABLE EARNINGS WHICH ARE OVER THE IRS LEGISLATIVE COMPENSATION LIMIT. SOME ASSOCIATES ARE GRANDFATHERED UNDER AN EARLIER LEGACY PENSION PLAN. IF A PARTICIPANT HAS PROTECTED PENSION BENEFITS UNDER SUCH LEGACY PLANS, HIS/HER PERCENTAGE IS ZERO UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, AS THE PROTECTED BENEFIT IS ALREADY EQUAL TO OR BETTER THAN CURRENT MARKET. PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FORM 990, SCHEDULE J, PART I, QUESTION 4B AND FORM 990, SCHEDULE J, PART II, COLUMN (F), COMPENSATION REPORTED AS DEFERRED IN PRIOR YEAR 990. LINDA K. MCCLUNG RECEIVED $81,699 DURING CALENDAR YEAR 2018 UNDER A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN. RANDOLPH W. SAFADY RECEIVED $109,445 DURING CALENDAR YEAR 2018 UNDER A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN. STEPHEN F. WRIGHT RECEIVED $73,765 DURING CALENDAR YEAR 2018 UNDER A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN. MARY ESTELA CHAPA RECEIVED $29,857 DURING CALENDAR YEAR 2018 UNDER A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN. SUPPLEMENTAL COMPENSATION INFORMATION FORM 990, SCHEDULE J, PART II W-2 COMPENSATION MAY INCLUDE PAYMENTS RELATED TO COMPENSATION DEFERRED IN PRIOR YEARS. DEFERRED COMPENSATION MAY INCLUDE DEFERRALS OF CURRENT YEAR COMPENSATION UNDER EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN AND PENSION RESTORATION PLAN. BONUS AND INCENTIVE COMPENSATION FORM 990, SCHEDULE J, PART II, COLUMN B(II) BONUS AND INCENTIVE COMPENSATION MAY INCLUDE AMOUNTS THAT WERE DEFERRED IN A PRIOR YEAR BUT PAID OUT IN CALENDAR YEAR 2018. DEFERRED COMPENSATION FORM 990, SCHEDULE J, PART II, COLUMN C DEFERRED COMPENSATION INCLUDES EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, EMPLOYER CONTRIBUTION TO 403(B) MATCHED SAVINGS PLAN, PENSION RESTORATION PLAN AND ESTIMATED PENSION BENEFITS UNDER CHRISTUS HEALTH CASH BALANCE PLAN. ESTIMATED PENSION BENEFITS WERE CALCULATED BASED ON THE PROVISIONS OF THE CURRENT CASH BALANCE PLAN AT 6% OF PENSIONABLE EARNINGS. SOME ASSOCIATES ARE GRANDFATHERED UNDER AN EARLIER PENSION PLAN. THESE GRANDFATHERED PARTICIPANTS, BASED ON COMPUTATION AT THE TIME OF THEIR RETIREMENT, WILL RECEIVE THE LARGER OF THE RETIREMENT BENEFIT COMPUTED UNDER THE CASH BALANCE PLAN COMPARED TO THE PREVIOUS PENSION PLAN. DUE TO THE COMPLEXITY OF CALCULATING AN ACCURATE BENEFIT COST FOR GRANDFATHERED PARTICIPANTS, THE FORM 990 REPORTS AS PENSION BENEFITS THEIR ANNUAL ESTIMATED CASH BALANCE PLAN ACCRUAL. COMPENSATION REPORTED AS DEFERRED IN PRIOR FORM 990 FORM 990, SCHEDULE J, PART II, COLUMN (F) THE AMOUNTS REPORTED ON FORM 990, SCHEDULE J, PART II, COLUMN (F) ARE THE PAYMENTS REPORTED AS REPORTABLE COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN (B)(III) TO THE EXTENT THAT SUCH PAYMENTS WERE REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. THE AMOUNTS REPORTED ON FORM 990, SCHEDULE J, PART II, COLUMN (F) ARE A RESULT OF PARTICIPATION IN THE FOLLOWING NONQUALIFIED SUPPLEMENTAL RETIREMENT PLANS: PENSION RESTORATION PLAN, DEFERRED INCOME ACCOUNT AND SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN.

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
Christus Health

Employer identification number
76-0590551

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	HARRIS COUNTY HEALTH FACILITIES DEV CORP	52-1284201	41315RFV1	11-08-2005	320,620,000	SEE SCH K, PART VI	X			X		X
B	HARRIS COUNTY HEALTH FACILITIES DEV CORP	52-1284201	41315RHY3	12-09-2010	96,654,505	SEE SCH K, PART VI	X			X		X
C	COASTAL BEND HEALTH FACILITIES DEV CORP	74-2352502	19042FAB2	11-08-2005	61,300,000	SEE SCH K, PART VI		X		X		X
D	LOUISIANA PUBLIC FACILITIES AUTHORITY	72-0895871	546399HA7	10-30-2018	70,942,111	SEE SCH K, PART VI		X		X		X
	LOUISIANA PUBLIC FACILITIES AUTHORITY	72-0895871	546398C71	08-12-2009	231,654,638	SEE SCH K, PART VI	X			X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	87638TGN7	10-30-2018	481,651,366	SEE SCH K, PART VI		X		X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	87638TDF7	12-19-2008	268,560,000	SEE SCH K, PART VI		X		X		X
	LOUISIANA PUBLIC FACILITIES AUTHORITY	72-0895871	546399GC4	04-02-2019	53,021,204	SEE SCH K, PART VI		X		X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	000000000	10-03-2016	174,304,000	SEE SCH K, PART VI		X		X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	87638TEA7	12-03-2009	73,865,293	SEE SCH K, PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	218,520,000		54,070,000		18,050,000		0
2 Amount of bonds legally defeased ..............	7,650,000		16,105,000		0		0
3 Total proceeds of issue ..................	320,968,617		96,654,505		62,857,619		71,484,383
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 ...............	1,687,416		0		337,093		0
8 Credit enhancement from proceeds .............	4,733,000		0		914,000		0
9 Working capital expenditures from proceeds .............	0		4,505		393,273		0
10 Capital expenditures from proceeds .............	3,624,407		0		18,182,274		0
11 Other spent proceeds .............	310,923,795		96,650,000		43,030,979		30,942,111
12 Other unspent proceeds .............	0		0		0		40,542,272
13 Year of substantial completion .............	2009				2009
	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?
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 ....	0.100 %		0 %		0.100 %		0.100 %
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 .........
6 Total of lines 4 and 5 .............	0.100 %		0.100 %		0.100 %		0.100 %
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 .........					3970 %
d Was the hedge superintegrated? ......						X
e Was the hedge terminated? ........						X

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 I

FORM 990, SCHEDULE K, PART I, PAGE 1 A. HARRIS COUNTY HEALTH FACILITIES DEVELOPMENT CORPORATION (F) DESCRIPTION OF PURPOSE: CONSTRUCT NEW HEALTHCARE FACILITIES AND ADVANCE REFUND A PRIOR ISSUE (JULY 28, 1999). B. HARRIS COUNTY HEALTH FACILITIES DEVELOPMENT CORPORATION (F) DESCRIPTION OF PURPOSE: CURRENTLY REFUND A PRIOR ISSUE (SEPTEMBER 17, 2007). C. COASTAL BEND HEALTH FACILITIES DEVELOPMENT CORPORATION (F) DESCRIPTION OF PURPOSE: CURRENTLY REFUND A PRIOR ISSUE (NOVEMBER 17, 1998) AND CONSTRUCT NEW HEALTHCARE FACILITIES. D. LOUISIANA PUBLIC FACILITIES AUTHORITY (F) CURRENTLY REFUND A PRIOR ISSUE (NOVEMBER 25, 2008); THE ACQUISITION,CONSTRUCTION AND/OR EQUIPPING OF CAPITAL IMPROVEMENTS FOR HOSPITALS. FORM 990, SCHEDULE K, PART I, PAGE 2 A. LOUISIANA PUBLIC FACILITIES AUTHORITY (F) DESCRIPTION OF PURPOSE: CURRENTLY REFUND A PRIOR ISSUE (NOVEMBER 20,2007, DECEMBER 19, 2008). B. TARRANT COUNTY CULTURAL EDUCATION FACILITIES FINANCE CORPORATION (F) DESCRIPTION OF PURPOSE: CURRENTLY REFUND A PRIOR ISSUE (NOVEMBER 25, 2008); THE ACQUISITION, CONSTRUCTION AND/OR EQUIPPING OF CAPITAL IMPROVEMENTS FOR HOSPITALS. C. TARRANT COUNTY CULTURAL EDUCATION FACILITIES FINANCE CORPORATION (F) DESCRIPTION OF PURPOSE: CURRENTLY REFUND A PRIOR ISSUE (NOVEMBER 8, 2005, NOVEMBER 20, 2007). D. LOUISIANA PUBLIC FACILITIES AUTHORITY (F) DESCRIPTION OF PURPOSE: CURRENTLY REFUND A PRIOR ISSUE (AUGUST 12, 2009). FORM 990, SCHEDULE K, PART I, PAGE 3 A. TARRANT COUNTY CULTURAL EDUCATION FACILITIES FINANCE CORPORATION (F) TO FINANCE THE ACQUISITION OF HEALTHCARE FACILITIES WHICH INCLUDE ONE OR MORE ACUTE CARE HOSPITALS. B. TARRANT COUNTY CULTURAL EDUCATION FACILITIES FINANCE CORPORATION (F) DESCRIPTION OF PURPOSE: CURRENTLY REFUND A PRIOR ISSUE (DECEMBER 19, 2008). FORM 990, SCHEDULE K PART II, PAGE 1 A. LINE 3. INVESTMENT EARNINGS = $348,617 C. LINE 3. INVESTMENT EARNINGS= $1,557,619 D. LINE 3. INVESTMENT EARNINGS=$542,272 FORM 990, SCHEDULE K, PART II, PAGE 2 A. LINE 3. INVESTMENT EARNINGS = $1,094,049 B. LINE 3. INVESTMENT EARNINGS = $2,242,199 C. LINE 3. INVESTMENT EARNINGS= $854 FORM 990, SCHEDULE K, PART II, PAGE 2 B. LINE 3. INVESTMENT EARNINGS= $3,833 LINE 16. REPORTED FINAL ALLOCATION HAS NOT BEEN MADE TO THE EXTENT WE HAVE UNSPENT TRANSFER PROCEEDS. FORM 990, SCHEDULE K PART IV, PAGE 1 A. LINE 2C - REBATE COMPUTATION PERFORMED JULY 24, 2014. B. LINE 2C - REBATE COMPUTATION PERFORMED DECEMBER 24, 2015. C. LINE 2C - REBATE COMPUTATION PERFORMED JULY 24, 2014. FORM 990, SCHEDULE K PART IV, PAGE 2 A. LINE 2C - REBATE COMPUTATION PERFORMED AUGUST 22, 2014. C. LINE 2C - REBATE COMPUTATION PERFORMED AUGUST 22, 2014. FORM 990, SCHEDULE K PART IV, PAGE 3 B. LINE 2C - REBATE COMPUTATION PERFORMED DECEMBER 7, 2014.

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
Christus Health

Employer identification number
76-0590551

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	HARRIS COUNTY HEALTH FACILITIES DEV CORP	52-1284201	41315RFV1	11-08-2005	320,620,000	SEE SCH K, PART VI	X			X		X
B	HARRIS COUNTY HEALTH FACILITIES DEV CORP	52-1284201	41315RHY3	12-09-2010	96,654,505	SEE SCH K, PART VI	X			X		X
C	COASTAL BEND HEALTH FACILITIES DEV CORP	74-2352502	19042FAB2	11-08-2005	61,300,000	SEE SCH K, PART VI		X		X		X
D	LOUISIANA PUBLIC FACILITIES AUTHORITY	72-0895871	546399HA7	10-30-2018	70,942,111	SEE SCH K, PART VI		X		X		X
	LOUISIANA PUBLIC FACILITIES AUTHORITY	72-0895871	546398C71	08-12-2009	231,654,638	SEE SCH K, PART VI	X			X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	87638TGN7	10-30-2018	481,651,366	SEE SCH K, PART VI		X		X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	87638TDF7	12-19-2008	268,560,000	SEE SCH K, PART VI		X		X		X
	LOUISIANA PUBLIC FACILITIES AUTHORITY	72-0895871	546399GC4	04-02-2019	53,021,204	SEE SCH K, PART VI		X		X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	000000000	10-03-2016	174,304,000	SEE SCH K, PART VI		X		X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	87638TEA7	12-03-2009	73,865,293	SEE SCH K, PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	218,520,000		54,070,000		18,050,000		0
2 Amount of bonds legally defeased ..............	7,650,000		16,105,000		0		0
3 Total proceeds of issue ..................	320,968,617		96,654,505		62,857,619		71,484,383
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 ...............	1,687,416		0		337,093		0
8 Credit enhancement from proceeds .............	4,733,000		0		914,000		0
9 Working capital expenditures from proceeds .............	0		4,505		393,273		0
10 Capital expenditures from proceeds .............	3,624,407		0		18,182,274		0
11 Other spent proceeds .............	310,923,795		96,650,000		43,030,979		30,942,111
12 Other unspent proceeds .............	0		0		0		40,542,272
13 Year of substantial completion .............	2009				2009
	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?
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 ....	0.100 %		0 %		0.100 %		0.100 %
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 .........
6 Total of lines 4 and 5 .............	0.100 %		0.100 %		0.100 %		0.100 %
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 .........					3970 %
d Was the hedge superintegrated? ......						X
e Was the hedge terminated? ........						X

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 I

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
Christus Health

Employer identification number
76-0590551

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	HARRIS COUNTY HEALTH FACILITIES DEV CORP	52-1284201	41315RFV1	11-08-2005	320,620,000	SEE SCH K, PART VI	X			X		X
B	HARRIS COUNTY HEALTH FACILITIES DEV CORP	52-1284201	41315RHY3	12-09-2010	96,654,505	SEE SCH K, PART VI	X			X		X
C	COASTAL BEND HEALTH FACILITIES DEV CORP	74-2352502	19042FAB2	11-08-2005	61,300,000	SEE SCH K, PART VI		X		X		X
D	LOUISIANA PUBLIC FACILITIES AUTHORITY	72-0895871	546399HA7	10-30-2018	70,942,111	SEE SCH K, PART VI		X		X		X
	LOUISIANA PUBLIC FACILITIES AUTHORITY	72-0895871	546398C71	08-12-2009	231,654,638	SEE SCH K, PART VI	X			X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	87638TGN7	10-30-2018	481,651,366	SEE SCH K, PART VI		X		X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	87638TDF7	12-19-2008	268,560,000	SEE SCH K, PART VI		X		X		X
	LOUISIANA PUBLIC FACILITIES AUTHORITY	72-0895871	546399GC4	04-02-2019	53,021,204	SEE SCH K, PART VI		X		X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	000000000	10-03-2016	174,304,000	SEE SCH K, PART VI		X		X		X
	TARRANT COUNTY CULTURAL EDUCATION FAC FIN CORP	04-3833551	87638TEA7	12-03-2009	73,865,293	SEE SCH K, PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	218,520,000		54,070,000		18,050,000		0
2 Amount of bonds legally defeased ..............	7,650,000		16,105,000		0		0
3 Total proceeds of issue ..................	320,968,617		96,654,505		62,857,619		71,484,383
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 ...............	1,687,416		0		337,093		0
8 Credit enhancement from proceeds .............	4,733,000		0		914,000		0
9 Working capital expenditures from proceeds .............	0		4,505		393,273		0
10 Capital expenditures from proceeds .............	3,624,407		0		18,182,274		0
11 Other spent proceeds .............	310,923,795		96,650,000		43,030,979		30,942,111
12 Other unspent proceeds .............	0		0		0		40,542,272
13 Year of substantial completion .............	2009				2009
	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?
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 ....	0.100 %		0 %		0.100 %		0.100 %
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 .........
6 Total of lines 4 and 5 .............	0.100 %		0.100 %		0.100 %		0.100 %
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 .........					3970 %
d Was the hedge superintegrated? ......						X
e Was the hedge terminated? ........						X

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 I

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 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

Christus Health

Employer identification number

76-0590551

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Roy Alston	HUSBAND OF CHERYL ALSTON	170,636	SEE PART V		No

Part V

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

Return Reference	Explanation
SCHEDULE L, PART IV, COLUMN D	BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS Roy Alston is an employee of Christus Health. His wife, Cheryl Alston is a director of Christus Health.

Schedule L (Form 990 or 990-EZ) 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

Christus Health

Employer identification number

76-0590551

Return Reference	Explanation
FORM 990, PAGE 1, ITEM C	DOING BUSINESS AS: CHRISTUS HEALTH SERVICE CENTER CHRISTUS HEALTH SYSTEM CHRISTUS HEALTHY LIVING SPA CHRISTUS INNOVATIONS INSTITUTE CHRISTUS ST. JOSEPH VILLAGE CHRISTUS ST. MICHAEL SIMULATION CENTER MARKETPLACE SOLUTIONS TECHSOURCE TLRA UNIFORMED SERVICES FAMILY HEALTH PLAN US FAMILY HEALTH PLAN USFHP TEXAS HEALTH INFORMATION NETWORK COLLABORATIVE
DESCRIPTION OF OTHER PROGRAM SERVICES	FORM 990, PART III, LINE 4D COMMUNITY SERVICES - POOR AND UNDERSERVED ROOTED IN OUR MISSION AND TRADITION, THE FOUNDERS AND SPONSORS OF CHRISTUS HEALTH AND THOSE WHO CO-MINISTER WITH THEM SEEK NEW AND INNOVATIVE WAYS OF DELIVERING QUALITY HEALTH CARE THAT IS BOTH AFFORDABLE AND ACCESSIBLE TO ALL. TODAY, MORE THAN EVER, WE MUST AIM TO IMPROVE THE TOTAL HEALTH STATUS OF THE COMMUNITY THROUGH PROGRAMS THAT PLACE OUR SERVICES WHERE THEY ARE NEEDED MOST, WITH SPECIAL ATTENTION AND PREFERENCE GIVEN TO PROGRAMS THAT SUPPORT AND BENEFIT THE HEALTH AND WELFARE OF THE POOR AND UNDERSERVED. COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED REPRESENT THE UNPAID COST OF SERVICES PROVIDED FOR WHICH A PATIENT IS NOT BILLED, OR FOR WHICH A FEE HAS BEEN ASSESSED THAT RECOVERS ONLY A PORTION OF THE COST OF THE RENDERED SERVICE. THIS CATEGORY INCLUDES INITIATIVES THAT REACH OUT TO THOSE IN NEED THROUGH COMMUNITY HEALTH AND SOCIAL PROGRAMS. THESE PROGRAMS SEEK JUSTICE FOR THE VULNERABLE AND WORK TO BRING ABOUT CHANGES IN OUR POLITICAL AND ECONOMIC SYSTEMS. THE PROGRAMS COVER A BROAD SPECTRUM OF SERVICES FROM COMMUNITY CLINICS TO IMMUNIZATIONS FOR CHILDREN AND SENIORS, MEALS ON WHEELS, TRANSPORTATION SERVICES, HOME REPAIR PROJECTS AND A VARIETY OF OTHER SOCIAL SERVICES. SOME EXAMPLES OF CHRISTUS HEALTH COMMUNITY BENEFITS ACCOUNTED FOR UNDER COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED INCLUDE THE CHRISTUS COMMUNITY DIRECT INVESTMENT PROGRAM (CDI) AND THE CHRISTUS FUND. THE CHRISTUS BOARD OF DIRECTORS APPROVED THE FUNDING OF A CDI LOAN PROGRAM TO ENSURE THAT THE WORK OF SOCIAL ACCOUNTABILITY AND MORAL AND ETHICAL STEWARDSHIP CONTINUES IN SPITE OF CHALLENGING FISCAL CONDITIONS FACED BY LOCAL OPERATING ENTITIES. THE PURPOSE OF THE CDI PROGRAM IS TO SUPPORT COMMUNITY-DRIVEN INITIATIVES PRIMARILY FOR AFFORDABLE HOUSING AND ECONOMIC DEVELOPMENT BY PROVIDING FINANCING AT BELOW-MARKET INTEREST RATES TO NOT-FOR-PROFIT ORGANIZATIONS AT TERMS NOT EXCEEDING MORE THAN FIVE YEARS. THE INCOME THAT WOULD HAVE BEEN EARNED AT THE MARKET RATE LESS OUR LOAN RATE (FOREGONE INCOME) IS CONSIDERED A COMMUNITY BENEFIT FOR REPORTING PURPOSES. THE TOTAL FOREGONE INTEREST REPORTED AS COMMUNITY BENEFIT FOR FY2019 WAS $25,764. THE COST OF THESE INVESTMENTS IS NOT INCLUDED IN THE PROGRAM SERVICE EXPENSES. THESE LOANS ARE PROVIDED TO OTHER NON-PROFIT ORGANIZATIONS. CHRISTUS HEALTH ESTABLISHED THE CHRISTUS FUND TO PROVIDE RESOURCES TO NOT-FOR-PROFIT AGENCIES AND GROUPS WHOSE VISION, MISSION AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES AND PHILOSOPHY OF A HEALTHY COMMUNITY. WE BELIEVE THAT BY WORKING TOGETHER, WE CAN MAKE A PROFOUND DIFFERENCE IN THE QUALITY OF PEOPLES' LIVES AND CREATE SUSTAINABLE HEALTH IMPROVEMENTS IN OUR COMMUNITIES. DURING FY 2019, GRANT FUNDS WERE DISTRIBUTED FROM CHRISTUS HEALTH FOUNDATION OF $2,655,705.
DESCRIPTION OF RELATIONSHIPS	FORM 990, PART VI, LINE 2 OFFICERS ERNIE SADAU AND RANDY SAFADY, AND KEY EMPLOYEES JOHN GILLEAN, MD HAVE A BUSINESS RELATIONSHIP AS EACH SERVED AS A DIRECTOR ON THE BOARD OF EMERALD ASSURANCE CAYMAN, LTD.
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS	FORM 990, PART VI, LINE 6 THE MEMBERS OF CHRISTUS HEALTH INCLUDE TWO SISTERS OF EACH OF THE FOUNDING SPONSORING CORPORATIONS, CONGREGATION OF THE SISTERS OF CHARITY OF THE INCARNATE WORD SAN ANTONIO, CONGREGATION OF THE SISTERS OF CHARITY OF INCARNATE WORD HOUSTON, AND ONE SISTER OF THE SISTERS OF THE HOLY FAMILY OF NAZARETH. THE MEMBERS HOLD THE AUTHORITY TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION (OTHER THAN THE FOUNDING SPONSORING CONGREGATION DIRECTORS), WITH OR WITHOUT PRIOR ACTION OR RECOMMENDATION OF THE BOARD OF DIRECTORS OR THE NOMINATING COMMITTEE OF THE CORPORATION.
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS	FORM 990, PART VI, LINE 7A THE MEMBERS OF CHRISTUS HEALTH INCLUDE TWO SISTERS OF EACH OF THE FOUNDING SPONSORING CORPORATIONS, CONGREGATION OF THE SISTERS OF CHARITY OF THE INCARNATE WORD SAN ANTONIO, CONGREGATION OF THE SISTERS OF CHARITY OF INCARNATE WORD HOUSTON, AND ONE SISTER OF THE SISTERS OF THE HOLY FAMILY OF NAZARETH. THE MEMBERS HOLD THE AUTHORITY TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION (OTHER THAN THE FOUNDING SPONSORING CONGREGATION DIRECTORS), WITH OR WITHOUT PRIOR ACTION OR RECOMMENDATION OF THE BOARD OF DIRECTORS OR THE NOMINATING COMMITTEE OF THE CORPORATION.
DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS	FORM 990, PART VI, LINE 7B THE MEMBERS HOLD THE AUTHORITY TO: APPROVE ANY AFFILIATION OR TRANSACTION THE RESULT OF WHICH WILL BE TO ADD A SPONSORING CONGREGATION, WITH OR WITHOUT PRIOR ACTION OR RECOMMENDATION OF THE BOARD OF DIRECTORS OF THE CORPORATION; TO APPROVE ANY AFFILIATION OR TRANSACTION THE RESULT OF WHICH WILL BE TO ADD AN OTHER-THAN-CATHOLIC AFFILIATED ENTITY TO THE SYSTEM, WITH OR WITHOUT PRIOR ACTION OR RECOMMENDATION OF THE BOARD OF DIRECTORS OF THE CORPORATION; TO ADOPT, APPROVE AND INTERPRET THE PHILOSOPHY, MISSION AND VISION OF THE CORPORATION, AS WELL AS ANY CHANGES THERETO, WITH OR WITHOUT PRIOR ACTION OR RECOMMENDATION OF THE BOARD OF DIRECTORS OF THE CORPORATION; TO ADOPT AND APPROVE ANY AMENDMENTS, MODIFICATIONS OR RESTATEMENTS OF THE ARTICLES OF INCORPORATION OR BYLAWS OF CORPORATION, WITH OR WITHOUT PRIOR ACTION OR RECOMMENDATION OF THE BOARD OF DIRECTORS OF THE CORPORATION; TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE CHAIRPERSON OF THE BOARD OF DIRECTORS OF THE CORPORATION; TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT OF THE CORPORATION AFTER CONSULTATION WITH THE BOARD OF DIRECTORS OF THE CORPORATION; TO APPROVE THE SALE, LEASE, MORTGAGE, TRANSFER OR ENCUMBRANCE OF REAL PROPERTY OF THE CORPORATION OR ANY SYSTEM PARTICIPANT WHEN THE AMOUNT INVOLVED IS IN EXCESS OF A THRESHOLD DOLLAR AMOUNT AS REQUIRED BY CANON LAW, SUBJECT TO ANY REQUIRED CANONICAL APPROVAL OF THE ORGANIZATIONS CANONICALLY ACCOUNTABLE UNDER THE ROMAN CATHOLIC CHURCH FOR SUCH REAL PROPERTY, WITH OR WITHOUT PRIOR ACTION OR RECOMMENDATION OF THE BOARD OF DIRECTORS OF THE CORPORATION; TO APPROVE THE THRESHOLD AGGREGATE AMOUNT OF DEBT TO BE INCURRED BY THE SYSTEM AND ANY INCURRENCE OF DEBT THE EFFECT OF WHICH WOULD BE TO EXCEED SUCH THRESHOLD AGGREGATE AMOUNT, WITH OR WITHOUT PRIOR ACTIONS OR RECOMMENDATION OF THE BOARD OF DIRECTORS OF THE CORPORATION; TO APPROVE ANY MERGER, CONSOLIDATION, ACQUISITION, LIQUIDATION OR DISSOLUTION OF THE CORPORATION, WITH OR WITHOUT PRIOR ACTION OR RECOMMENDATION OF THE BOARD OF DIRECTORS OF THE CORPORATION; TO APPROVE ANY MERGER, CONSOLIDATION, ACQUISITION, LIQUIDATION OR DISSOLUTION OF ANY SYSTEM PARTICIPANT THAT OWNS DESIGNATED MINISTRY PROPERTY OF THE CORPORATION, WITH OR WITHOUT PRIOR ACTION OR RECOMMENDATION OF THE BOARD OF DIRECTORS OF THE CORPORATION; AND TO APPROVE ANY COURSE OF ACTION PROPOSED BY A SYSTEM PARTICIPANT, WITH OR WITHOUT PRIOR ACTION OR RECOMMENDATION OF THE BOARD OF DIRECTORS OF THE CORPORATION, THE EFFECT OF WHICH WOULD BE TO CHANGE EITHER (A) THE FUNDAMENTAL USE OF DESIGNATED MINISTRY PROPERTY OR (B) THE TYPE OF SERVICES PROVIDED IN CONNECTION WITH DESIGNATED MINISTRY PROPERTY.
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990	FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED AND REVIEWED BY THE ORGANIZATION'S EXTERNAL INDEPENDENT ACCOUNTANTS. THE CHRISTUS HEALTH ACCOUNTING DEPARTMENT WORKS WITH AN EXTERNAL ACCOUNTING FIRM IN PREPARATION AND REVIEW OF THE FORM 990. THE FILING ORGANIZATION'S CFO, OR OTHER DESIGNEE, REVIEWS THE FORM 990. THE FINAL FORM 990 THAT WILL BE FILED WITH THE IRS IS POSTED TO A SECURE INTERNET PORTAL FOR ALL MEMBERS OF THE BOARD OF DIRECTORS TO VIEW. REVIEW OF THE FINAL FORM 990 OCCURS PRIOR TO FILING WITH THE IRS IN THE SPRING OF 2020 VIA A WEB PORTAL POLLING TOOL BY THE CHRISTUS ORGANIZATION'S BOARD, BASED ON A SET OF SUGGESTED REVIEW PROCESSES DEVELOPED BY CHRISTUS HEALTH.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST	FORM 990, PART VI, LINE 12C A CONFLICT OF INTEREST QUESTIONNAIRE WAS DISTRIBUTED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES DURING THE FISCAL YEAR. THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT THOROUGHLY REVIEWS ALL COMPLETED AND EXECUTED CONFLICT OF INTEREST QUESTIONNAIRE FORMS TO ENSURE ACCURACY AND THAT NO POTENTIAL OR IDENTIFIED CONFLICT IS DISCLOSED OR EXISTS. A CONFLICT OF INTEREST QUESTIONNAIRE WAS DISTRIBUTED TO THE ORGANIZATION'S OFFICERS, KEY EMPLOYEES AND DIRECTORS DURING THE NEXT FISCAL YEAR BY THE ORGANIZATION'S CORPORATE SECRETARY. THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY OF THE ORGANIZATION.
COMPENSATION DETERMINATION PROCESS	FORM 990, PART VI, LINES 15A & 15B THE EXECUTIVE COMPENSATION COMMITTEE OF CHRISTUS HEALTH DETERMINES THE COMPENSATION OF THE CEO (OR EXECUTIVE DIRECTOR, AS APPLICABLE), OFFICERS AND KEY EMPLOYEES OF CHRISTUS HEALTH AND CERTAIN OTHER OFFICERS AND KEY EMPLOYEES OF RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE IS COMPOSED OF INDIVIDUALS WHO HAVE NO CONFLICT OF INTEREST WITH THE COMPENSATION ARRANGEMENTS AT HAND. CHRISTUS HEALTH CEO'S COMPENSATION IS SUBJECT TO APPROVAL BY THE CHRISTUS HEALTH BOARD, AFTER DISCUSSION BY THE EXECUTIVE COMPENSATION COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE OF THE CHRISTUS HEALTH BOARD SELECTS AN INDEPENDENT EXTERNAL FIRM TO PERFORM AN INDEPENDENT COMPENSATION REVIEW, TO ENSURE THAT ALL COMPENSATION IS REASONABLE AND COMPARABLE TO OTHER SIMILARLY SITUATED ORGANIZATIONS, FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS, AND TO PROVIDE SUPPORTING INFORMATION OF COMPENSATION DECISIONS. ON AN ANNUAL BASIS THE EXTERNAL CONSULTANT: 1. COMPLETES A REVIEW OF THE COMPENSATION AND BENEFITS OF THE CEO AND PROVIDES A WRITTEN REPORT, AND APPEARS IN PERSON WITH THE COMMITTEE TO ADDRESS THE ANNUAL COMPENSATION REVIEW AND ANY DECISIONS RELATED TO SUCH COMPENSATION FOR THE CEO. THE CONSULTANT ALSO PROVIDES ALL OF THE COMPARABLE MARKET DATA TO SUPPORT RECOMMENDATIONS AND DECISIONS. 2. DEVELOPS THE MERIT INCREASE RECOMMENDATIONS FOR ALL DESIGNATED SYSTEM EXECUTIVES BASED ON MARKET COMPARABILITY. 3. RECOMMENDS THE CHANGES IN THE COMPENSATION STRUCTURE (GRADES) BASED ON THE MARKET CHANGES. 4. COMPLETES A REVIEW AND EVALUATION OF NEWLY CREATED POSITIONS TO RECOMMEND A GRADE PLACEMENT TO THE COMMITTEE FOR ITS DISCUSSION AND APPROVAL. ON A BI-ANNUAL BASIS, THE EXTERNAL CONSULTANT COMPLETES A DETAILED REVIEW OF ALL OTHER DESIGNATED SYSTEM EXECUTIVES' COMPENSATION AND BENEFITS. THIS GROUP INCLUDES ALL TOP MANAGEMENT OFFICIALS, OTHER OFFICERS AND KEY LEADERS OF THE ORGANIZATION. THE REVIEW INCLUDES RECOMMENDATIONS TO THE COMMITTEE ON ANY CHANGES NECESSARY IN EITHER SPECIFIC COMPENSATION OR COMPENSATION STRUCTURE TO ENSURE MARKET COMPETITIVENESS, REASONABLENESS AND INTERNAL EQUITY. UPON RECOMMENDATIONS FROM THE INDEPENDENT EXTERNAL FIRM, THE EXECUTIVE COMPENSATION COMMITTEE MAKES FINAL COMPENSATION DECISIONS. ADDITIONALLY, THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS ALL COMPENSATION PAYMENTS FOR EXCESS BENEFIT TRANSACTIONS. THE DISCUSSION AND DECISIONS OF THE COMMITTEE ARE DOCUMENTED AND FORMALIZED IN THE COMMITTEE MINUTES AND MAINTAINED ON RECORD.
PUBLIC DISCLOSURE OF 1023 AND FORMS 990 & 990-T	FORM 990, PART VI, LINE 18 CHRISTUS HEALTH AND MOST OF ITS AFFILIATED ENTITIES DO NOT HAVE FORMS 1023 BECAUSE OF THEIR INCLUSION IN THE IRS GROUP RULING WITH THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS, WHICH COVERS THE ORGANIZATION LISTED IN THE ANNUAL OFFICIAL CATHOLIC DIRECTORY. CHRISTUS HEALTH'S WEBSITE DISPLAYS THE IRS GROUP RULING AND RELEVANT ANNUAL OFFICIAL CATHOLIC DIRECTORY PAGES FOR THE ORGANIZATIONS RELATED TO CHRISTUS HEALTH. FORMS 990 AND 990-T ARE MADE AVAILABLE UPON REQUEST.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC	FORM 990, PART VI, QUESTION 19 THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CHRISTUS HEALTH ARE MADE AVAILABLE TO THE PUBLIC VIA THE CHRISTUS HEALTH WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FUNCTIONAL EXPENSE, LINE 8, PENSION PLAN CONTRIBUTIONS FORM 990, PART IX REPORTED IN PENSION PLAN CONTRIBUTIONS IS THE PENSION EXPENSE INCURRED BY THE FILING ORGANIZATION NETTED WITH THE PENSION EXPENSE ALLOCATED TO THE FILING ORGANIZATION'S SUBSIDIARIES. PENSION EXPENSE ALLOCATED EXCEEDED THE PENSION EXPENSE INCURRED FOR FISCAL YEAR ENDING JUNE 30, 2019.
OTHER CHANGES IN NET ASSETS OR FUND BALANCES	FORM 990, PART XI, LINE 9 CHANGE IN NONCONTROLLING INTEREST $ 59,023,856 SWAP FAIR VALUE $ 25,511,064 EQUITY IN CONSOLIDATED SUBSIDIARIES $ 16,876,012 INTERCOMPANY EQUITY ADJUSTMENT $ (312,839,141) BOND FUNDING $ (125,241,580) CHANGE IN PENSION LIABILITY $ (55,844,944) CURRENT YEAR EQUITY ADJUSTMENTS $ (10,723,362) OTHER $ (283,563) ---------------- LINE 9 TOTAL $ (403,521,658)
FORM 990 PART IX LINE 11G	DESCRIPTION:REPAIR & MAINTENANCE SERVICES TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER FEES TOTAL FEES:62723384
FORM 990 PART IX LINE 11G	DESCRIPTION:SVC - PHARMACY, PHYSICIAN TOTAL FEES:48176844
FORM 990 PART IX LINE 11G	DESCRIPTION:MARKETING & CONSULTING SERVICE TOTAL FEES:28225822
FORM 990 PART IX LINE 11G	DESCRIPTION:CAPITALTION EXPENSES TOTAL FEES:14732175
FORM 990 PART IX LINE 11G	DESCRIPTION:PURHCASED SERVICES TOTAL FEES:1437513
FORM 990 PART IX LINE 11G	DESCRIPTION:LINE OF CREDIT FEES TOTAL FEES:1211093
FORM 990 PART IX LINE 11G	DESCRIPTION:COLLECTION FEES TOTAL FEES:649
FORM 990 PART IX LINE 11G	DESCRIPTION:LOBBYING EXPENSES TOTAL FEES:-1111091
FORM 990 PART IX LINE 11G	DESCRIPTION:INTRCMPNY OVERHEAD ALLOCATION TOTAL FEES:-5763751
FORM 990 PART IX LINE 11G	DESCRIPTION:INTERCO PROF & SYSTEM FEES TOTAL FEES:-67932189

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

Christus Health

Employer identification number

76-0590551

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) CH SANTA ROSA QUALITY CARE ALLIANCE LLC 919 HIDDEN RIDGE DR IRVING,TX75038 47-4580155	ACO	TX	0	0	CH
(2) CHRISTUS LOUISIANA ACO LLC 919 HIDDEN RIDGE DR IRVING,TX75038 47-4592015	ACO	LA	0	0	CH
(3) CH ARK-LA-TEX QUALITY CARE ALLIANCE LLC 919 HIDDEN RIDGE DR IRVING,TX75038 47-4599144	ACO	TX	0	0	CH
(4) CHRISTUS QUALITY CARE ALLIANCE LLC 919 HIDDEN RIDGE DR IRVING,TX75038 47-4607533	ACO	TX	0	0	CH

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)CHRISTUS HEALTH ARK-LA-TEX 2600 ST MICHAEL DRIVE TEXARKANA,TX75503 75-2796815	HLTHCARE SVCS	TX	501(C)(3)	3	CH	Yes
(2)CHRISTUS HEALTH CENTRAL LOUISIANA 3330 MASONIC DRIVE ALEXANDRIA,LA71301 72-0408984	HLTHCARE SVCS	LA	501(C)(3)	3	CH	Yes
(3)CHRISTUS HEALTH GULF COAST PO BOX 922037 HOUSTON,TX77292 76-0591592	HLTHCARE SVCS	TX	501(C)(3)	3	CH	Yes
(4)CHRISTUS HEALTH NORTHERN LOUISIANA ONE SAINT MARY PLACE SHREVEPORT,LA71101 72-0408982	HLTHCARE SVCS	LA	501(C)(3)	3	CH	Yes
(5)Christus Spohn Health System Corporation 600 ELIZABETH STREET CORPUS CHRISTI,TX78404 74-1109836	HLTHCARE SVCS	TX	501(C)(3)	3	CH	Yes
(6)CHRISTUS HEALTH SOUTHEAST TEXAS 2830 Calder Street BEAUMONT,TX77726 76-0591590	HLTHCARE SVCS	TX	501(C)(3)	3	CH	Yes
(7)CHRISTUS HEALTH SOUTHWESTERN LOUISIANA 524 DR MICHAEL DEBAKEY DR LAKE CHARLES,LA70601 72-0411322	HLTHCARE SVCS	LA	501(C)(3)	3	CH	Yes
(8)CHRISTUS SANTA ROSA HEALTH CARE CORP 333 N SANTA ROSA STREET SAN ANTONIO,TX78207 74-1109665	HLTHCARE SVCS	TX	501(C)(3)	3	CH	Yes
(9)CHRISTUS Continuing Care 1700 W LOOP SOUTH SUITE 1100 HOUSTON,TX77027 74-2898615	HLTHCARE SVCS	TX	501(C)(3)	3	CH	Yes
(10)CH WILKINSON PHYSICIAN NETWORK 1700 WEST LOOP SOUTH STE 400B HOUSTON,TX77027 76-0422435	HLTHCARE SVCS	TX	501(C)(3)	12-TYPE 1	CH	Yes
(11)DUBUIS HEALTH SYSTEM INC 1700 WEST LOOP SOUTHSTE 1100A HOUSTON,TX77027 72-1270964	HLTHCARE SVCS	TX	501(C)(3)	3	CH	Yes
(12)CHRISTUS HEALTH FOUNDATION 919 HIDDEN RIDGE DRIVE IRVING,TX75038 61-1500100	SUPP HTH SVCS	TX	501(C)(3)	12-TYPE 1	CH	Yes
(13)ST FRANCES CABRINI HPL FDN OF ALEXANDRIA 3330 MASONIC DRIVE ALEXANDRIA,LA71301 72-0998302	SUPP HTH SVCS	LA	501(C)(3)	7	CNLA	Yes
(14)CHRISTUS FOUNDATION FOR HEALTHCARE PO BOX 1919 HOUSTON,TX77251 74-6074210	SUPP HTH SVCS	TX	501(C)(3)	7	CH	Yes
(15)CHRISTUS FOUNDATION SHREVEPORT-BOSSIER ONE ST MARY PLACE SHREVEPORT,LA71101 72-1219280	SUPP HTH SVCS	LA	501(C)(3)	7	NOLA	Yes
(16)CHRISTUS SPOHN HTH SYSTEM DEVELOPMENT FD 600 ELIZABETH STREET CORPUS CHRISTI,TX78404 74-1906005	SUPP HTH SVCS	TX	501(C)(3)	7	SPOHN HS	Yes
(17)CHRISTUS HEALTH FDN OF SOUTHEAST TX 2830 CALDER BEAUMONT,TX77702 76-0136274	SUPP HTH SVCS	TX	501(C)(3)	12-TYPE 1	SETX	Yes
(18)FRIENDS OF SANTA ROSA FOUNDATION 333 N SANTA ROSA STREET SAN ANTONIO,TX78207 74-2723391	SUPP HTH SVCS	TX	501(C)(3)	12-TYPE 1	CSRHCC	Yes
(19)SANTA ROSA FAMILY HEALTH CENTER 333 N SANTA ROSA STREET SAN ANTONIO,TX78207 74-2806531	HLTHCARE SVCS	TX	501(C)(3)	10	CSRHCC	Yes
(20)CHRISTUS HEALTH PLAN 600 ELIZABETH STREET CORPUS CHRISTI,TX78404 45-2106295	MEDICAID HMO	TX	501(C)(4)		CSHSC	Yes
(21)ST FRANCES CABRINI HOSPITAL AUXILIARY 3330 MASONIC DRIVE ALEXANDRIA,LA71301 23-7255175	SUPP HTH SVCS	LA	501(C)(3)	10	CNLA	Yes
(22)Christus Santa Rosa Med Ctr Auxiliary 2827 Babock Road San Antonio,TX78229 73-1655493	SUPP HTH SVCS	TX	501(C)(3)	10	CSRHCC	Yes
(23)CHRISTUS Health Strategic Growth 919 hidden ridge drive irving,TX75038 46-2798043	supp hth svcs	TX	501(c)(3)	12-type I	CH	Yes
(24)Christus Health Plan Louisiana 919 Hidden Ridge Dr Irving,TX75038 46-4617988	Medicaid HMO	LA	501(c)(4)		CH	Yes
(25)Christus Pediatric Physician Group 919 Hidden Ridge Dr Irving,TX75038 46-5203505	Hlthcare Svcs	TX	501(c)(3)	3	CH	Yes
(26)Christus Health Latin America 919 hidden ridge drive irving,TX75038 46-2816604	spt hlth svcs	TX	501(C)(3)	12-type 1	CH Stra Grth	Yes
(27)Christus HEALTH International 919 hidden RIDGE drive irving,TX75038 46-2811167	spt hlth svcs	TX	501(C)(3)	12-type 1	CH Stra Grth	Yes
(28)CHRISTUS ST MICHAEL FOUNDATION 2600 ST MICHAEL DRIVE TEXARKANA,TX75503 47-1655865	SPT HLTH SVCS	TX	501(c)(3)	7	ALT	Yes
(29)CHRISTUS ST PATRICK FOUNDATION 524 DR MICHAEL DEBAKEY DR LAKE CHARLES,LA70601 47-1496376	SPT HLTH SVCS	LA	501(C)(3)	7	SWLA	Yes
(30)CHRISTUS HOPKINS HEALTH ALLIANCE 115 AIRPORT RD SULPHUR SPRINGS,TX75482 81-1708177	HLTHCARE SVCS	TX	501(c)(3)	3	ch	Yes
(31)MOTHER FRANCES HOSPITAL - JACKSONVILLE 1315 DOCTORS DRIVE TYLER,TX75701 75-1976930	HOSPITAL	TX	501(C)(3)	3	CTMFHS	Yes
(32)CHRISTUS-TRINITY MOTHER FRANCES FDN 1315 DOCTORS DRIVE TYLER,TX75701 75-2028241	SUPPORT	TX	501(C)(3)	12-TYPE 1	CTMFHS	Yes
(33)REGIONAL MEDICAL SERVICES ASSOCIATION 1315 DOCTORS DRIVE TYLER,TX75701 75-2511459	HEALTHCARE	TX	501(C)(3)	3	MFH REG	Yes
(34)MOTHER FRANCES HOSPITAL - WINNSBORO 1315 DOCTORS DRIVE TYLER,TX75701 75-2771569	HOSPITAL	TX	501(C)(3)	3	CTMFHS	Yes
(35)TRINITY CLINIC 1315 DOCTORS DRIVE TYLER,TX75701 75-2616977	HEALTHCARE	TX	501(C)(3)	3	CTMFHS	Yes
(36)MOTHER FRANCES HOSPITAL REGIONAL HC CTR 1315 DOCTORS DRIVE TYLER,TX75701 75-0818167	HOSPITAL	TX	501(C)(3)	3	CTMFHS	Yes
(37)ALIGNED PROVIDERS OF EAST TEXAS 1315 DOCTORS DRIVE TYLER,TX75701 46-5720165	HEALTHCARE	TX	501(C)(3)	3	MFH REG	Yes
(38)CHRISTUS TRINITY MOTHER FRANCES HS 1315 DOCTORS DRIVE TYLER,TX75701 75-2616975	HLTHCARE SVCS	TX	501(C)(3)	12-TYPE II	CH	Yes
(39)Good Shepherd Health System INC 700 E MARSHALL AVE LONGVIEW,TX75601 75-2027157	hlthcare svcs	TX	501(c)(3)	12-type II	CH	Yes
(40)CHRISTUS ARK-LA-TEX HEALTH SYSTEM 919 HIDDEN RIDGE DR IRVING,TX75038 82-2109465	hlthcare svcs	TX	501(c)(3)	12-type II	CH	Yes
(41)Champion EMS 2201 S Mobberly Ave Longview,TX75602 75-2747708	Hlthcare Svcs	TX	501(c)(3)	10	GSHS INC	Yes
(42)HCMH Retail Clinic 115 Airport Road Sulphur Springs,TX75482 47-5417965	HLTHCARE SVCS	TX	501(C)(3)	3	GSHS INC	Yes
(43)GSHS ADMINISTRATIVE SERVICES ORG INC 700 E MARSHALL AVE LONGVIEW,TX75601 86-1132471	ADMIN SUPPORT	TX	501(C)(3)	12-TYPE I	GSHS INC	Yes
(44)THE GOOD SHEPHERD HOSPITAL INC 700 E MARSHALL AVE LONGVIEW,TX75601 75-1041154	HEALTHCARE	TX	501(C)(3)	3	GSHS INC	Yes
(45)GOOD SHEPHERD FOUNDATION INC 700 E MARSHALL AVE LONGVIEW,TX75601 75-2056700	SUPPORT	TX	501(C)(3)	12-TYPE I	GSHS INC	Yes
(46)GOOD SHEPHERD HOSPITAL AUXILIARY 700 E MARSHALL AVE LONGVIEW,TX75601 23-7203364	SUPPORT	TX	501(C)(3)	10	GSH INC	Yes
(47)SERVICE ORGANIZATION OF GOOD SHEPHERD 2950 50TH ST LUBBOCK,TX79413 38-3914883	SUPPORT	TX	501(C)(3)	12-TYPE I	GSH INC	Yes
(48)MARSHALL HOSPITAL FOUNDATION INC 811 SOUTH WASHINGTON AVE MARSHALL,TX75670 75-2605699	HEALTHCARE	TX	501(C)(3)	7	GSMC	Yes
(49)CHRISTUS GOOD SHEPHERD MEDICAL CENTER 811 SOUTH WASHINGTON AVE MARSHALL,TX75670 75-0974351	HEALTHCARE	TX	501(C)(3)	3	GSHS INC	Yes
(50)BAPTISTST ANTHONY'S HEALTH SYSTEM 1600 WALLACE BLVD AMARILLO,TX79106 75-1858993	SUPPORT	TX	501(C)(3)	12-TYPE I	N/A		No
(51)CHRISTUS CONNECTED CARE NETWORK 919 HIDDEN RIDGE DRIVE IRVING,TX75038 47-3403356	SPT HLTH SVCS	TX	501(C)(4)		CH	Yes
(52)HOPKINS COUNTY HEALTH CAE FDN INC 115 AIRPORT ROAD SULPHUR SPRINGS,TX75482 75-2845157	SUPPORT	TX	501(C)(3)	7	CH	Yes
(53)MARSHALL HEALTH SERVICES INC 700 E MARSHALL AVE LONGVIEW,TX75601 75-2580686	HEALTH CARE	TX	501(C)(3)	3	CTMFHS	Yes
(54)GOOD SHEPHERD MED CENTER - LINDEN INC 700 E MARSHALL AVE LONGVIEW,TX75601 01-0829282	HEALTH SVCS	TX	501(C)(3)	3	GSHS INC	Yes
(55)GSMC - LINDEN FOUNDATION INC 404 N KAUMAN LINDEN,TX75563 20-0845127	SUPPORT	TX	501(C)(3)	12-TYPE I	GSHS INC	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?
(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) ST ELIZ REHAB PRTNRS 2830 CALDER BEAUMONT,TX77702 20-5657181	HLTHCARE SVCS	TX	H VENTURES-SETX
(2) SOUTH RYAN MRI LLC 650 M DEBAKEY LK CHLS,LA70601 74-3103662	IMAGING SVCS	LA	OCCUPATIONAL HS
(3) NEW BRN SUG CTR LLC 333 N SN SAN ANT,TX78207 81-0571408	HLTHCARE SVCS	TX	CSRHCC
(4) CSR OTPT SUR NB 333 SN ROSA SAN ANT,TX78207 81-0571409	HLTHCARE SVCS	TX	CSRHCC
(5) CSR AMB SUR CTR 333 SN ROSA San Ant,TX78207 41-2092141	HLTHCARE SVCS	TX	CSRHCC
(6) COL EDNSPY CTR 524 M DBKY LK CHRLS,LA70601 72-1274256	HLTHCARE SVCS	LA	SWLA
(7) ALAMO HTS SUR GP 333 SN ROSA SAN ANT,TX78207 46-2683189	HLTHCARE SVCS	TX	CSRHCC
(8) ALAMO HTS SUR HOS 333 SN ROSA SN ANT,TX78207 90-0974203	HLTHCARE SVCS	TX	CSRHCC
(9) PROMPTU IMAGING 919 HIDDEN RDG IRVING,TX75038 81-3074600	IMAGING SVCS	TX	ASPG INC
(10) LA ATHLETIC CLB LLC COLLEGE DR PINEVILLE,LA71359 72-1461793	HEALTH CLUB	LA	CNLA
(11) ETMF JV LLC 8686 NEW TRAILS DR SPRING,TX77381	INACTIVE	TX	CTMFHS	INACTIVE
(12) IMPERIAL CAL SURG CTR 1757 IMP RD LK CHRLS,LA70605	ASC	LA	SWLA	RELATED
(13) Tyler Radiation Equip Leas 10101 woodloch Forest Drive Woodlands,TX77380	Equipment leasing	TX	MFH Reg	UNRELATED
(14) NORTH LA CARDIAC 919 HIDDEN RG IRVING,TX75038 81-3758914	HEALTHCARE SVCS	LA	NOLA
(15) GS AMB SURG CTR 700 E MARSH LONGVIEW,TX75601 90-0259782	SURGERY CENTER	TX	GSHS ENTERPRISE
(16) GSPS Gastro PLLC 701 MARSHALL LONGVIEW,TX75601 27-3871232	HEALTHCARE SVCS	TX	GSHS ENTERPRISE
(17) Good Shep Surg Assc 701 Marshall Longview,TX75601 45-3620439	SURGERY CENTER	TX	GSHS ENTERPRISE

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) ARK-LA-TEX HEALTH NETWORK PO BOX 2911 TEXARKANA,TX755042911 75-2562459	HEALTHCARE SVCS	TX	CH Ark-La-Tex	C-Corp				Yes
(2) AK INTEGRATED COMM HLTH NTWK 2600 ST MICHAEL DRIVE TEXARKANA,TX75503 76-0480684	HEALTHCARE SVCS	TX	CH Ark-La-Tex	C-Corp				Yes
(3) SCH MGMNT SOLUTIONS INC ONE ST MARY PLACE SHREVEPORT,LA71101 72-1270625	MGT JOINT VENTR	LA	NOLA	C-Corp				Yes
(4) SPOHN HEALTH NETWORK 600 ELIZABETH STREET CORPUS CHRISTI,TX78404 74-2616328	HEALTH PLAN ADMIN	TX	Spohn HSC	C-Corp				Yes
(5) SPOHN INVESTMENT CORPORATION 600 ELIZABETH STREET CORPUS CHRISTI,TX78404 74-2322574	RENTALS	TX	Spohn HSC	C-Corp				Yes
(6) CHRISTUS SOUTHEAST TEXAS PHO 3010 HARRISON STREET SUITE 202 BEAUMONT,TX77702 76-0429902	MEDICAL SVCS	TX	CH SETX	C-Corp				Yes
(7) HEALTH VENTURES OF SE TEXAS 1700 WEST LOOP SOUTH SUITE 400A HOUSTON,TX77027 76-0397263	BUILDING RENT	TX	CH SETX	C-Corp				Yes
(8) OCCUPATIONAL HEALTH SVCS INC 524 DR MICHAEL DEBAKEY DRIVE LAKE CHARLES,LA70601 72-1217389	MEDICAL SVCS	LA	CH SWLA	C-Corp				Yes
(9) SOUTHWESTERN LOUISIANA PHO 524 DR MICHAEL DEBAKEY DRIVE LAKE CHARLES,LA70601 72-1274256	HEALTHCARE SVCS	LA	CH SWLA	C-Corp				Yes
(10) SOUTH RYAN DEVELOPMENT CORP 524 DR MICHAEL DEBAKEY DRIVE LAKE CHARLES,LA70601 72-1183790	LEASING BLDG	LA	CH SWLA	C-Corp				Yes
(11) MCKENNA PROF BLDG OWNERS ASSOC 598 N UNION ST SUITE 210 NEW BRAUNFELS,TX78130 74-2742934	BUILDING ASSOC	TX	CSRHCC	C-Corp				Yes
(12) SOUTH TEXAS HEALTH ALLIANCE 6243 IH 10 WEST SUITE 480 SAN ANTONIO,TX78201 74-2782184	HEALTHCARE SVCS	TX	CSRHCC	C-Corp				Yes
(13) CHRISTUS Muguerza SAPI de CV Hidalgo PTE 2525 64060 Col Obispado Monterrey,N.L. MX	HEALTHCARE SVCS	MX	CH	C-Corp	26,862,070	118,286,816	86.559 %	Yes
(14) EMERALD ASSURANCE CAYMAN LTD PO BOX 1051 GRAND CAYMAN KY1-1102 CJ 98-0407545	INSURANCE	CJ	CH	C-Corp	40,343,007	152,667,304	100.000 %	Yes
(15) AMBULATORY STRATEGIES PHYSICIAN GROUP 919 HIDDEN RIDGE IRVING,TX75038 47-2897722	HEALTHCARE SVCS	TX	CCC	C-CORP				Yes
(16) CHRISTUS TEXARKANA UNIT OWNERS ASSOC 2600 ST MICHAEL DRIVE TEXARKANA,TX75503 47-2486362	BUILDING ASSOC	TX	ALT	C-CORP				Yes
(17) EVANGELINE CLINICAL SERVICES INC 3330 MASONIC DRIVE ALEXANDRIA,LA71301 46-3977886	HEALTHCARE SVCS	LA	CNLA	C-CORP				Yes
(18) LTACH CONDOMINIUM UNIT OWNERS ASSOC 600 ELIZABETH STREET CORPUS CHRISTI,TX77726 47-2404808	BUILDING ASSOC	TX	SPOHN	C-CORP				Yes
(19) AMATISTA FINANCING COMPANY LTD 3RD FL1ST CARIBBEAN HOUSE KY1-1104 GEORGE TOWN CJ	FINANCING	CJ	CH STRAT GRWTH	C-CORP				Yes
(20) CHRISTUS CHILE SPA MIRAFLORES 222 28TH FLOOR 8320198 SANTIAGO CI	INVESTING	CI	CH LATIN AMER	C-CORP				Yes
(21) DEDICATED SYSTEM SUPPORT INC 919 HIDDEN RIDGE DR IRVING,TX75038 81-0861043	MANAGEMENT SVCS	TX	CCC	C-CORP				Yes
(22) CHRISTUS LOUISIANA QUALITY ALLIANCE 919 HIDDEN RIDGE DR IRVING,TX75038 47-4618648	ACO	LA	CH	C-CORP	480,102	463,358	100.000 %	Yes
(23) TRINCARE INC 1315 DOCTORS DRIVE TYLER,TX75701 75-2161369	RETAIL HEALTH SVC	TX	CTMFHS	C-CORP				Yes
(24) HEALTHPLAN OF TEXAS INC 1315 DOCTORS DRIVE TYLER,TX75701 75-2636862	THIRD PARTY ADMIN	TX	CTMFHS	C-CORP				Yes
(25) THE REGIONAL HEALTHCARE ALLIANCE 1315 DOCTORS DRIVE TYLER,TX75701 75-2484109	PREFER PROVIDER	TX	CTMFHS	C-CORP				Yes
(26) TEXAS HEALTH FACILITY INSUR CORP LTD PO BOX 1109 BWI CJ 98-0136025	INSURANCE	CJ	MFH REG	C-CORP				Yes
(27) GSHS ENTERPRISES INC 700 E MARSHALL AVE LONGVIEW,TX75601 75-2027162	HEALTHCARE	TX	GSHS INC	C CORP				Yes
(28) GOOD SHEPHERD HEALTH NETWORK 700 E MARSHALL AVE LONGVIEW,TX75601 75-2554695	INACTIVE	TX	GSH INC	C CORP				Yes
(29) MARSHALL PHYSICIAN HOSPITAL ORGANIZATION 700 E MARSHALL AVE LONGVIEW,TX75601 75-2580689	INACTIVE	TX	GSMC	C CORP				Yes
(30) NORTHEAST TEXAS PHYSICIAN SERVICES 700 E MARSHALL AVE LONGVIEW,TX75601 75-2712245	MGMT SERVICES	TX	GSHS ENTERPRISE	C CORP				Yes
(31) GSHS ENTERPRISES HOLDING INC 700 E MARSHALL AVE LONGVIEW,TX75601 51-0412465	HOLDING COMPANY	DE	GSHS ENTERPRISE	C CORP				Yes
(32) GSHS ENTERPRISES OPERATING 1 700 E MARSHALL AVE LONGVIEW,TX75601 75-2954772	HEALTHCARE	DE	GSHS ENTERPRISE	C CORP				Yes
(33) GSHS ENTERPRISES OPERATING 2 700 E MARSHALL AVE LONGVIEW,TX75601 75-2954777	HEALTHCARE	DE	GSHS ENTERPRISE	C CORP				Yes
(34) TYLER COUNTY CLINICAL SERVICES 2801 VIA FORTUNA AUSTIN,TX78746 47-2135795	HEALTHCARE	TX	SETX	C CORP				Yes
(35) CH COLUMBIA SAS CL 70 A 4 41 BOGOTA CO	MANAGEMENT SVCS	CO	CHI	C CORP				Yes
(36) CLINICA PALMA REAL SAS CARRERA 28 44 35 CALI CO	HEALTHCARE SVCS	CO	CHI	C CORP				Yes
(37) SINERGIA GLOBAL EN SALUD SAS CARRERA 44 A 9 C 67 CALI CO	HEALTHCARE SVCS	CO	CHI	C CORP				Yes
(38) GSHS CUSTOMER SERVICE BUILDING LLC 700 E MARSHALL AVE LONGVIEW,TX75601 71-0896055	CUSTOMER SERVICES	DE	GSHS INC	LLC				Yes
(39) THE LAMC BUILDING E			NA					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 .....................

Yes

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

Yes

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

Yes

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ALAMO HEIGHTS SURGICAL GROUP	A(I)	1,252,486	ACCRUAL
(2) ALAMO HEIGHTS SURGICAL GROUP	L	550,011	ACCRUAL
(3) ALAMO HEIGHTS SURGICAL GROUP	M	1,634,910	ACCRUAL
(4) ALAMO HEIGHTS SURGICAL GROUP	Q	2,120,837	ACCRUAL
(5) ALAMO HEIGHTS SURGICAL GROUP	S	1,285,751	ACCRUAL
(6) ALIGNED PROVIDERS OF EAST TEXAS	Q	97,496	ACCRUAL
(7) AMBULATORY STRATEGY PHYSICIANS GROUP	Q	572,805	ACCRUAL
(8) C H WILKINSON PHYSICIAN NETWORK	A(I)	103,180	ACCRUAL
(9) C H WILKINSON PHYSICIAN NETWORK	L	1,410,249	ACCRUAL
(10) C H WILKINSON PHYSICIAN NETWORK	M	1,786,987	ACCRUAL
(11) C H WILKINSON PHYSICIAN NETWORK	O	73,138	ACCRUAL
(12) C H WILKINSON PHYSICIAN NETWORK	Q	36,942,679	ACCRUAL
(13) C H WILKINSON PHYSICIAN NETWORK	S	162,814	ACCRUAL
(14) CHRISTUS CONNECTED CARE NETWORK	M	60,603	ACCRUAL
(15) CHRISTUS GOOD SHEPHERD MEDICAL CENTER	A(I)	1,056,880	ACCRUAL
(16) CHRISTUS GOOD SHEPHERD MEDICAL CENTER	Q	3,077,328	ACCRUAL
(17) CHRISTUS GOOD SHEPHERD MEDICAL CENTER	S	1,096,848	ACCRUAL
(18) CHRISTUS HEALTH ARK-LA-TEX	A(I)	5,081,602	ACCRUAL
(19) CHRISTUS HEALTH ARK-LA-TEX	L	8,054,133	ACCRUAL
(20) CHRISTUS HEALTH ARK-LA-TEX	M	25,758,388	ACCRUAL
(21) CHRISTUS HEALTH ARK-LA-TEX	Q	34,469,810	ACCRUAL
(22) CHRISTUS HEALTH ARK-LA-TEX	S	6,980,388	ACCRUAL
(23) CHRISTUS HEALTH PLAN	M	26,593,538	ACCRUAL
(24) CHRISTUS HOPKINS HEALTH ALLIANCE	M	2,211,417	ACCRUAL
(25) CHRISTUS HOPKINS HEALTH ALLIANCE	Q	3,230,549	ACCRUAL
(26) CHRISTUS HEALTH CENTRAL LOUISIANA	A(I)	7,341,453	ACCRUAL
(27) CHRISTUS HEALTH CENTRAL LOUISIANA	L	6,896,338	ACCRUAL
(28) CHRISTUS HEALTH CENTRAL LOUISIANA	M	20,208,121	ACCRUAL
(29) CHRISTUS HEALTH CENTRAL LOUISIANA	Q	32,691,792	ACCRUAL
(30) CHRISTUS HEALTH CENTRAL LOUISIANA	S	9,047,420	ACCRUAL
(31) CHRISTUS HEALTH GULF COAST	Q	160,424	ACCRUAL
(32) CHRISTUS HEALTH SOUTHEAST TEXAS	A(I)	6,330,326	ACCRUAL
(33) CHRISTUS HEALTH SOUTHEAST TEXAS	A(IV)	5,648	ACCRUAL
(34) CHRISTUS HEALTH SOUTHEAST TEXAS	L	10,300,913	ACCRUAL
(35) CHRISTUS HEALTH SOUTHEAST TEXAS	M	29,086,410	ACCRUAL
(36) CHRISTUS HEALTH SOUTHEAST TEXAS	Q	42,616,569	ACCRUAL
(37) CHRISTUS HEALTH SOUTHEAST TEXAS	S	9,123,076	ACCRUAL
(38) CHRISTUS HEALTH NORTHERN LOUISIANA	A(I)	7,682,946	ACCRUAL
(39) CHRISTUS HEALTH NORTHERN LOUISIANA	L	66,620,942	ACCRUAL
(40) CHRISTUS HEALTH NORTHERN LOUISIANA	M	15,644,655	ACCRUAL
(41) CHRISTUS HEALTH NORTHERN LOUISIANA	Q	26,531,777	ACCRUAL
(42) CHRISTUS HEALTH NORTHERN LOUISIANA	S	9,129,320	ACCRUAL
(43) CHRISTUS HEALTH SOUTHWEST LOUISIANA	A(IV)	2,183	ACCRUAL
(44) CHRISTUS HEALTH SOUTHWEST LOUISIANA	K	101,149	ACCRUAL
(45) CHRISTUS HEALTH SOUTHWEST LOUISIANA	L	5,707,526	ACCRUAL
(46) CHRISTUS HEALTH SOUTHWEST LOUISIANA	M	15,242,433	ACCRUAL
(47) CHRISTUS HEALTH SOUTHWEST LOUISIANA	P	602,576	ACCRUAL
(48) CHRISTUS HEALTH SOUTHWEST LOUISIANA	Q	24,713,753	ACCRUAL
(49) CHRISTUS HEALTH SOUTHWEST LOUISIANA	S	1,713,437	ACCRUAL
(50) CHRISTUS SANTA ROSA HEALTH CARE CORPORATION	A(I)	17,844,027	ACCRUAL
(51) CHRISTUS SANTA ROSA HEALTH CARE CORPORATION	K	268,908	ACCRUAL
(52) CHRISTUS SANTA ROSA HEALTH CARE CORPORATION	L	16,901,827	ACCRUAL
(53) CHRISTUS SANTA ROSA HEALTH CARE CORPORATION	M	48,537,818	ACCRUAL
(54) CHRISTUS SANTA ROSA HEALTH CARE CORPORATION	P	269,140	ACCRUAL
(55) CHRISTUS SANTA ROSA HEALTH CARE CORPORATION	Q	67,104,330	ACCRUAL
(56) CHRISTUS SANTA ROSA HEALTH CARE CORPORATION	S	22,422,030	ACCRUAL
(57) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION	A(I)	10,439,854	ACCRUAL
(58) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION	L	16,815,901	ACCRUAL
(59) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION	M	69,732,093	ACCRUAL
(60) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION	P	24,000,000	ACCRUAL
(61) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION	Q	72,281,484	ACCRUAL
(62) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION	R	2,396,708	ACCRUAL
(63) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION	S	13,619,866	ACCRUAL
(64) DEDICATED SYSTEM SUPPORT INC	A(I)	119,349	ACCRUAL
(65) DEDICATED SYSTEM SUPPORT INC	M	224,144	ACCRUAL
(66) DEDICATED SYSTEM SUPPORT INC	Q	1,051,541	ACCRUAL
(67) DEDICATED SYSTEM SUPPORT INC	S	119,349	ACCRUAL
(68) EMERALD ASSURANCE CAYMAN	P	36,278,721	ACCRUAL
(69) EVANGELINE CLINICAL SERVICES	M	68,750	ACCRUAL
(70) EVANGELINE CLINICAL SERVICES	Q	786,629	ACCRUAL
(71) GSHS INC	S	196,452	ACCRUAL
(72) GSHS ADMINISTRATIVE SERVICES ORG INC	L	9,278,348	ACCRUAL
(73) GSHS ADMINISTRATIVE SERVICES ORG INC	M	10,671,274	ACCRUAL
(74) GSHS ADMINISTRATIVE SERVICES ORG INC	Q	4,198,542	ACCRUAL
(75) MOTHER FRANCES HOSPITAL - JACKSONVILLE	Q	1,836,589	ACCRUAL
(76) MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE	A(I)	1,474,385	ACCRUAL
(77) MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE	Q	30,394,886	ACCRUAL
(78) MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE	S	1,478,807	ACCRUAL
(79) MOTHER FRANCES HOSPITAL - WINNSBORO	Q	923,732	ACCRUAL
(80) THE GOOD SHEPHERD HOSPITAL INC	A(I)	2,270,572	ACCRUAL
(81) THE GOOD SHEPHERD HOSPITAL INC	Q	16,040,820	ACCRUAL
(82) THE GOOD SHEPHERD HOSPITAL INC	S	2,270,572	ACCRUAL
(83) CHRISTUS MUGUERZA SAPI DE CV	L	6,779,717	ACCRUAL
(84) CHRISTUS MUGUERZA SAPI DE CV	M	6,779,717	ACCRUAL
(85) SANTA ROSA FAMILY HEALTH CENTER	L	101,740	ACCRUAL
(86) SANTA ROSA FAMILY HEALTH CENTER	M	193,426	ACCRUAL
(87) SANTA ROSA FAMILY HEALTH CENTER	Q	1,187,419	ACCRUAL
(88) CHRISTUS SR NB OUTPATIENT SURGERY CENTER	Q	532,796	ACCRUAL
(89) SPOHN HEALTH NETWORK	L	54,900	ACCRUAL
(90) SPOHN HEALTH NETWORK	M	54,900	ACCRUAL
(91) SPOHN INVESTMENT CORPORATION	M	182,955	ACCRUAL
(92) CHRISTUS CHILE SPA	A(I)	1,754,718	ACCRUAL
(93) CHRISTUS CHILE SPA	S	1,754,718	ACCRUAL
(94) CHRISTUS SR PHYSICIAN AMBULATORY SURGERY CNTR	A(I)	2,137	ACCRUAL
(95) CHRISTUS SR PHYSICIAN AMBULATORY SURGERY CNTR	Q	487,655	ACCRUAL
(96) CHRISTUS ST PATRICK FOUNDATION	R	89,276	ACCRUAL
(97) CHRISTUS ST PATRICK FOUNDATION	S	89,276	ACCRUAL
(98) CHRISTUS TRINITY MOTHER FRANCES HEALTH SYSTEM	L	16,116,496	ACCRUAL
(99) CHRISTUS TRINITY MOTHER FRANCES HEALTH SYSTEM	M	19,917,705	ACCRUAL
(100) CHRISTUS TRINITY MOTHER FRANCES HEALTH SYSTEM	O	59,769	ACCRUAL
(101) CHRISTUS TRINITY MOTHER FRANCES HEALTH SYSTEM	P	97,209	ACCRUAL
(102) CHRISTUS TRINITY MOTHER FRANCES HEALTH SYSTEM	Q	31,883,858	ACCRUAL
(103) CHAMPION EMS	Q	2,739,852	ACCRUAL
(104) TRINCARE INC	Q	288,895	ACCRUAL
(105) TRINITY CLINIC	J	148,969	ACCRUAL
(106) TRINITY CLINIC	L	10,422,512	ACCRUAL
(107) TRINITY CLINIC	Q	16,596,654	ACCRUAL
(108) TRINITY CLINIC	S	150,746	ACCRUAL
(109) ST VINCENT HOSPITAL	L	15,208,370	ACCRUAL
(110) ST VINCENT HOSPITAL	Q	9,533,752	ACCRUAL
(111) CHRISTUS PEDIATRIC PHYSICIAN GROUP	A(I)	49,623	ACCRUAL
(112) CHRISTUS PEDIATRIC PHYSICIAN GROUP	L	204,916	ACCRUAL
(113) CHRISTUS PEDIATRIC PHYSICIAN GROUP	M	258,816	ACCRUAL
(114) CHRISTUS PEDIATRIC PHYSICIAN GROUP	Q	965,250	ACCRUAL
(115) CHRISTUS PEDIATRIC PHYSICIAN GROUP	S	62,377	ACCRUAL
(116) CHRISTUS SPOHN HEALTH DEVELOPMENT FOUNDATION	B	83,000	ACCRUAL
(117) CHRISTUS HOPKINS HEALTH ALLIANCE	L	1,964,467	ACCRUAL
(118) CHRISTUS MUGUERZA SAPI DE CV	R	2,000,000	ACCRUAL

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	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