TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) VARSHI BROUMAND...................................................................... DIRECTOR (Term 12/2018)	1.0 ................. 0.0	X		0	0
(2) YOLANDA SANTOS DR PH...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(3) Jelynne Leblanc-Burley...................................................................... Director	1.0 ................. 0.0	X		0	0
(4) Edward Riojas JR...................................................................... DIRECTOR (TERM 11/2018)	1.0 ................. 0.0	X		0	0
(5) DR Roberto San Martin MD...................................................................... Director (EFF 07/2018)	1.0 ................. 0.0	X		0	0
(6) Miguel Ybarra...................................................................... Director	1.0 ................. 0.0	X		0	0
(7) Ray Still...................................................................... Director (Term 11/2018)	1.0 ................. 0.0	X		0	0
(8) J Michael Belz...................................................................... vice chair	1.0 ................. 0.0	X	X	0	0
(9) Elaine Mendoza...................................................................... Director/Chair	1.0 ................. 0.0	X	X	0	0
(10) Dean Alexander...................................................................... Dir/Pres/CEO	40.0 ................. 0.0	X	X	591,146	122,833
(11) CHARLES HANKINS MD...................................................................... CMO (EFF 10/2018)	1.0 ................. 39.0	X	X	806,402	126,835
(12) CHARLIE AMATO...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(13) CRIS DASKEVICH...................................................................... CEO CHOSA (EFF 10/2018)	1.0 ................. 39.0	X	X	736,099	139,913
(14) DAVID HENKES MD...................................................................... MED STF PRES/DIR (EFF 01/2019)	1.0 ................. 0.0	X		0	0
(15) GARY ARTHUR...................................................................... DIRECTOR (EFF 10/2018)	1.0 ................. 0.0	X		0	0
(16) LISA CAMPOS...................................................................... DIRECTOR (EFF 01/2019)	1.0 ................. 0.0	X		0	0
(17) PAT FROST...................................................................... DIRECTOR (EFF 10/2018)	1.0 ................. 0.0	X		0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) SR CINDY STACY........................................................................ DIRECTOR	1.0 .......................0.0	X					0	0	0
(19) SR HANNA PARADOWSKA........................................................................ DIRECTOR (EFF 01/2019)	1.0 .......................0.0	X					0	0	0
(20) SISTER YOLANDA TARANGO........................................................................ DIRECTOR (TERM 12/2018)	1.0 .......................0.0	X					0	0	0
(21) SISTER RICCA DIMALIBOT........................................................................ DIRECTOR (TERM 7/2018)	1.0 .......................39.0	X					0	119,141	3,944
(22) Tammy Rivers........................................................................ Secretary	40.0 .......................0.0		X				64,768	0	75
(23) Linda Mary K Kirks........................................................................ CFO/BOARD TREASURER	1.0 .......................39.0		X				0	395,948	84,293
(24) David Mier........................................................................ CFO-Childrens Hospital of SA	1.0 .......................39.0			X			0	295,239	31,833
(25) Patricia Toney........................................................................ VP/Chief Nurse Executive	1.0 .......................39.0			X			0	434,929	75,332
(26) Jim Wesson........................................................................ VP/New Braunfels	1.0 .......................39.0			X			0	371,248	93,295
(27) STEPHANIE A PARKER........................................................................ VP OF FINANCE	1.0 .......................39.0			X			0	235,614	26,608
(28) KATHLEEN TREGEAR........................................................................ CHIEF NURSING OFFICER	40.0 .......................0.0			X			0	197,002	9,730
(29) Alexis Arel........................................................................ VP Finance	40.0 .......................0.0			X			0	161,766	1,860
(30) Karen Bryant........................................................................ VP - Strategy - Bus Devlopment	40.0 .......................0.0			X			0	309,010	56,407
(31) Kenneth Davis MD........................................................................ chief medical officer	40.0 .......................0.0			X			0	589,965	110,459
(32) Dennis Gonzales........................................................................ VP Mission Integration	40.0 .......................0.0			X			0	201,417	42,352
(33) Eileen Huss........................................................................ Chief Nursing Officer	40.0 .......................0.0			X			0	321,724	53,021
(34) Asha Rodriguez........................................................................ President	40.0 .......................0.0			X			0	193,072	24,845
(35) Ian Thompson........................................................................ Pres. & VP Market Oncology	40.0 .......................0.0			X			0	412,786	76,286
(36) Rhonda Thompson........................................................................ chief nursing officer	40.0 .......................0.0			X			0	331,198	16,618
(37) MICHAEL DAVIS........................................................................ VP-FINANCE WESTOVER HILLS	40.0 .......................0.0			X			0	163,669	25,661
(38) Angela Lambert........................................................................ Chief Nsg Ofcr Medical Center	40.0 .......................0.0			X			0	229,167	48,595
(39) CRYSTAL KOHANKE........................................................................ VP-HUMAN RESOURCES	40.0 .......................0.0			X			0	423,020	89,976
(40) JOHN BEL........................................................................ VP/CHIEF DEV OFFICER	40.0 .......................0.0			X			0	315,129	28,596
(41) DOMINIC DOMINGUEZ........................................................................ REGIONAL CEO	40.0 .......................0.0			X			0	1,108,350	191,803
(42) DAVID GLAZENER........................................................................ VP FINANCE	40.0 .......................0.0			X			0	139,655	29,467
(43) CARLA MORENO........................................................................ VP, PATIENT PLACEMENT	40.0 .......................0.0			X			0	261,292	18,480
(44) ROXANNE R JENKINS........................................................................ DIR.-CLIN INTRGRTIN-COMPLAINCE	40.0 .......................0.0				X		198,264	0	18,712
(45) TERRY KYLE........................................................................ VP - FOUNDATION	40.0 .......................0.0				X		195,327	0	12,450
(46) Jodee M Kerestes........................................................................ DIRECTOR CANCER SVCS BUS DEV	40.0 .......................0.0				X		173,651	0	21,786
(47) CYNTHIA A KOGER........................................................................ DIRECTOR OF PHARMACY	40.0 .......................0.0				X		172,644	0	21,455
(48) EDUARDO LARA........................................................................ PRACTICE ADMINISTRATOR	40.0 .......................0.0				X		182,052	0	31,568
(49) Patrick B Carrier........................................................................ FORMER PRES/CEO (term 03/2015)	0.0 .......................40.0					X	0	1,502,606	56,259

(A) Name and business address	(B) Description of services	(C) Compensation
BAYLOR COLLEGE OF MEDICINE, One Baylor Plaza HOUSTON,TX77030	MEDICAL SERVICES	39,377,254
BARTLETT COCKE GENERAL, 8706 LOCKWAY SAN ANTONIO,TX78217	MEDICAL SERVICES	8,209,744
STONE OAK MOB LP, 540 Madison Oak SAN ANTONIO,TX78258	RENTAL SERVICES	3,565,890
WOUND CARE SPECIALISTS OF AMERICA, 5224 75TH STREET SUITE D LUBBOCK,TX79424	MEDICAL SERVICES	2,780,426
NEXCORE PROPERTIES LLC, 1550 MARKET STREET SUITE 200 DENVER,CO80202	RENTAL SERVICES	2,377,993
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 135

- 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 Santa Rosa Health Care Corporation

Employer identification number

74-1109665

Part I

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

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

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

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

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

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

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

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

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

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

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

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

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

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

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

Section D. Computation of Investment Income Percentage

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

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

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

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

Section A. All Supporting Organizations

Yes

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

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

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

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

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

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

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

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

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

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

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

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

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

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

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2018

Name of the organization

Christus Santa Rosa Health Care Corporation

Employer identification number

74-1109665

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

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

Name of organization Christus Santa Rosa Health Care Corporation

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

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

Page 3

Name of organization Christus Santa Rosa Health Care Corporation		Employer identification number 74-1109665

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

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

Page 4


Name of organization Christus Santa Rosa Health Care Corporation			Employer identification number 74-1109665
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

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

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

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

OMB No. 1545-0047

2018

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

Christus Santa Rosa Health Care Corporation

Employer identification number

74-1109665

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

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

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

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

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

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

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

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

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

Yes

67,173

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

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

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

67,173

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
FORM 990, SCHEDULE C, PART II-B, LINES 1D & 1G	LOBBYING DESCRIPTION At the state level, had direct contact with members of the Texas Legislature and their respective staff through emails, letters, telephone calls, and meetings on issues related to Medicaid reimbursement, access to health care and state funding for safety net providers, graduate medical education, trauma network and services, local provider participation funds, opioid abuse, the Public Information Act, maternal health, childrens health issues, behavioural health, Medicaid managed care, prescription drugs costs, pharmacy and prescribing authority, rural hospitals, physician relations, surprise billing, and the 1115 waiver program. At the federal level, had direct contact with members and staff through emails, letters, telephone calls and meetings to discuss issues related to safety-net providers, access to care, health care reform proposals, quality program implementation, rural hospitals, remote medical technology, 340b drug program, childrens health issues, the ACE Kids Act, CHGME, Medicaid, rural health program reauthorization, and health care for veterans. 205 executive hours. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION DID NOT SUBSTANTIALLY LOBBY DURING THE FISCAL YEAR ENDING 6-30-19.

Return Reference

Explanation

FORM 990, SCHEDULE C, PART II-B, LINES 1D & 1G

LOBBYING DESCRIPTION At the state level, had direct contact with members of the Texas Legislature and their respective staff through emails, letters, telephone calls, and meetings on issues related to Medicaid reimbursement, access to health care and state funding for safety net providers, graduate medical education, trauma network and services, local provider participation funds, opioid abuse, the Public Information Act, maternal health, childrens health issues, behavioural health, Medicaid managed care, prescription drugs costs, pharmacy and prescribing authority, rural hospitals, physician relations, surprise billing, and the 1115 waiver program. At the federal level, had direct contact with members and staff through emails, letters, telephone calls and meetings to discuss issues related to safety-net providers, access to care, health care reform proposals, quality program implementation, rural hospitals, remote medical technology, 340b drug program, childrens health issues, the ACE Kids Act, CHGME, Medicaid, rural health program reauthorization, and health care for veterans. 205 executive hours. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION DID NOT SUBSTANTIALLY LOBBY DURING THE FISCAL YEAR ENDING 6-30-19.

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 Santa Rosa Health Care Corporation

Employer identification number

74-1109665

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 .....	22,871,588		22,871,588
b	Buildings ....	475,742,237	188,852,118	286,890,119
c	Leasehold improvements	9,883,100	4,280,046	5,603,054
d	Equipment ....	207,225,412	150,591,542	56,633,870
e	Other .....	36,561,305	10,753,447	25,807,858
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				397,806,489

Schedule D (Form 990) 2018

Page 3

Part VII

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

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

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value
(1) INTEREST IN SUPPORTING ORGS				88,952,085
(2) DEFERRED RENT				6,550,058
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				95,502,143

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
DUE TO CHRISTUS HEALTH BOND FUND	223,675,455
CASH MANAGEMENT SYSTEM	257,614,141
NET DUE FROM RELATED ORGS	-2,628,140
L/T PORTION-CAPITAL LEASE BLDG/HOSP	4,101,250
DEFERRED LEASE INCENTIVE	1,015,620
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	483,778,326
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-BEARING INTEREST

FORM 990, SCHEDULE D, PART X, LINE 1 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

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Christus Santa Rosa Health Care Corporation

Employer identification number

74-1109665

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other 300 %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			28,349,145		28,349,145	4.400 %
b	Medicaid (from Worksheet 3, column a) . . . . .			194,026,844	135,046,980	58,979,864	9.160 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			222,375,989	135,046,980	87,329,009	13.560 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	11	42,269	2,123,803	0	2,123,803	0.330 %
f	Health professions education (from Worksheet 5) . . .	1	207	120,647	0	120,647	0.020 %
g	Subsidized health services (from Worksheet 6) . . . .			0	0	0
h	Research (from Worksheet 7) .			0	0	0
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	4	0	18,843,367	0	18,843,367	2.920 %
j	Total. Other Benefits . .	16	42,476	21,087,817	0	21,087,817	3.270 %
k	Total. Add lines 7d and 7j .	16	42,476	243,463,806	135,046,980	108,416,826	16.830 %

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

Schedule H (Form 990) 2018

Page

Part II

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

		(a) Number of activities or programs (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	1	55,971	55,971	0.010 %
8	Workforce development
9	Other
10	Total	1	55,971	55,971	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

71,059,283

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

547,156

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

Section B. Medicare

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

112,756,426

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

118,216,070

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

-5,459,644

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1CH SN RSA OTPT SGY	OUTPATIENT SURGERY CENTER	51.534 %	41.72 %
2CR SN RS PH AB SG CT	SURGERY CENTER	57.809 %	27.96 %
3N BRNFLS SRG CN LLC	SURGERY CENTER	54 %	46.64 %
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?5Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)								Facility reporting group
1	CHRISTUS SANTA ROSA NEW BRAUNFELS 600 N UNION AVENUE NEW BRAUNFELS,TX78130 www.christushealth.org/santa-rosa 000339	X	X				X	A
2	CHRISTUS SANTA ROSA WESTOVER HILLS 10539 STATE HWY 151 SAN ANTONIO,TX78251 www.christushealth.org/santa-rosa 100165	X	X				X	A
3	CHRISTUS SANTA ROSA MEDICAL CENTER 2827 BABCOCK ROAD SAN ANTONIO,TX78229 www.christushealth.org/santa-rosa 000339	X	X				X	A
4	CHRISTUS SANTA ROSA ALAMO HEIGHTS 403 TREELINE PARK SAN ANTONIO,TX78209 www.christushealth.org/santa-rosa 000339	X	X				X	A
5	Children's Hospital of San Antonio 333 N Santa Rosa Street SAN ANTONIO,TX78207 www.chofsa.org 100166	X	X	X	X	X	X	A

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	A
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

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

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): See Part V, Section C

Other website (list url):

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

Other (describe in Section C)

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

Yes

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

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

Yes

If "Yes" (list url): See Part V, Section C

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.% and FPG family income limit for eligibility for discounted care of 400.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

see part v, section c

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

see part v, section c

A plain language summary of the FAP was widely available on a website (list url):
see part v, section c

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
SCHEDULE H, PART V, SECTION B, LINE 3E	THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MANY PRIORITIES TO BE ADDRESSED BY THE MEMBERS OF THE HEALTH COLLABORATIVE; HOWEVER, GIVEN THE LARGE POPULATION OF UNINSURED PATIENTS WITH CHRONIC ILLNESS WHO SEEK CARE AT CHRISTUS SANTA ROSA HEALTH SYSTEM, CSRHS CHOOSES TO IMPLEMENT PROGRAMS TARGETED SPECIFICALLY AT THIS POPULATION. TO THAT END, THE MAJOR COMMUNITY BENEFIT ACTIVITIES ENACTED BY CSRHS ARE FOCUSED ON HEALTHY EATING AND ACTIVE LIVING, HEALTHY CHILD AND FAMILY DEVELOPMENT, Safe Behavioral Health and Mental Well Being Communities, COMMUNICABLE DISEASE, CHRONIC DISEASE OUTCOMES, AND ACCESS TO CARE. CSRHS ANTICIPATES MEETING ALL OF THE NEEDS IDENTIFIED. SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING QUANTITATIVE DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS FOR THE COUNTY. QUANTITATIVE DATA WAS COMPILED AND ANALYZED FROM A NUMBER OF SOURCES, INCLUDING THE U.S. CENSUS, CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, TEXAS DEPARTMENT OF STATE HEALTH SERVICES, SAN ANTONIO METROPOLITAN HEALTH DISTRICT, AND NOWDATA. TYPES OF DATA INCLUDED PUBLIC HEALTH DISEASE SURVEILLANCE DATA, HOSPITALIZATION RECORDS, VITAL STATISTICS BASED ON BIRTH AND DEATH DATA, AND SELF-REPORTS OF HEALTH BEHAVIORS FROM LARGE, POPULATION-BASED SURVEYS, SUCH AS THE BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY AND YOUTH RISK BEHAVIOR SURVEY. WHEN POSSIBLE, DATA WAS PROVIDED DOWN TO THE SUBSECTOR LEVEL TO PROVIDE RELEVANT INFORMATION FOR MORE GRANULAR GEOGRAPHIC AREAS WITHIN BEXAR COUNTY. TO COMPLIMENT THESE QUANTITATIVE DATA, QUALITATIVE INFORMATION WAS COLLECTED FROM 14 FOCUS GROUPS, 19 INTERVIEWS, AND 4 COMMUNITY DIALOGUES. FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED WITH PEOPLE FROM ACROSS BEXAR COUNTY, AND WITH A RANGE OF INDIVIDUALS REPRESENTING DIFFERENT AUDIENCES, INCLUDING RESIDENTS, FAITH COMMUNITIES, SOCIAL SERVICE PROVIDERS, HOSPITAL ADMINISTRATORS, COUNTY AND LOCAL GOVERNMENT OFFICIALS, AND PUBLIC HEALTH LEADERS. ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED OVER 280 INDIVIDUALS. IN COMAL COUNTY, THE ASSESSMENT USES A MODEL ADAPTED FROM THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS ENTITLED MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS. THE MAPP ASSESSMENTS AND THE ISSUES THEY ADDRESS PROVIDE A DEEPER UNDERSTANDING OF THE ISSUES THAT RESIDENTS FEEL ARE IMPORTANT BY ANSWERING THE QUESTIONS. THE QUESTIONS WERE EXPLORED IN 2 WAYS. FIRST, A SERIES OF 12 FOCUSED GROUP DISCUSSIONS INVOLVING MORE THAN 100 PARTICIPANTS WAS CONDUCTED TO IDENTIFY KEY ISSUES FOR THE COMMUNITY. THIS PROCESS ALSO YIELDED A ROSTER OF INTERESTED AND ACTIVE PERSONS WHO WERE LATER INVITED TO PARTICIPATE IN AN ONLINE SURVEY DESIGNED TO ASSESS THE DEGREE OF CONCERN ABOUT EACH KEY ISSUE AND RANK THE TOP FOUR CONCERNS WITHIN EACH OF FOUR ISSUE AREAS. THE RESULTS OF THIS ASSESSMENT WERE USED TO GUIDE ADDITIONAL DATA COLLECTION. NEARLY 200 PERSONS REPRESENTING A BROAD CROSS SECTION OF THE COMMUNITY'S KEY INFORMANTS RESPONDED TO THE ONLINE SURVEY.
SCHEDULE H, PART V, SECTION B, LINES 6a & 6b	IN BEXAR COUNTY, CHRISTUS SANTA ROSA HEALTH SYSTEM, METHODIST HEALTHCARE MINISTRIES, BAPTIST HEALTH SYSTEM, WELLMED MEDICAL MANAGEMENT, UNIVERSITY HEALTH SYSTEM; IN COMAL COUNTY, THE ASSESSMENT WAS ALSO CONDUCTED WITH A MULTITUDE OF STATE, COUNTY, PRIVATE, PUBLIC, FOR-PROFIT AND NOT-FOR-PROFIT COMMUNITY-BASED ORGANIZATIONS IN ADDITION TO CHRISTUS SANTA ROSA AND MCKENNA HEALTH SYSTEM. SCHEDULE H, PART V, SECTION B, LINE 7A THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING WEBSITE URL: HTTP://CHRISTUSHEALTH.ORG/CHNA-CHIP
SCHEDULE H, PART V, SECTION B, LINE 10A	THE URL FOR THE ORGANIZATION'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS: HTTP://WWW.CHRISTUSHEALTH.ORG/CHNA-CHIP SCHEDULE H, PART V, SECTION B, LINE 11 THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MANY PRIORITIES TO BE ADDRESSED BY THE MEMBERS OF THE HEALTH COLLABORATIVE; HOWEVER, GIVEN THE LARGE POPULATION OF UNINSURED PATIENTS WITH CHRONIC ILLNESS WHO SEEK CARE AT CHRISTUS SANTA ROSA HEALTH SYSTEM, CSRHS CHOOSES TO IMPLEMENT PROGRAMS TARGETED SPECIFICALLY AT THIS POPULATION. TO THAT END, THE MAJOR COMMUNITY BENEFIT ACTIVITIES ENACTED BY CSRHS ARE FOCUSED ON HEALTHY EATING AND ACTIVE LIVING, HEALTHY CHILD AND FAMILY DEVELOPMENT, SAFE COMMUNITIES, COMMUNICABLE DISEASE, CHRONIC DISEASE OUTCOMES, AND ACCESS TO CARE. CSRHS ANTICIPATES MEETING ALL OF THE NEEDS IDENTIFIED.
SCHEDULE H, PART V, SECTION B, LINE 13A	DETERMINATION OF ELIGIBILITY FOR DISCOUNTED CARE UNDER THE HOSPITAL'S POLICY, PATIENTS WHO WERE UNINSURED AND MET CERTAIN FINANCIAL CRITERIA WERE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE POLICY ALSO PROVIDED FOR ASSISTANCE FOR MEDICALLY INDIGENT PATIENTS. IN GENERAL, PATIENTS WHO WERE BELOW 300% OF FEDERAL POVERTY GUIDELINES RECEIVED FREE CARE. PATIENTS WHO WERE UNINSURED AND ABOVE 300% OF THE FEDERAL POVERTY GUIDELINE WERE BILLED RATES CONSISTENT WITH AMOUNTS GENERALLY BILLED TO COMMERCIAL PAYERS. PATIENTS WHO WERE UNINSURED AND BETWEEN 300% AND 400% OF FEDERAL POVERTY GUIDELINES COULD APPLY FOR ADDITIONAL ASSISTANCE TO PAY AMOUNTS LESS THAN AGB. PART V, SECTION B, LINE 13B ELIGIBILITY CRITERIA EXPLAINED IN THE FAP UNDER THE HOSPITAL'S POLICY, PATIENTS WHO WERE UNINSURED AND MET CERTAIN FINANCIAL CRITERIA WERE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE POLICY ALSO PROVIDED FOR ASSISTANCE FOR MEDICALLY INDIGENT PATIENTS. IN GENERAL, PATIENTS WHO WERE BELOW 300% OF FEDERAL POVERTY GUIDELINES RECEIVED FREE CARE. PATIENTS WHO WERE UNINSURED AND ABOVE 300% OF THE FEDERAL POVERTY GUIDELINE WERE BILLED RATES CONSISTENT WITH AMOUNTS GENERALLY BILLED TO COMMERCIAL PAYERS. PATIENTS WHO WERE UNINSURED AND BETWEEN 300% TO 400% OF FEDERAL POVERTY GUIDELINES COULD APPLY FOR ADDITIONAL ASSISTANCE TO PAY AMOUNTS LESS THAN AGB. SCHEDULE H, PART V, SECTION B, LINE 15E IN ADDITION TO REGULAR APPLICATIONS, THE HOSPITAL ALSO ASSESSED PATIENTS FOR PRESUMPTIVE ELIGIBILITY TO FACILITATE GIVING ASSISTANCE TO NEEDY PATIENTS. THE HOSPITAL IMPLEMENTED ELECTRONIC ELIGIBILITY TOOLS THAT USED PATIENT DEMOGRAPHIC DATA, CREDIT REPORTS, AND OTHER PUBLICLY AVAILABLE INFORMATION TO ESTIMATE A PATIENT'S INCOME, ASSETS, AND LIQUIDITY. PATIENTS WERE SCREENED AS PART OF THE COLLECTION ATTEMPT PROCESS. WHEN ELECTRONIC SCREENING WAS USED AS THE BASIS FOR PRESUMPTIVE ELIGIBILITY, THE HIGHEST DISCOUNT OF FULL FREE CARE WAS GRANTED FOR ELIGIBLE SERVICES FOR RETROSPECTIVE DATES OF SERVICE ONLY. IF A PATIENT DID NOT QUALIFY UNDER THE ELECTRONIC ENROLLMENT PROCESS, THE PATIENT COULD STILL BE CONSIDERED UNDER THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS.
SCHEDULE H, PART V, SECTION B, LINES 16 a-c	THE HOSPITAL FACILITY'S COMPLETE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE POLICY APPLICATION, AND PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY ARE WIDELY AVAILABLE ON A WEBSITE LOCATED AT THE FOLLOWING URL: https://www.christushelath.org/SANTA-ROSA/PATIENT-RESOURCES/FINANCIAL-ASSI STANCE SCHEDULE H, PART V, SECTION B, LINE 16J HOW THE HOSPITAL FACILITY PUBLICIZES THE FINANCIAL ASSISTANCE POLICY THE HOSPITAL POSTED SIGNS TO INFORM PATIENTS ABOUT THE AVAILABILITY OF CHARITY CARE IN THE EMERGENCY DEPARTMENT, LOBBY, AND ADMISSIONS AREAS. IN ADDITION, A SUMMARY OF THE POLICY AND DOCUMENTS NEEDED TO APPLY FOR ASSISTANCE WAS WIDELY AVAILABLE AT WWW.CHRISTUSHEALTH.ORG/CHARITYCARE. (THIS WEBSITE WAS THE FIRST RESULT IN GOOGLE WHEN PATIENTS SEARCHED FOR THE HOSPITAL NAME AND CHARITY CARE OR FINANCIAL ASSISTANCE.) EFFECTIVE JULY 1, 2016, THE INDIVIDUAL HOSPITAL'S HOMEPAGE HAD A CONSPICUOUS FINANCIAL ASSISTANCE LINK DIRECTING PATIENTS TO THE CHARITY CARE HOMEPAGE. COUNSELORS ALSO PUBLICIZED THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING ONE-ON-ONE VISITS WITH PATIENTS. THE HOSPITAL ATTEMPTED TO PROVIDE ALL UNINSURED PATIENTS WITH FINANCIAL COUNSELING. SPENDING TIME FACE-TO-FACE WITH PATIENTS ALLOWED COUNSELORS TO FACILITATE THE APPLICATION PROCESS FOR PATIENTS WHO OTHERWISE MIGHT NOT HAVE SOUGHT ASSISTANCE. COUNSELORS HELPED COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND EVALUATE PAYMENT PLANS FOR OUTSTANDING BALANCES. UNINSURED PATIENTS WERE SCREENED FOR MEDICAID ELIGIBILITY, AND COUNSELORS ALSO ASSISTED ELIGIBLE PATIENTS IN COMPLETING THOSE APPLICATIONS.
SCHEDULE H, PART V, SECTION B, LINE 17	DID THE HOSPITAL FACILITY HAVE IN PLACE DURING THE TAX YEAR A SEPARATE BILLING AND COLLECTIONS POLICY, OR A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINED ACTION THE HOSPITAL FACILITY MAY TAKE UPON NON-PAYMENT? THE HOSPITAL DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS DURING THE TAX YEAR. THE POLICY STRICTLY PROHIBITED TAKING LEGAL ACTION AGAINST PATIENTS AND ALSO FORBADE PLACING A LIEN ON THE PATIENT'S HOME. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS. SCHEDULE H, PART V, SECTION B, LINE 20 WHEN COLLECTION CALLS RESULTED IN PATIENT CONTACT, BUSINESS AGENTS PERFORMED A VERBAL SCREENING TO SEE IF THE PATIENT MIGHT BE ELIGIBLE FOR CHARITY CARE. IN ADDITION, BILLING STATEMENTS CONTAINED THE FOLLOWING NOTICE: (YOU MAY QUALIFY FOR FINANCIAL ASSISTANCE BASED UPON YOUR INCOME LEVEL. IF YOU DO NOT QUALIFY AND CANNOT MAKE PAYMENT IN FULL, WE WILL WORK WITH YOU TO SET UP AN ACCEPTABLE PAYMENT PLAN.)
SCHEDULE H, PART V, SECTION B, LINE 22D	DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE THE HOSPITAL USED THE AVERAGE COMMERCIAL INSURANCE REIMBURSEMENT RATE FROM FISCAL YEAR ENDING 6/30/09 TO DETERMINE AMOUNTS GENERALLY BILLED TO PATIENTS WITH INSURANCE. THIS AVERAGE RATE WAS THE AVERAGE REIMBURSEMENT RECEIVED FOR CATEGORIES OF SERVICES FROM ALL PRIVATE INSURERS THAT REIMBURSE HOSPITALS ACROSS THE CHRISTUS HEALTH SYSTEM, EXCEPT FOR ST. VINCENT AND LONG-TERM HOSPITALS, AND EXCLUDING IMPLANT AND DRUG CONTRIBUTION DOLLARS. ALL UNINSURED PATIENTS WERE CHARGED NO MORE THAN THE AVERAGE REIMBURSEMENT RATE FOR THE RELEVANT SERVICE LINE. PATIENTS ELIGIBLE FOR ADDITIONAL FINANCIAL ASSISTANCE WERE CHARGED THE AMOUNT GENERALLY BILLED (AGB) RATE (FOR INCOME LEVELS FROM 301% TO 400% OF FPL) OR RECEIVED FREE CARE (INCOMES BELOW 300% FPL). FOR LAB SERVICES, ELIGIBLE PATIENTS WERE CHARGED A PERCENTAGE OF THE MEDICARE RATE.

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?6
Name and address		Type of Facility (describe)
1	CHRISTUS SR PHYS AMB SURG CENTER SA 502 Madison Oak SAN ANTONIO,TX78258	SURGERY CENTER
2	CHRISTUS SR PHYS AMB SURG CENTER SA 423 Treeline Park Ste 202 SAN ANTONIO,TX78209	SURGERY CENTER
3	CHRISTUS SR PHYS AMB SURG CENTER NB 1738 E Common St New Braunfels,TX78130	SURGERY CENTER
4	CHRISTUS SR PHYS AMB SURG CENTER NB 1305 Wonder World Dr 105 San Marcos,TX78666	SURGERY CENTER
5	Christus SR Emergency Center - Creekside 244 Creekside Crossing New Braunfels,TX78130	Emergency Center
6	Christus Santa Rosa - Alon 11503 NW Military Highway Suite 12 San Antonio,TX78231	Emergency Center
7
8
9
10

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 5	BUDGETED CHARITY CARE THE ORGANIZATION BUDGETS CHARITY CARE FOR INTERNAL FINANCIAL REVIEW PURPOSES ONLY. THE PROVISION OF CHARITY CARE IS NOT LIMITED TO AMOUNTS ESTABLISHED FOR BUDGETARY PURPOSES.
PART I, LINE 6A	ANNUAL COMMUNITY BENEFIT REPORT A REPORT OF COMMUNITY BENEFIT IS INCLUDED IN A WRITTEN ANNUAL REPORT FOR CHRISTUS HEALTH, THE ORGANIZATION'S PARENT COMPANY. CHRISTUS HEALTH IS AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM FORMED IN 1999 WITH A MISSION "TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST." THE ANNUAL COMMUNITY BENEFIT REPORT SUMMARIZES ACTIVITIES AND PROGRAMS CONDUCTED DURING THE PAST YEAR TO IMPROVE HEALTH INCLUDING PROACTIVE COMMUNITY HEALTH SERVICES. HOWEVER, THE ANNUAL REPORT IS ONLY A SNAPSHOT OF HOW THE ORGANIZATION DISTINGUISHES ITSELF IN ITS VISION TO BE A LEADER, A PARTNER, AND AN ADVOCATE IN CREATING INNOVATIVE HEALTH AND WELLNESS SOLUTIONS THAT IMPROVE THE LIVES OF INDIVIDUALS AND COMMUNITIES.
PART I, LINE 7B	UNREIMBURSED MEDICAID CHRISTUS SANTA ROSA HEALTH CARE CORPORATION REINVESTS ALL SURPLUS FUNDS BACK IN TO THE COMMUNITIES WE SERVE THROUGH EXPANDED HEALTH SERVICES, NEW TECHNOLOGIES, AND BETTER FACILITIES.
PART I, LINE 7, COLUMN(F)	PERCENT OF TOTAL EXPENSE TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN(A) IS $715,305,470. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $71,059,283. THIS LEAVES A TOTAL EXPENSE OF $644,246,187 FOR PURPOSES OF CALCULATING LINES 7, COLUMN(F). PART I, LINE 7, COLUMN(F) DESCRIPTION OF FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS AS PERCENTAGE OF TOTAL COSTS THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS REPORTED ON PART I, LINE 7K, COLUMN(C) AS A PERCENTAGE OF TOTAL EXPENSE IS 37.79%, WHICH EXCEEDS THE AMOUNT REPORTED ON PART I, LINE 7K COLUMN(F) WHICH IS COMPUTED USING NET COMMUNITY BENEFIT EXPENSE. PART I, LINE 7(I) CASH AND IN-KIND CONTRIBUTIONS CHRISTUS SANTA ROSA HEALTH CARE CORPORATION MADE OVER $18,843,367 IN CASH AND IN-KIND CONTRIBUTIONS DURING FISCAL YEAR 2019. THE AFOREMENTIONED AMOUNT IS DETERMINED IN ACCORDANCE WITH REPORTING RULES FOR SCHEDULE H, WORKSHEET 8. AS SUCH THIS AMOUNT DIFFERS FROM GRANTS REPORTED AT FORM 990, SCHEDULE I, GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS, GOVERNMENTS, AND INDIVIDUALS AND PART IX, LINES 1 THROUGH 3 GRANTS AND OTHER ASSISTANCE. CHRISTUS HEALTH ESTABLISHED THE CHRISTUS FUND, A GRANT FUND TO PROVIDE RESOURCES TO NONPROFIT AGENCIES AND GROUPS WHOSE VISION, MISSION, AND GOALS ARE CONSISTENT WITH CHRISTUS HEALTH'S MISSION, VALUES AND PHILOSOPHY OF A HEALTHY COMMUNITY. CHRISTUS FUND GRANTS TOTALING $514,500 WERE DONATED BY CHRISTUS HEALTH TO NONPROFIT ORGANIZATIONS LOCATED IN THE COMMUNITY SERVED BY CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. THE GRANT DOLLARS WERE USED TO SUPPORT PROGRAMS THAT PROMOTE THE HEALTH OF THE COMMUNITIES THAT CHRISTUS SANTA ROSA HEALTH CARE CORPORATION SERVES. ALL GRANTS MADE TO OUTSIDE ORGANIZATIONS THROUGH THE CHRISTUS FUND ARE MADE TO NONPROFIT ORGANIZATIONS THAT SUPPORT THE COMMUNITY. INDIGENT FUNDING EXPENSE OF $25,850,990 IS INCLUDED IN SCHEDULE H, PART I, LINE 7(I). PART I, LINE 7 LINE 7A: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7B: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7E: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7F: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7I: ACTUAL EXPENSE OF THE CONTRIBUTIONS
PART II	COMMUNITY BUILDING ACTIVITIES THE CHRISTUS HEALTH BOARD OF DIRECTORS APPROVED FUNDING OF A COMMUNITY DIRECT INVESTMENT (CDI) LOAN PROGRAM TO ENSURE THAT THE WORK OF SOCIAL ACCOUNTABILITY AND MORAL AND ETHICAL STEWARDSHIP CONTINUE 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 NONPROFIT ORGANIZATIONS AT TERMS NOT EXCEEDING MORE THAN FIVE YEARS. THE INCOME EARNED AT THE MARKET RATE LESS OUR LOAN RATE (FOREGONE INCOME) IS CONSIDERED A COMMUNITY BENEFIT FOR REPORTING PURPOSES. THE FOREGONE INTEREST FOR THE CHRISTUS SANTA ROSA REGION IN FISCAL YEAR ENDING JUNE 30, 2019 WAS $0. IN AN EFFORT TO MEET AND ADDRESS THE IDENTIFIED HEALTH CARE NEEDS IN THE COMMUNITIES IT SERVES, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES ACCESS TO HEALTH CARE SERVICES THROUGH PROGRAMS AND LOCAL COMMUNITY PARTNERS AND SERVICE ORGANIZATIONS. THE CHRISTUS HEALTH ADVOCACY DEPARTMENT IS WORKING IN PARTNERSHIP WITH LOCAL, STATE AND FEDERAL POLICY MAKERS TO ENSURE ACTIVITIES AND PROGRAMS ARE IN PLACE THAT WILL ENHANCE PUBLIC HEALTH AND ADVANCE GENERAL KNOWLEDGE THROUGH IMPROVED ACCESS TO HEALTH SERVICES AND ADVANCE GENERAL KNOWLEDGE. DURING FY 2019, CHRISTUS HEALTH ADVOCATED FOR IMPROVING PUBLIC POLICIES BY WORKING TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTHCARE SERVICES FOR THE CONSTITUENTS WE SERVE. THESE ARE SOME OF THE MAIN COMMUNITY BUILDING ACTIVITIES THAT ARE IMPROVING ACCESS TO HEALTH SERVICES, ENHANCING PUBLIC HEALTH, AND ADVANCING KNOWLEDGE.
PART III, SECTION A, LINE 1	BAD DEBT REPORTING IN ACCORDANCE WITH HFMA STATEMENT 15 CHRISTUS HEALTH FOLLOWS IN PRINCIPLE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. THE SYSTEM HAS ADOPTED AN UNCOMPENSATED CARE POLICY WHERE REVENUE FROM SERVICES PROVIDED TO THE UNINSURED IS RECOGNIZED AT THE TIME OF PAYMENT, RATHER THAN AT THE TIME OF SERVICE. THIS POLICY IS THE RESULT OF A LACK OF REASONABLE ASSURANCE OF COLLECTION FOR SERVICES PROVIDED TO THE UNINSURED DUE TO THE SYSTEM'S HISTORICALLY LOW COLLECTION RATE. MANAGEMENT HAS ESTIMATED THAT THE DIFFERENCE BETWEEN RECORDING REVENUE FROM THE UNINSURED ON A CASH BASIS, RATHER THAN THE ACCRUAL BASIS, IS IMMATERIAL. ACCORDINGLY, ALL ACCOUNTS RECEIVABLE FROM THE UNINSURED HAVE BEEN FULLY RESERVED IN THE ALLOWANCE FOR UNCOMPENSATED CARE.
PART III, SECTION A, LINE 2	METHODOLOGY USED IN DETERMINING BAD DEBT THE ORGANIZATION'S TOTAL BAD DEBT EXPENSE (TOTAL OF ALL HOSPITAL FACILITIES) IS IN ACCORDANCE WITH THE ORGANIZATION'S FINANCIAL STATEMENTS, WHICH IS COMPUTED AS BAD DEBT NET OF CONTRACTUAL ALLOWANCE, PAYMENTS RECEIVED AND RECOVERIES OF BAD DEBT PREVIOUSLY WRITTEN OFF.
PART III, SECTION A, LINE 3	ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ORGANIZATION'S CHARITY CARE POLICY THE FILING ORGANIZATION RECOGNIZES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO SEEK FINANCIAL ASSISTANCE DUE TO BARRIERS SUCH AS EDUCATIONAL LEVEL, LITERACY, DOCUMENTATION REQUIREMENTS, OR BEING INTIMIDATED BY THE APPLICATION PROCESS. IN ORDER TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT SUBMITTED AN APPLICATION, THE ORGANIZATION ENGAGED PARO DECISION SUPPORT, LLC. PARO CHARITY SCORE IS DESIGNED TO IDENTIFY PATIENTS THAT LIKELY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON A PREDICTIVE MODEL AND OTHER FINANCIAL AND ASSET ESTIMATES FOR THE PATIENT DERIVED FROM PUBLIC RECORD SOURCES. IN ORDER TO ASSESS THE BAD DEBT ACCOUNTS THAT WOULD LIKELY QUALIFY FOR CHARITY CARE, THE FOLLOWING CRITERIA WERE ESTABLISHED BASED ON AN ANALYSIS OF HISTORICAL DATA OF CHRISTUS HEALTH AND ITS RELATED ORGANIZATIONS: 1. PARO SCORE OF LESS THAN OR EQUAL TO 586, WHICH IS A PREDICTOR DEFINING THE LIKELY SOCIOECONOMIC CONDITIONS FOR THE PATIENT; 2. ESTIMATED FEDERAL POVERTY LEVEL OF LESS THAN OR EQUAL TO 226%, WHICH IS BASED ON ESTIMATED HOUSEHOLD SIZE AND HOUSEHOLD ESTIMATED INCOME; AND 3. THIRD PARTY DATA AVAILABLE ON PATIENT ACCOUNTS WHICH INDICATE THAT THE PATIENT IS NOT A HOMEOWNER OR A PROBABLE HOMEOWNER. FOR THE FISCAL YEAR ENDING JUNE 30, 2011, THE ORGANIZATION REPORTED THAT 30% OF BAD DEBT EXPENSES WERE ATTRIBUTABLE TO PATIENTS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE BUT WERE NOT RESPONSIVE TO THE APPLICATION PROCESS EXISTING AT THAT TIME. THIS FIGURE WAS BASED ON THE PARO ANALYSIS AND ESTIMATES OF PATIENTS' FINANCIAL NEEDS THAT EXAMINED WHETHER PATIENTS WERE CHARACTERISTIC OF OTHERS WHO HISTORICALLY QUALIFIED FOR ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. THE PRESUMPTIVE CHARITY CARE ANALYSIS PERFORMED FOR THE PRIOR FISCAL YEAR DETERMINED A BENCHMARK OF BAD DEBT ACCOUNTS IN THE CHRISTUS HEALTH SYSTEM THAT LACKED THE INFORMATION TO QUALIFY FOR CHARITY CARE UNDER THE FILING ORGANIZATION'S CUSTOMARY PROCESS BUT WOULD HAVE LIKELY QUALIFIED FOR ASSISTANCE. DURING THE FISCAL YEAR ENDING JUNE 30, 2019, THE ORGANIZATION UTILIZED THE PARO SCORE TO IDENTIFY THE ACCOUNTS OF INDIVIDUAL PATIENTS THAT WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE DESPITE HAVING NOT COMPLETED AN APPLICATION, AND SUCH ANALYSIS DETERMINED THAT 42.9% OF SUCH ACCOUNTS WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY FOR THESE ACCOUNTS AND THEY WERE RECLASSIFIED UNDER OUR FINANCIAL ASSISTANCE POLICY. THESE AMOUNTS WERE NOT REPORTED AS BAD DEBT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3 IS THE DIFFERENCE BETWEEN THE PRESUMPTIVE CHARITY CARE BENCHMARK ESTABLISHED IN THE FISCAL YEAR ENDING JUNE 30, 2011 AND THE AGGREGATE OF INDIVIDUAL ACCOUNTS FOR WHICH THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY IN THE FISCAL YEAR ENDING JUNE 30, 2019. THUS, THE ORGANIZATION ESTIMATES THAT ONLY 0.77% OF THE BAD DEBT EXPENSES IN FISCAL YEAR ENDING JUNE 30, 2019 ARE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. IT IS IMPORTANT TO NOTE THAT THE FIGURE CALCULATED FOR FISCAL YEAR ENDING JUNE 30, 2011 WAS ESTIMATED AND NOT EXACT, AND THEREFORE THE DIFFERENCE BETWEEN THE AMOUNTS QUALIFIED AS PRESUMPTIVE CHARITY CARE IN ANY FISCAL YEAR MAY VARY FROM THE BENCHMARK ESTABLISHED IN FISCAL YEAR ENDING JUNE 30, 2011.
PART III, SECTION A, LINE 4	BAD DEBT EXPENSE FOOTNOTE THE FOOTNOTE TO THE CHRISTUS HEALTH CONSOLIDATED FINANCIAL STATEMENTS SAYS, "THE PREPARATION OF THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES (U.S. GAAP) REQUIRES MANAGEMENT OF THE SYSTEM TO MAKE ASSUMPTIONS, ESTIMATES, AND JUDGMENTS THAT AFFECT THE AMOUNTS REPORTED IN THE FINANCIAL STATEMENTS, INCLUDING THE NOTES THERETO, AND RELATED DISCLOSURES OF COMMITMENTS AND CONTINGENCIES, IF ANY. THE SYSTEM CONSIDERS CRITICAL ACCOUNTING POLICIES TO BE THOSE THAT REQUIRE MORE SIGNIFICANT JUDGMENTS AND ESTIMATES IN THE PREPARATION OF ITS FINANCIAL STATEMENTS, INCLUDING THE FOLLOWING: RECOGNITION OF NET PATIENT SERVICE REVENUES, WHICH INCLUDE CONTRACTUAL ALLOWANCES; AND THE PROVISIONS FOR BAD DEBT; ESTIMATES FOR REIMBURSEMENT UNDER THE UPPER PAY LIMIT, DISPROPORTIONATE SHARE AND MEDICAID 1115 WAIVER PROGRAMS; RESERVES FOR LOSSES AND EXPENSES RELATED TO HEALTH CARE PROFESSIONAL AND GENERAL LIABILITIES; ACCRUALS FOR CLAIMS INCURRED BUT NOT YET REPORTED RELATED TO THE SYSTEM'S HEALTH PLANS; DETERMINATION OF FAIR VALUES OF CERTAIN FINANCIAL INSTRUMENTS; DETERMINATION OF FAIR VALUE OF CERTAIN GOODWILL AND LONG-LIVED ASSETS, INCLUDING ASSETS ACQUIRED; AND RISKS AND ASSUMPTIONS FOR MEASUREMENT OF PENSION AND RETIREE MEDICAL LIABILITIES. MANAGEMENT RELIES ON HISTORICAL EXPERIENCE AND ON OTHER ASSUMPTIONS BELIEVED TO BE REASONABLE UNDER THE CIRCUMSTANCES IN MAKING ITS JUDGMENT AND ESTIMATES. ACTUAL RESULTS COULD DIFFER MATERIALLY FROM THESE ESTIMATES."
PART III, SECTION B, LINE 8	EXTENT TO WHICH SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT COSTING METHODOLOGY THE SHORTFALL ON PART III, LINE 7 IS NOT COUNTED AS A COMMUNITY BENEFIT. THE AMOUNT ON SCHEDULE H, PART III, LINE 6 IS DETERMINED BY CALCULATING MEDICARE ALLOWABLE COSTS USING WORKSHEET A OF THE MEDICARE COST REPORT. WORKSHEET A OF THE MEDICARE COST REPORT REQUIRES THE ORGANIZATION TO REMOVE NON-ALLOWABLE EXPENSES FROM TOTAL EXPENSES VIA THE ADJUSTMENTS TO EXPENSES WORKSHEETS WITHIN THE MEDICARE COST REPORT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE FILING ORGANIZATION ASSOCIATED WITH THE FILING ORGANIZATION'S PROVISIONS OF SERVICES TO MEDICARE PATIENTS. SCHEDULE H, PART III, LINE 7 WOULD EQUAL A SHORTFALL OF (5,459,644) IF TOTAL EXPENSES ALLOCABLE TO MEDICARE SERVICES WERE SUBSTITUTED ON SCHEDULE H, PART III, LINE 6.
PART III, SECTION C, LINE 9B	COLLECTION POLICY IT IS THE POLICY OF THE ORGANIZATION TO PURSUE COLLECTIONS OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR THESE SERVICES. CHRISTUS HEALTH APPLIES ITS COLLECTION EFFORTS CONSISTENTLY AND FAIRLY TO ALL PATIENTS REGARDLESS OF INSURANCE. IF A PATIENT DOES NOT HAVE THE FINANCIAL RESOURCES TO PAY THEIR OUTSTANDING BALANCES, THE GOAL OF THE ORGANIZATION IS TO QUALIFY THESE PATIENTS THROUGH THE ORGANIZATION'S CHARITY POLICY OR SCREEN THE PATIENTS THROUGH ORGANIZATION'S PRESUMPTIVE CHARITY TESTS. IF THE PATIENT QUALIFIES UNDER EITHER POLICY THE ACCOUNT WILL BE WRITTEN OFF BASED UPON LEVEL OF QUALIFICATION. THESE POLICIES SUPPORT THE MISSION AND VISION OF THE ORGANIZATION AND ARE APPROVED BY SENIOR LEADERSHIP.
PART VI, LINE 2	NEEDS ASSESSMENT THE CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S FY 2019 COMMUNITY BENEFIT PLAN IS BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED BY THE BEXAR COUNTY COMMUNITY HEALTH COLLABORATIVE IN 2016. IN ADDITION TO THE CHNA CONDUCTED BY THE HEALTH COLLABORATIVE, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION SUPPORTED THE COMAL COUNTY ASSESSMENT OF SOCIAL AND ENVIRONMENTAL DETERMINENTS OF WELL-BEING. RESULTS OF THE NEEDS ASSESSMENT WERE SHARED PUBLICLY WITH CITY AND COUNTY OFFICIALS, AS WELL AS LEADERS FROM THE WIDER MEDICAL COMMUNITY, SOCIAL SERVICE PROVIDERS, EDUCATIONAL AND RESEARCH INSTITUTIONS, BUSINESS LEADERS AND OTHER COMMUNITY STAKEHOLDERS. THE COMMUNITY HEALTH PRIORITIES SET FORTH BY CHRISTUS SANTA ROSA HEALTH CARE CORPORATION ARE BASED ON A CAREFUL REVIEW AND ANALYSIS OF THESE REPORTS AND ANALYSIS OF HEALTH ISSUES IDENTIFIED AT EACH SANTA ROSA HOSPITAL. THE COMMUNITY IS DEFINED AS RESIDENTS OF BEXAR AND COMAL COUNTY. WITHIN BEXAR COUNTY, 10 ZIP CODES WERE IDENTIFIED THAT ARE CONSIDERED AREAS OF HIGH RISK AND UNRESOLVED ONGOING PUBLIC HEALTH PROBLEMS. COMMUNITY DELIVERY WILL CONTINUE TO FOCUS ON THE UNINSURED POPULATION WITH ADDED EMPHASIS ON CHRONIC ILLNESS. SERVICES ARE BASED ON BEST PRACTICES DEVELOPMENT AND IMPLEMENTATION BASED ON COMMUNITY HEALTH SERVICES. THE HEALTH COLLABORATIVE IS A CONSORTIUM OF ORGANIZATIONS JOINED TOGETHER TO PRIORITIZE AND ADDRESS SIGNIFICANT COMMUNITY HEALTH ISSUES. MEMBERS OF THE HEALTH COLLABORATIVE INCLUDE CHRISTUS SANTA ROSA HEALTH CARE CORPORATION, BAPTIST HEALTH SYSTEM, METHODIST HEALTHCARE SYSTEM, UNIVERSITY HEALTH SYSTEM, COMMUNITY FIRST HEALTH PLANS, METHODIST HEALTHCARE MINISTRIES, THE YMCA OF GREATER SAN ANTONIO, AND VARIOUS LOCAL UNIVERSITIES. THE HEALTH COLLABORATIVE HAS COMMISSIONED THE COMMUNITY HEALTH NEEDS ASSESSMENT APPROXIMATELY EVERY THREE YEARS DATING BACK TO 1998. THE 2016 HEALTH COLLABORATIVE CHNA WAS CONDUCTED AND THEN RELEASED IN A 3-PHASE FORMAT. PHASE 1 OF THE ASSESSMENT RELIES ON TRADITIONAL PUBLIC HEALTH SOURCES TO CONSTRUCT OUTCOME INDICATORS OF COMMUNITY HEALTH. THESE FINDINGS ARE LABELED AS HEALTH OUTCOMES. PHASE 2 RELIES ON THE BEXAR COUNTY COMPONENT OF THE BEHAVIOR RISK FACTOR SURVEILLANCE (BRFSS) ADMINISTERED BY THE CENTERS FOR DISEASE CONTROL (CDC) AND OTHER SOURCES OF INFORMATION THAT PERTAIN TO THE COUNTY. INDICATORS OF BEHAVIORS THAT PROMOTE GOOD HEALTH OUTCOMES AND THAT ELEVATE THE RISK OF POOR HEALTH OUTCOMES ARE INCLUDED IN PHASE 2 AND ARE LABELED AS HEALTH BEHAVIORS. IN ADDITION TO THE DATA COLLECTION, CHRISTUS SANTA ROSA HEALTH CORPORATION PARTICIPATED IN COMMUNITY FOCUS GROUP MEETINGS AND NEIGHBORHOOD MEETINGS TO ALLOW RESIDENTS TO PROVIDE INSIGHT INTO THEIR COMMUNITIES. FINALLY, PHASE 3 IS THE ROBUST REVIEW AND ANALYSIS OF THE DATA COLLECTED - BOTH QUANTITATIVE AND QUALITATIVE - AND THE COMPILATION AND RELEASE OF THE REPORT. THE HEALTH COLLABORATIVE HAS BEEN RECOGNIZED AS A NATIONAL BEST PRACTICE.
PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE CHRISTUS SANTA ROSA HEALTH CARE CORPORATION MAKES EVERY EFFORT TO EDUCATE PATIENTS ON ITS CHARITY AND DISCOUNT POLICY AND ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS DURING REGISTRATION, PRE REGISTRATION (FOR SCHEDULED TESTS AND SURGERIES), POST REGISTRATION (DURING THEIR HOSPITALIZATION) AND FOLLOWING DISCHARGE (TELEPHONE OR WRITTEN INQUIRY) IN LANGUAGES APPROPRIATE FOR THE POPULATION BEING SERVED. PATIENTS ARE GIVEN INFORMATION AND FORMS BY A FINANCIAL COUNSELOR WHO HELPS THEM COMPLETE THE FORMS DURING THEIR INPATIENT AND OUTPATIENT VISITS. PATIENTS ARE ASKED TO BRING OR MAIL SUPPORTING DOCUMENTATION TO DETERMINE INCOME, ASSETS AND HOUSEHOLD EXPENSES. THE BUSINESS OFFICE REVIEWS THE APPLICATION BASED ON THE INFORMATION PROVIDED BY THE PATIENT. IF THE PATIENT QUALIFIES FOR CHARITY CARE OR A DISCOUNT, A NEW BILL IS GENERATED. PATIENTS WHO DO NOT PROVIDE THE REQUIRED DOCUMENTATION ARE CONSIDERED INELIGIBLE AND ARE BILLED ACCORDINGLY. IF THE DOCUMENTATION IS PROVIDED AT A LATER TIME, THE PATIENT MAY THEN BE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR A DISCOUNT. DOCUMENTATION IS RETAINED BY THE BILLING OFFICE FOR SEVEN YEARS. A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY IS POSTED IN PROMINENT PLACES THROUGHOUT THE HOSPITALS, INCLUDING BUT NOT LIMITED TO THE EMERGENCY ROOM WAITING AREAS AND THE ADMISSIONS OFFICE WAITING AREAS, AS REQUIRED BY BOTH THE STATE OF TEXAS COMMUNITY BENEFIT STANDARD (WHICH ADDRESSES THE DUTIES AND RESPONSIBILITIES OF NONPROFIT HOSPITALS) AND CHRISTUS HEALTH COMMUNITY BENEFIT GUIDELINES #050. IN ADDITION, A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY AND INFORMATION ON FINANCIAL ASSISTANCE ARE ALSO POSTED ON THE CHRISTUS HEALTH WEBSITE. THE INFORMATION ON FINANCIAL ASSISTANCE INCLUDES EXPLANATIONS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE, WHO QUALIFIES, AND HOW TO APPLY FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4	COMMUNITY INFORMATION CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS HEADQUARTERED IN SAN ANTONIO, TEXAS, IN THE SOUTH CENTRAL AREA OF THE STATE. IT HAS FIVE HOSPITAL CAMPUSES. IT SERVICES THE SOUTHWESTERN BORDER OF TEXAS AND INTO THE CENTRAL TEXAS HILL COUNTRY. THE AREA COMPRISES A POPULATION OF MORE THAN 3.2 MILLION INDIVIDUALS. THE POPULATION CONSISTS OF 63.20% HISPANIC AND 36.80% NON-HISPANIC. THE MEDIAN INCOME FOR THE CITY OF SAN ANTONIO IS $49,711, AND HIGH SCHOOL GRADUATES REPRESENT 81.99% OF THE POPULATION.
PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE FROM THE COMMUNITIES IT SERVES. IT CONDUCTS ITS ACTIVITIES AND ITS HEALTH CARE PURPOSE WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. ONE OF THE TOP HEALTH CARE ORGANIZATIONS IN SOUTH TEXAS, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION HAS FIVE HOSPITAL CAMPUSES: (1) CHRISTUS SANTA ROSA MEDICAL CENTER, LOCATED IN THE SOUTH TEXAS MEDICAL CENTER; (2) CHILDREN'S HOSPITAL OF SAN ANTONIO, LOCATED IN DOWNTOWN SAN ANTONIO; (3) CHRISTUS SANTA ROSA -WESTOVER HILLS IN THE WESTOVER HILLS AREA OF SAN ANTONIO; (4) CHRISTUS SANTA ROSA ALAMO HEIGHTS; AND (5) CHRISTUS SANTA ROSA NEW BRAUNFELS, LOCATED IN NEW BRAUNFELS, TEXAS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S OTHER HEALTH FACILITIES INCLUDE CHRISTUS SANTA ROSA FAMILY HEALTH CENTER, A CLINICAL OUTPATIENT CARE ORGANIZATION WHICH SERVES AS A LEVEL 3 CERTIFIED PATIENT CENTERED MEDICAL HOME AND AS A HOSPITAL-BASED ACADEMIC TRAINING PROGRAM FOR 29 FAMILY MEDICINE RESIDENTS. IN ADDITION, THE ORGANIZATION OWNS A MAJORITY INTEREST IN CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTER-NEW BRAUNFELS, A JOINT VENTURE WITH NEARLY 150 PHYSICIANS AND A MAJORITY INTEREST IN CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTERS-SAN ANTONIO, WHICH HAS 3 LOCATIONS. THE ORGANIZATION ALSO OWNS A PARTIAL INTEREST IN NEW BRAUNFELS SURGICAL CENTER, LLC. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS ALSO ONE OF THE COLLABORATING PARTNERS IN BEXAR COUNTY CLINICAL SERVICES, INC. WHICH PROVIDE PHYSICIAN AND OTHER HEALTH CARE SERVICES TO MEDICAID AND INDIGENT PATIENTS. EACH OF THE FACILITIES OF CHRISTUS SANTA ROSA SHARES ONE OBJECTIVE - TO LEAD THE WAY TO A HEALTHIER COMMUNITY. EACH OF THE FIVE HOSPITALS OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES A 24 HOUR EMERGENCY ROOM THAT IS OPEN TO SERVE ALL THOSE IN NEED OF EMERGENCY CARE, REGARDLESS OF ABILITY TO PAY. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION WORKS TO FACILITATE AND STRENGTHEN ACCESSIBILITY OF QUALITY COMPREHENSIVE HEALTH CARE SERVICES FOR ALL, PARTICULARLY THE VULNERABLE AND UNDERSERVED POPULATIONS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION ALSO SUPPORTS MANY LOCAL COMMUNITY HEALTH SERVICES, OFFERING CONVENIENT LOCATIONS FOR PRIMARY CARE THROUGH FAMILY HEALTH CLINICS AND MOBILE HEALTH CLINICS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION OFFERS SERVICES SUCH AS: COMPREHENSIVE PEDIATRIC CARE, INCLUDING A NEONATAL INTENSIVE CARE UNIT, A 45-BED, LEVEL III C NURSERY PROVIDING BOTH INTENSIVE AND INTERMEDIATE CARE TO CRITICALLY ILL INFANTS REQUIRING MEDICAL AND/OR SURGICAL INTERVENTIONS SUCH AS THE NEONATAL ECMO PROGRAM THAT PROVIDES VENO-VENOUS OR VENO-ARTERIAL EXTRACORPOREAL LIFE SUPPORT FOR UP TO TWO INFANTS IN THE NICU; THE TITANIUM RIB IMPLANT PROGRAM; THE CHRISTUS TRANSPLANT INSTITUTE (CTI); AND A WOUND CARE AND HYPERBARIC CENTER. IN ADDITION, WE OFFER THE FOLLOWING: CARDIAC CARE THAT IS NATIONALLY CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR) AND ACCREDITED AS A CHEST PAIN CENTER WITH PERCUTANEOUS CORONARY INTERVENTION (PCI) DESIGNATION FROM THE SOCIETY OF CHEST PAIN CENTERS (SCPC); A COMPREHENSIVE CANCER PROGRAM; COMPLETE OBSTETRICAL AND NEWBORN SERVICES; SURGICAL UNITS; A DIABETES CARE PROGRAM; AND STATE-OF-THE-ART MEDICAL CARE FOR CHILDREN WITH AN ARRAY OF SPECIALTY SERVICES AND ORTHOPEDIC SERVICES. WE ALSO OFFER REHABILITATION TREATMENT FOR THOSE WHO HAVE EXPERIENCED A STROKE, A SPINAL CORD INJURY, CLOSED HEAD INJURIES AND MORE. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION COLLABORATES WITH COMMUNITIES, CHURCHES, AND OTHER HEALTH CARE ORGANIZATIONS TO PROVIDE COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES AND PROACTIVE HEALTCARE PROGRAMS. THE HEALTH COLLABORATIVE'S (AS DEFINED IN SCHEDULE H, PART VI, QUESTION 2) EXISTING PRIORITIES OF FITNESS AND NUTRITION, AS THEY RELATE TO DIABETES AND OBESITY, WILL CONTINUE TO BE ADDRESSED THROUGH THE CHRONIC CARE MANAGEMENT FOR CHILDREN AND ADULTS AS WELL AS PREVENTATIVE CARE AND HEALTH EDUCATION THROUGH COLLABORATIVE RELATIONSHIPS WITH SCHOOL DISTRICTS. THE CHRISTUS SANTA ROSA HEALTH CARE CORPORATION COMMUNITY BENEFIT PLAN ("THE PLAN") SUPPORTS THE INITIATIVES OF THE HEALTH COLLABORATIVE. THE PLAN FOCUSES ON COMMUNITY INITIATIVES THAT CAN IMPACT FAMILY MEMBERS OF ALL AGES WITH DIABETES, HEART DISEASE, OBESITY AND CANCER. THESE INITIATIVES ARE PROVIDED THROUGH A PEDIATRIC MOBILE CLINIC, SCHOOL-BASED HEALTH CENTERS, COMMUNITY HEALTH WORKER PROGRAMS AND DIABETES EDUCATION PROGRAMS. THE PLAN INCLUDES THE WORK PERFORMED AT THE CENTER FOR MIRACLES WHICH IS DEDICATED TO PROVIDING FREE SERVICES FOR ABUSED/NEGLECTED CHILDREN AND THEIR AFFECTED FAMILY MEMBERS. OTHER EFFORTS ARE TO PROVIDE APPLICATION ASSISTANCE TO MEDICAID/CHIP PATIENTS TO ENSURE HEALTH CARE OPPORTUNITIES ARE OFFERED TO WOMEN AND CHILDREN. WOMEN, INFANT AND CHILDREN (WIC) SERVICES PROVIDE NUTRITION/BREASTFEEDING EDUCATION AND FOOD VOUCHERS TO HELP DECREASE THE INCIDENCE OF LOW BIRTH WEIGHT INFANTS AND IMPROVE INFANT MORTALITY RATES IN BEXAR COUNTY. CHRISTUS HEALTH REINVESTS ALL SURPLUS FUNDS BACK INTO THE COMMUNITIES IT SERVES THROUGH EXPANDED HEALTH SERVICES, NEW TECHNOLOGIES, AND BETTER FACILITIES. AS A NOT FOR PROFIT ORGANIZATION AND AS PART OF CHRISTUS HEALTH, A REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE MAKEUP OF THE AREA WE SERVE GUIDES CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. WE ARE PRIVILEGED TO HAVE AN OPEN MEDICAL STAFF COMPRISED OF QUALIFIED PHYSICIANS WHO WORK WITH US TO PROVIDE CARE TO OUR COMMUNITIES. ALL QUALIFIED PHYSICIANS WHO ARE GRANTED PRIVILEGES TO SERVE WITH US IN OUR HOSPITALS MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING AND ORIENTATION PROCESS. ICAL EXPERIENCE AND OTHER EDUCATION FOR ALL PERSONS EMPLOYED AND AFFILIATED WITH CHRISTUS SANTA ROSA HEALTH CARE CORPORATION ARE REQUIRED TO COMPLETE ANNUAL CONFLICT OF INTEREST STATEMENTS. EMPLOYED AND AFFILIATED WITH CHRISTUS SANTA ROSA HEALTH CARE CORPORATION ARE REQUIRED TO COMPLETE ANNUAL CONFLICT OF INTEREST STATEMENTS.
PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS PART OF CHRISTUS HEALTH, AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM COMPRISED OF ALMOST 350 SERVICES AND FACILITIES INCLUDING MORE THAN 60 HOSPITALS AND LONG TERM CARE FACILITIES, 175 CLINICS AND OUTPATIENT CENTERS, AND OTHER COMMUNITY HEALTH MINISTRIES AND COMMUNITY DEVELOPMENT VENTURES. CHRISTUS SERVICES CAN BE FOUND IN: ARKANSAS, GEORGIA, IOWA, LOUISIANA, NEW MEXICO, TEXAS, AND INTERNATIONALLY IN THE COUNTRIES OF MEXICO AND CHILE. A COMMON MISSION, CORE VALUES, AND VISION UNITE THE HEALTH SYSTEM. EACH REGION, INCLUDING CHRISTUS SPOHN HEALTH SYSTEM CORPORATION, DEVELOPS FIVE-YEAR AND TEN-YEAR STRATEGIC PLANS THAT HELP SET THE YEARLY OPERATIONAL PLANS AND BUDGETS. REGIONAL STRATEGIC GOALS ARE SET IN COLLABORATION WITH CHRISTUS HEALTH AND INCLUDE METRICS THAT WILL BE USED TO MEASURE COMMUNITY BENEFIT, CLINICAL OUTCOMES, PATIENT SATISFACTION, AND ASSOCIATE ENGAGEMENT. CHRISTUS HEALTH PROVIDES UPDATED MARKET, DEMOGRAPHICS, AND HEALTH INDICATOR DATA ON AN ANNUAL BASIS. THE DATA SUPPLIED FROM CHRISTUS HEALTH ALONG WITH THE SYSTEM WIDE STRATEGIC INITIATIVES ARE CONSISTENT WITH THE COMMUNITY NEEDS ASSESSMENT OF THE REGION. CHRISTUS SPOHN HEALTH SYSTEM CORPORATION, IN TURN, PARTNERS WITH OTHER NONPROFIT GROUPS (CHURCHES, HEALTH CARE PROVIDERS, AND GOVERNMENT AGENCIES) TO CREATE COLLABORATIONS WHERE HEALTH NEEDS CAN BE ADDRESSED AND THE GENERAL HEALTH OF INDIVIDUALS AND THE COMMUNITY IS IMPROVED.
PART VI, LINE 7	COMMUNITY BENEFIT REPORT A COMMUNITY BENEFIT REPORT IS FILED FOR THE STATE OF TEXAS IN THE FORM OF THE ANNUAL STATEMENT OF COMMUNITY BENEFITS STANDARD (ASCBS) FORM AS REQUIRED BY THE HEALTH AND SAFETY CODE, SECTIONS 311.045 AND 311.046. THE CODE REQUIRES NONPROFIT HOSPITALS TO FILE THE ASCBS FORM AND ANNUAL REPORT OF THE COMMUNITY BENEFITS PLAN WITH THE TEXAS DEPARTMENT OF STATE HEALTH SERVICES (DSHS). THE 2012 ASCBS FORM IS EXPANDED TO COLLECT THE INFORMATION ON CHARITY CARE POLICIES AND COMMUNITY BENEFITS IN A STANDARDIZED FORMAT. ALL CHRISTUS HEALTH ENTITIES INCLUDING FACILITIES LOCATED IN STATES THAT DO NOT REQUIRE ANNUAL COMMUNITY BENEFIT REPORTING (I.E., LOUISIANA, AND NEW MEXICO), FOLLOW THE SAME REPORTING RULES AS OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT, COPYRIGHT 2008. TOTAL COMMUNITY BENEFIT FOR CHRISTUS HEALTH IS ALSO REPORTED IN THE ANNUAL REPORT PREPARED AND DISTRIBUTED BY THE SYSTEM OFFICE. STATE FILING OF COMMUNITY BENEFIT REPORT: TX

Schedule H (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 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 Santa Rosa Health Care Corporation

Employer identification number
74-1109665

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) CITY OF SAN ANTONIO 856 GEMBLER RD SAN ANTONIO,TX78219	74-6002070	Govt	122,400

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) BEXAR COUNTY CLINICAL SERVICES	1	25,851,000	INDIGENT CARE
(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. THE FILING ORGANIZATION PROVIDES INDIGENT FUNDING GRANTS TO THE COUNTIES IN WHICH IT SERVES VIA GRANTS PAID TO OTHER HOSPITALS AND HEALTHCARE ORGANIZATIONS LOCATED WITHIN SUCH COUNTIES. THIS CHARITABLE DONATION HELPS RELIEVE THE ADDITIONAL EXPENSE OF HEALTHCARE FOR THE INDIGENT POPULATION WITHIN OUR COMMUNITIES THAT THE FILING ORGANIZATION MAY NOT DIRECTLY SERVE IN ONE OF ITS HOSPITALS. THIS IS A RESULT OF OUR MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, ESPECIALLY TO THE POOR AND UNDERSERVED.

Schedule I (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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 Santa Rosa Health Care Corporation

Employer identification number

74-1109665

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)
1David Mier CFO-Childrens Hospital of SA	(i) (ii)	0 ------------- 241,517	0 ------------- 49,699	0 ------------- 4,023	0 ------------- 8,250	0 ------------- 23,583	0 ------------- 327,072	0 ------------- 0
2Patricia Toney VP/Chief Nurse Executive	(i) (ii)	0 ------------- 320,346	0 ------------- 48,772	0 ------------- 65,811	0 ------------- 66,251	0 ------------- 9,081	0 ------------- 510,261	0 ------------- 0
3Jim Wesson VP/New Braunfels	(i) (ii)	0 ------------- 304,804	0 ------------- 16,760	0 ------------- 49,684	0 ------------- 71,118	0 ------------- 22,177	0 ------------- 464,543	0 ------------- 0
4ROXANNE R JENKINS DIR.-CLIN INTRGRTIN-COMPLAINCE	(i) (ii)	192,117 ------------- 0	6,147 ------------- 0	0 ------------- 0	15,826 ------------- 0	2,886 ------------- 0	216,976 ------------- 0	0 ------------- 0
5TERRY KYLE VP - FOUNDATION	(i) (ii)	184,928 ------------- 0	10,000 ------------- 0	399 ------------- 0	5,969 ------------- 0	6,481 ------------- 0	207,777 ------------- 0	0 ------------- 0
6Patrick B Carrier FORMER PRES/CEO (term 03/2015)	(i) (ii)	0 ------------- 507,454	0 ------------- 361,063	0 ------------- 634,089	0 ------------- 43,149	0 ------------- 13,110	0 ------------- 1,558,865	0 ------------- 0
7STEPHANIE A PARKER VP OF FINANCE	(i) (ii)	0 ------------- 190,482	0 ------------- 40,625	0 ------------- 4,507	0 ------------- 7,408	0 ------------- 19,200	0 ------------- 262,222	0 ------------- 0
8KATHLEEN TREGEAR CHIEF NURSING OFFICER	(i) (ii)	0 ------------- 130,990	0 ------------- 11,218	0 ------------- 54,794	0 ------------- 4,303	0 ------------- 5,427	0 ------------- 206,732	0 ------------- 0
9Alexis Arel VP Finance	(i) (ii)	0 ------------- 150,975	0 ------------- 6,539	0 ------------- 4,252	0 ------------- 0	0 ------------- 1,860	0 ------------- 163,626	0 ------------- 0
10Karen Bryant VP - Strategy - Bus Devlopment	(i) (ii)	0 ------------- 233,458	0 ------------- 71,951	0 ------------- 3,601	0 ------------- 43,035	0 ------------- 13,372	0 ------------- 365,417	0 ------------- 0
11Kenneth Davis MD chief medical officer	(i) (ii)	0 ------------- 420,380	0 ------------- 161,181	0 ------------- 8,404	0 ------------- 74,012	0 ------------- 36,447	0 ------------- 700,424	0 ------------- 0
12Dennis Gonzales VP Mission Integration	(i) (ii)	0 ------------- 187,864	0 ------------- 8,951	0 ------------- 4,602	0 ------------- 26,877	0 ------------- 15,475	0 ------------- 243,769	0 ------------- 0
13Eileen Huss Chief Nursing Officer	(i) (ii)	0 ------------- 211,965	0 ------------- 82,038	0 ------------- 27,721	0 ------------- 41,071	0 ------------- 11,950	0 ------------- 374,745	0 ------------- 0
14Asha Rodriguez President	(i) (ii)	0 ------------- 193,072	0 ------------- 0	0 ------------- 0	0 ------------- 12,566	0 ------------- 12,279	0 ------------- 217,917	0 ------------- 0
15Ian Thompson Pres. & VP Market Oncology	(i) (ii)	0 ------------- 268,550	0 ------------- 113,303	0 ------------- 30,933	0 ------------- 67,534	0 ------------- 8,752	0 ------------- 489,072	0 ------------- 0
16Rhonda Thompson chief nursing officer	(i) (ii)	0 ------------- 223,454	0 ------------- 57,156	0 ------------- 50,588	0 ------------- 0	0 ------------- 16,618	0 ------------- 347,816	0 ------------- 0
17Dean Alexander Dir/Pres/CEO	(i) (ii)	0 ------------- 488,057	0 ------------- 87,396	0 ------------- 15,693	0 ------------- 103,676	0 ------------- 19,157	0 ------------- 713,979	0 ------------- 0
18Linda Mary K Kirks CFO/BOARD TREASURER	(i) (ii)	0 ------------- 330,943	0 ------------- 21,683	0 ------------- 43,322	------------- 47,071	------------- 37,222	0 ------------- 480,241	0 ------------- 0
19Jodee M Kerestes DIRECTOR CANCER SVCS BUS DEV	(i) (ii)	145,494 ------------- 0	28,057 ------------- 0	100 ------------- 0	4,634 ------------- 0	17,152 ------------- 0	195,437 ------------- 0	0 ------------- 0
20MICHAEL DAVIS VP-FINANCE WESTOVER HILLS	(i) (ii)	0 ------------- 150,537	0 ------------- 6,974	0 ------------- 6,158	0 ------------- 6,237	0 ------------- 19,424	0 ------------- 189,330	0 ------------- 0
21Angela Lambert Chief Nsg Ofcr Medical Center	(i) (ii)	0 ------------- 184,331	0 ------------- 10,034	0 ------------- 34,802	0 ------------- 37,508	0 ------------- 11,087	0 ------------- 277,762	0 ------------- 0
22CHARLES HANKINS MD CMO (EFF 10/2018)	(i) (ii)	0 ------------- 511,161	0 ------------- 207,929	0 ------------- 87,312	0 ------------- 117,344	0 ------------- 9,491	0 ------------- 933,237	0 ------------- 0
23CRIS DASKEVICH CEO CHOSA (EFF 10/2018)	(i) (ii)	0 ------------- 438,862	0 ------------- 207,929	0 ------------- 89,308	0 ------------- 125,875	0 ------------- 14,038	0 ------------- 876,012	0 ------------- 0
24CYNTHIA A KOGER DIRECTOR OF PHARMACY	(i) (ii)	172,644 ------------- 0	0 ------------- 0	0 ------------- 0	14,413 ------------- 0	7,042 ------------- 0	194,099 ------------- 0	0 ------------- 0
25EDUARDO LARA PRACTICE ADMINISTRATOR	(i) (ii)	181,338 ------------- 0	0 ------------- 0	714 ------------- 0	7,524 ------------- 0	24,044 ------------- 0	213,620 ------------- 0	0 ------------- 0
26CRYSTAL KOHANKE VP-HUMAN RESOURCES	(i) (ii)	0 ------------- 323,002	0 ------------- 93,131	0 ------------- 6,887	0 ------------- 66,644	0 ------------- 23,332	0 ------------- 512,996	0 ------------- 0
27JOHN BEL VP/CHIEF DEV OFFICER	(i) (ii)	0 ------------- 268,256	0 ------------- 41,565	0 ------------- 5,308	0 ------------- 17,563	0 ------------- 11,033	0 ------------- 343,725	0 ------------- 0
28DOMINIC DOMINGUEZ REGIONAL CEO	(i) (ii)	0 ------------- 655,631	0 ------------- 431,626	0 ------------- 21,093	0 ------------- 179,134	0 ------------- 12,669	0 ------------- 1,300,153	0 ------------- 0
29DAVID GLAZENER VP FINANCE	(i) (ii)	0 ------------- 131,266	0 ------------- 6,136	0 ------------- 2,253	0 ------------- 4,462	0 ------------- 25,005	0 ------------- 169,122	0 ------------- 0
30CARLA MORENO VP, PATIENT PLACEMENT	(i) (ii)	0 ------------- 169,829	0 ------------- 81,435	0 ------------- 10,028	0 ------------- 3,648	0 ------------- 14,832	0 ------------- 279,772	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

SUPPLEMENTAL COMPENSATION INFORMATION

FORM 990, PART VII, LINE 1A AND 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. BOARD MEMBERS SPEND TIME AS NEEDED FOR BOARD MEETINGS AND FUNCTIONS. 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. SUPPLEMENTAL COMPENSATION INFORMATION RELATED ORG DETERMINING CEO/EXECUTIVE DIRECTOR'S COMPENSATION FORM 990, SCHEDULE J, PART I, LINE 3 THE FILING ORGANIZATION'S CEO/EXECUTIVE DIRECTOR IS AN EMPLOYEE OF CHRISTUS HEALTH, A RELATED ORGANIZATION. AS A RESULT, COMPENSATION IS ESTABLISHED AT THE CHRISTUS HEALTH LEVEL AND THE FILING ORGANIZATION DOES NOT HAVE A ROLE IN IMPLEMENTING THE METHODS USED TO ESTABLISH COMPENSATION OR IN DETERMINING CEO/EXECUTIVE DIRECTOR COMPENSATION. 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 BI-ANNUAL COMPENSATION SURVEY. SEVERANCE PAYMENTS FORM 990, SCHEDULE J, PART I, LINE 4A THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS: PATRICK B. CARRIER $89,854 KATHLEEN TREGEAR $53,108 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. THE FORM 990 REPORTS AS PENSION BENEFITS THEIR ANNUAL ESTIMATED CASH BALANCE PLAN ACCRUAL.

Schedule J (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Christus Santa Rosa Health Care Corporation

Employer identification number

74-1109665

Return Reference	Explanation
Description of Other Program Services	FORM 990, PAGE 1, ITEM C CHRISTUS HEALTH SANTA ROSA HEALTH CARE CORPORATION OPERATES UNDER THE FOLLOWING NAMES: CHILDREN'S HOSPITAL OF SAN ANTONIO CHRISTUS BREAST RENEWAL CENTER - ALAMO HEIGHTS CHRISTUS CARDIOVASCULAR CHRISTUS Cardiovascular Medical Center CHRISTUS Cardiovascular New Braunfels CHRISTUS Cardiovascular Westover Hills CHRISTUS Oncology CHRISTUS Oncology - Medical Center CHRISTUS Oncology - New Braunfels CHRISTUS Oncology - Westover Hills CHRISTUS SANTA ROSA CARDIOTHORACIC CENTER CHRISTUS SANTA ROSA CHILDREN'S HOSPITAL CHRISTUS Santa Rosa Emergency Center - Creekside CHRISTUS Santa Rosa Emergency - Bandera CHRISTUS Santa Rosa Emergency Center - Alon CHRISTUS Santa Rosa Emergency Center - Bitters CHRISTUS SANTA ROSA EMERGENCY CENTER - BANDERA CHRISTUS SANTA ROSA EMERGENCY CENTER NEW BRAUNFELS CHRISTUS SANTA ROSA EMERGENCY CENTER CHRISTUS SANTA ROSA HEALTH SYSTEM CHRISTUS SANTA ROSA HOSPITAL - ALAMO HEIGHTS CHRISTUS SANTA ROSA HOSPITAL - NEW BRAUNFELS CHRISTUS SANTA ROSA HOSPITAL - WESTOVER HILLS CHRISTUS SANTA ROSA HOSPITAL CHRISTUS Santa Rosa Hospital Alamo Heights Outpatient Surgery Center CHRISTUS SANTA ROSA IMAGING CENTER - ALAMO HEIGHTS CHRISTUS Santa Rosa Hospital - Medical Center CHRISTUS SANTA ROSA MEDICAL CENTER CHRISTUS Santa Rosa Neurosurgical Spine CHRISTUS Santa Rosa Orthopaedics & Sports Medicine CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTER ALAMO HEIGHTS CHRISTUS SANTA ROSA Quality Care Alliance CHRISTUS Santa Rosa Specialty Clinic New Braunfels CHRISTUS SANTA ROSA REHABILITATION SERVICES The Children's Hospital of San Antonio The Children's Hospital of San Antonio - Multispecialty Center The Children's Hospital of San Antonio CHRISTUS Health - Health Pavilion Stone Oak The Children's Hospital of San Antonio Emergency Center - Bandera The Children's Hospital of San Antonio Specialty Care Center CHRISTUS TRANSPLANT INSTITUTE CHRISTUS WEIGHT LOSS INSTITUTE - WESTOVER HILLS SPINAL AND THORACIC TREATMENT AND RESEARCH CENTER (STTAR CENTER) DESCRIPTION OF OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D COMMUNITY SERVICES FOR THE 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, OUTREACH PROGRAMS FOR CHILDREN AND SENIORS, HEALTH EDUCATION, AIR AMBULANCE AND A VARIETY OF OTHER SOCIAL SERVICES. ONE EXAMPLE OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S COMMUNITY BENEFITS ACCOUNTED FOR UNDER COMMUNITY SERVICES FOR THE POOR AND UNDERSERVED INCLUDE THE CHRISTUS HEALTH COMMUNITY DIRECT INVESTMENT PROGRAM (CDI). THE CHRISTUS HEALTH BOARD OF DIRECTORS APPROVED THE FUNDING OF THE 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 IS LOST FROM THE MARKET RATE LESS OUR LOAN RATE (FOREGONE INCOME) IS CONSIDERED A COMMUNITY BENEFIT FOR REPORTING PURPOSES. THE COST OF THESE INVESTMENTS IS NOT INCLUDED IN THE PROGRAM SERVICE EXPENSES OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. THOUGH OUTSTANDING LOAN BALANCES VARY THROUGHOUT THE YEAR, THE OUTSTANDING LOAN BALANCE AT THE END OF FISCAL YEAR 2019 WAS $0. THE FOREGONE INTEREST FOR CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IN FY 2019 WAS $0. CHRISTUS HEALTH HAS ESTABLISHED THE CHRISTUS FUND TO PROVIDE RESOURCES TO NOT-FOR-PROFIT AGENCIES AND GROUPS WHOSE MISSION, VISION 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 IN OUR COMMUNITIES. DURING FY 2019, THE TOTAL GRANT MONEY DISTRIBUTED BY CHRISTUS HEALTH TO THE CHRISTUS SANTA ROSA HEALTH CARE CORPORATION REGION WAS $514,500. THE COST OF THESE GRANTS IS NOT INCLUDED IN THE PROGRAM SERVICE EXPENSES FOR CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. SEVERAL CHRISTUS REGIONS PROVIDE INDIGENT FUNDING DONATIONS OR "GRANTS" TO AID THE COUNTIES IN WHICH THEY, OR ANOTHER CHRISTUS REGION, SERVE. SUCH GRANTS MAY BE PAID TO THE COUNTY DIRECTLY OR VIA ANOTHER HOSPITAL OR HEALTHCARE ORGANIZATION IN THE AREA. THIS CHARITABLE DONATION HELPS RELIEVE THE ADDITIONAL EXPENSE OF HEALTHCARE FOR THE INDIGENT POPULATION WITHIN OUR COMMUNITIES THAT CHRISTUS MAY NOT DIRECTLY SERVE IN ONE OF OUR HOSPITALS. THIS IS A RESULT OF OUR MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST, ESPECIALLY TO THE POOR AND UNDERSERVED. DESCRIPTION OF OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D COMMUNITY SERVICES FOR THE BROADER COMMUNITY THE GREATEST SHARE OF THESE EXPENSES IS USED 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 SANTA ROSA HEALTH CARE CORPORATION 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 INCREASE ACCESS TO HEALTH CARE, SUPPORT CAUSES LIKE THE FIGHT AGAINST CANCER, HEART DISEASE, DIABETES, AND FOR MANY OTHER EQUALLY WORTHY PURPOSES. DURING FY 2019, CHRISTUS SANTA ROSA ADVOCATED FOR IMPROVING PUBLIC POLICIES, WORKING TO ESTABLISH, AND IN SOME INSTANCES AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTHCARE SERVICES FOR THE CONSTITUENTS WE SERVE.
BUSINESS OR FAMILY RELATIONSHIPS	FORM 990, PART VI, LINE 2 FORMER OFFICER PAT CARRIER HAS A BUSINESS RELATIONSHIP BECAUSE HE SERVES AS MEMBERS OF THE MANAGING BOARD OF CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTER-SAN ANTONIO, LLC. KEY EMPLOYEE PATRICIA TONEY HAS A BUSINESS RELATIONSHIP BECAUSE SHE SERVES AS MEMBERS OF THE MANAGING BOARD OF CHRISTUS SANTA ROSA OUTPATIENT SURGERY CENTER-NEW BRAUNFELS, LP.
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS	FORM 990, PART VI, LINE 6 CHRISTUS HEALTH IS THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION.
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS	FORM 990, PART VI, LINE 7A CHRISTUS HEALTH, THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION, HAS THE POWER TO APPOINT ALL MEMBERS OF THE FILING ORGANIZATION'S GOVERNING BODY.
DESCR CLASSES OF PERSONS, DECS REQUIRING APPR & TYPE OF VOTING RIGHTS	FORM 990, PART VI, LINE 7B CHRISTUS HEALTH'S BOARD OF DIRECTORS HAS THE FOLLOWING POWERS: APPROVE, CHANGE AND/OR INTERPRET THE FILING ORGANIZATION'S PHILOSOPHY, MISSION AND VISION; APPROVE THE ADOPTION OR AMENDMENT OF THE FILING ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS; APPOINT AND REMOVE MEMBERS OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS; APPOINT AND REMOVE THE FILING ORGANIZATION'S CHAIR OF THE BOARD OF DIRECTORS AND VICE CHAIRPERSON OF BOARD OF DIRECTORS; APPROVE INCURRENCE OF DEBT THAT EXCEEDS $5 MILLION PER INCURRENCE OR $25 MILLION ANNUALLY; APPROVE ANY MERGER, CONSOLIDATION, ACQUISITION, DISSOLUTION OR LIQUIDATION BY THE FILING ORGANIZATION; APPROVE THE IMPLEMENTATION OF SYSTEM-WIDE POLICIES FOR THE FILING ORGANIZATION; APPROVE SYSTEM-WIDE CONSOLIDATED BUDGET AND PERFORMANCE INDICATORS FOR THE FILING ORGANIZATION; APPROVE THE INDEPENDENT AUDIT REPORTS OF THE FILING ORGANIZATION; APPROVE CAPITAL PROJECTS GREATER THAN $10 MILLION FOR THE FILING ORGANIZATION; APPROVE ANY TRANSACTION BY THE FILING ORGANIZATION THE EFFECT OF WHICH IS TO CREATE A NEW LEGAL ENTITY OR JOINT VENTURE, ANY TRANSACTION INVOLVING A SYSTEM PARTICIPANT OR LOCAL ENTITY WHICH CREATES A NEW LEGAL ENTITY OR JOINT VENTURE, OR CHANGES IN BUSINESS PURPOSE OR RELATIONSHIP OF ANY LOCAL ENTITY; AND APPROVE AND AUTHORIZE ACTIONS RESERVED IN ORGANIZATION DOCUMENTS OR SIMILAR GOVERNANCE DOCUMENTS. THE CHRISTUS HEALTH CEO HAS THE FOLLOWING POWERS: POWER TO APPOINT AND REMOVE THE PRESIDENT OF THE FILING ORGANIZATION; APPROVE THE SALE, LEASE, MORTGAGE, TRANSFER, EASEMENT OR ENCUMBRANCE OF THE FILING ORGANIZATION'S REAL PROPERTY DESIGNATED AS NON-DESIGNATED MINISTRY PROPERTY UNDER $5 MILLION BUT MORE THAN $1 MILLION; APPROVE THE INCURRENCE OF DEBT UP TO A $5 MILLION CAP OR $25 MILLION ANNUALLY BY THE FILING ORGANIZATION; APPROVE STRATEGIC PLANS OF THE FILING ORGANIZATION; APPROVE THE FILING ORGANIZATION'S BUDGET; SET THE THRESHOLD OF CAPITAL PROJECTS LESS THAN $10 MILLION BY THE FILING ORGANIZATION; AND APPROVE MANAGEMENT DIRECTIVES FOR THE FILING ORGANIZATION. THE CHRISTUS HEALTH MEMBERS ARE THE CONGREGATION OF SISTERS OF CHARITY OF THE INCARNATE WORD, HOUSTON, TEXAS AND THE CONGREGATION OF SISTERS OF CHARITY OF THE INCARNATE WORD (OF SAN ANTONIO). THE CHRISTUS HEALTH MEMBERS HAVE THE FOLLOWING POWERS: APPROVE THE ADOPTION AND AMENDMENT OF ARTICLES OF INCORPORATION AND BYLAWS OF THE FILING ORGANIZATION IF THE CHANGE IS RELATED TO RESERVED POWERS OF MEMBERS; APPROVE THE SALE, LEASE, MORTGAGE, TRANSFER, EASEMENT OR ENCUMBRANCE OF REAL PROPERTY IN EXCESS OF A $5 MILLION THRESHOLD DOLLAR AMOUNT REQUIRED BY CANON LAW FOR THE FILING ORGANIZATION; APPROVE THE SALE, LEASE, MORTGAGE, TRANSFER, EASEMENT, OR ENCUMBRANCE OF REAL PROPERTY DESIGNATED AS DESIGNATED MINISTRY PROPERTY BY THE FILING ORGANIZATION, BUT NOT IN EXCESS OF $5 MILLION; APPROVE THE CHANGE OF OWNERSHIP, MANAGEMENT OR CONTROL, (EXCEPT IN THE ORDINARY COURSE OF BUSINESS OFFICE AND SPACE LEASES) THE FUNDAMENTAL USE BY CHANGE IN LICENSE THAT WOULD SIGNIFICANTLY CHANGE A FACILITY, OR THE ELIMINATION OF OB, PED, PSYCH OR EMERGENCY SERVICES ON REAL PROPERTY PROVIDED IN CONNECTION WITH DESIGNATED MINISTRY PROPERTY OWNED BY THE FILING ORGANIZATION; AND APPROVE THE MERGER, CONSOLIDATION, ACQUISITION, DISSOLUTION OR LIQUIDATION OF THE FILING ORGANIZATION IF IT OWNS DESIGNATED MINISTRY PROPERTY.
DESC 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 RESPECTIVE 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 AT THE END OF EACH CALENDAR YEAR, THE CHRISTUS HEALTH CORPORATE SECRETARY DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE TO ALL OF THE ORGANIZATION'S BOARD AND COMMITTEE MEMBERS FOR COMPLETION PRIOR TO THE 1ST OF JANUARY IN THE NEXT YEAR. THE CORPORATE SECRETARY 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. 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 INCLUDING CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. THE EXECUTIVE COMPENSATION COMMITTEE IS COMPOSED OF INDIVIDUALS WHO HAVE NO CONFLICT OF INTEREST WITH THE COMPENSATION ARRANGEMENTS AT HAND. 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. DEVELOPS THE MERIT INCREASE RECOMMENDATIONS FOR ALL DESIGNATED SYSTEM EXECUTIVES BASED ON MARKET COMPARABILITY. 2. RECOMMENDS THE CHANGES IN THE COMPENSATION STRUCTURE (GRADES) BASED ON THE MARKET CHANGES. 3. 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. THE FILING ORGANIZATION DETERMINES THE COMPENSATION OF THE SECRETARY BY USE OF AN INDEPENDENT AND EXTERNAL CONSULTANT. THE CONSULTANT HELPS DETERMINE PAY RATES FOR THE ASSOCIATES OF THE FILING ORGANIZATION, TAKING INTO ACCOUNT MARKET DATA AND SHIFT DIFFERENTIAL. THE COMPENSATION RATES ARE APPROVED BY THE FILING ORGANIZATION. BASED ON THE AFOREMENTIONED PROCEDURE, THE SECRETARY'S COMPENSATION IS NOT REVIEWED BY A COMPENSATION COMMITTEE.
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 ORGANIZATIONS 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, LINE 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.
OTHER CHANGES IN NET ASSETS OR FUND BALANCES	FORM 990, PART XI, LINE 9 RELEASE FROM RESTRICTED - CAPITAL $ (316,774) CONTRIBUTION $ (89,689) PENSION FUNDING $ (1,290,590) PENSION LIABILITY/EXPENSE $ 1,514,046 I/C NET ASSETS -UNRESTRICTED $ 145,778,673 TEMPORARILY RESTRICTED $ 14,099,796 PERMANENTLY RESTRICTED $ 992,317 NET CHANGE IN BENEFICIAL INTEREST $ (14,278,063) ----------------- TOTAL $ 146,409,716
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICIAN FEES TOTAL FEES:49212384
FORM 990 PART IX LINE 11G	DESCRIPTION:OCCUPANCY TOTAL FEES:14459303
FORM 990 PART IX LINE 11G	DESCRIPTION:REPAIR AND MAINTENANCE TOTAL FEES:5881986
FORM 990 PART IX LINE 11G	DESCRIPTION:BILLING AND COLLECTIONS FEES TOTAL FEES:5792723
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING SERVICES TOTAL FEES:2693318
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL SERVICES TOTAL FEES:348184
FORM 990 PART IX LINE 11G	DESCRIPTION:MARKETING TOTAL FEES:33
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER SERVICES TOTAL FEES:21206718

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 Santa Rosa Health Care Corporation

Employer identification number

74-1109665

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)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 DRIVE LAKE CHARLES,LA70601 72-0411322	HLTHCARE SVCS	LA	501(c)(3)	3	CH	Yes
(8)CHRISTUS HEALTH 919 HIDDEN RIDGE DRIVE IRVING,TX75038 76-0590551	SPT HLTH SVCS	TX	501(c)(3)	10	NA		No
(9)CHRISTUS CONTINUING CARE 1700 WEST LOOP SOUTH STE 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 I	CH	Yes
(11)DUBUIS HEALTH SYSTEM INC 1700 WEST LOOP SOUTH STE 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	SPT HLTH SVCS	TX	501(c)(3)	12-Type I	CH	Yes
(13)FRIENDS OF SANTA ROSA FOUNDATION 333 N SANTA ROSA STREET SAN ANTONIO,TX78207 74-2723391	SPT HLTH SVCS	TX	501(c)(3)	12-Type I	CSRHCC	Yes
(14)SANTA ROSA FAMILY HEALTH CENTER 333 N SANTA ROSA STREET SAN ANTONIO,TX78207 74-2806531	HLTHCARE SVCS	TX	501(c)(3)	10	CSRHCC	Yes
(15)CHRISTUS SANTA ROSA MED CTR AUXILIARY 2827 BABCOCK ROAD SAN ANTONIO,TX78229 73-1655493	SPT HLTH SVCS	TX	501(c)(3)	10	CSRHCC	Yes
(16)CHRISTUS HEALTH STRATEGIC GROWTH 919 HIDDEN RIDGE DRIVE IRVING,TX75038 46-2798043	SPT HLTH SVCS	TX	501(c)(3)	12-Type I	CH	Yes
(17)CHRISTUS HEALTH PLAN LOUISIANA 919 HIDDEN RIDGE DRIVE IRVING,TX75038 46-4617988	MEDICAID HMO	LA	501(c)(4)		CH	Yes
(18)CHRISTUS PEDIATRIC PHYSICIAN GROUP 919 HIDDEN RIDGE DRIVE IRVING,TX75038 46-5203505	HLTHCARE SVCS	TX	501(c)(3)	3	CH	Yes
(19)SANTA ROSA CHILDREN'S HOSPITAL FND 1 INTL CTR 100 NE LP 410 706 SAN ANTONIO,TX78216 74-1224362	FUNDRAISING	TX	501(c)(3)	7	CSRHCC	Yes
(20)CHRISTUS FOUNDATION FOR HEALTHCARE PO BOX 1919 HOUSTON,TX77251 74-6074210	SUPP HTH SVCS	TX	501(c)(3)	7	CH	Yes
(21)CHRISTUS HOPKINS HEALTH ALLIANCE 115 AIRPORT ROAD SULPHUR SPRINGS,TX75482 81-1708177	HEALTH SVCS	TX	501(c)(3)	3	CH	Yes
(22)CHRISTUS TRINITY MOTHER FRANCES HS 1315 DOCTORS DRIVE TYLER,TX75701 75-2616975	HLTHCARE SVCS	TX	501(c)(3)	12-Type II	CH	Yes
(23)Good Shepherd Health System Inc 700 E MARSHALL AVE LONGVIEW,TX75601 75-2027157	HLTHCARE SVCS	TX	501(c)(3)	12-TYPE II	CH	Yes
(24)CHRISTUS ARK-LA-TEX HEALTH SYSTEM 919 HIDDEN RIDGE Drive IRVING,TX75038 82-2109465	HLTHCARE SVCS	TX	501(c)(3)	12-TYPE II	CH	Yes
(25)CHRISTUS HEALTH PLAN 600 ELIZABETH STREET CORPUS CHRISTI,TX78404 45-2106295	MEDICAID HMO	TX	501(C)(4)		cshsc	Yes
(26)CHRISTUS CONNECTED CARE NETWORK 919 HIDDEN RIDGE DRIVE IRVING,TX75038 47-3403356	SPT HLTH SVCS	TX	501(C)(4)		CH	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) CSR PASC SA LLC 333 SN ROS SAN ANT,TX78207 41-2092141	HEALTHCARE SVCS	TX	CSRHCC	RELATED	561,793	4,843,648		No			No	57.809 %
(2) CSR OUTPT SRG NB LP 333 SN ROS SAN ANTN,TX78207 81-0571409	HEALTHCARE SVCS	TX	CSRHCC	RELATED	6,044,416	12,905,633		No			No	51.534 %
(3) ALAMO HTS SUR GP 333 SN ROS SN ANTN,TX78207 46-2683189	HEALTHCARE SVCS	TX	CSRHCC	RELATED	0	0		No			No	100.000 %

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) SOUTH TEXAS HEALTH ALLIANCE 6243 IH 10 WEST SUITE 480 SAN ANTONIO,TX78201 74-2782184	HEALTHCARE SVCS	TX	CSRHCC	C Corp	0	-50	100.000 %	Yes
(2) CHRISTUS MUGUERZA SAPI DE CV HIDALGO PTE 2525 COL OBISPADO MONTERREY,N.L.64060 MX	HEALTHCARE SVCS	MX	CH	C Corp				Yes
(3) EMERALD ASSURANCE CAYMAN LTD PO BOX 1051 GRAND CAYMAN,CAYMAN ISLANDSKY1-1102 CJ 98-0407545	INSURANCE	CJ	CH	C Corp				Yes
(4) MCKENNA PROFESSIONAL BLDG OWNER'S ASSOC 598 N UNION STREET SUITE 210 NEW BRAUNFELS,TX78310 74-2742934	BUILDING ASSOC	TX	CSRHCC	C Corp	164,139	16,132	80.000 %	Yes
(5) CHRISTUS LOUISIANA QUALITY ALLIANCE 919 HIDDEN RIDGE DRIVE IRVING,TX75038 47-4618648	ACO	LA	CH	C Corp				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 SURGERY CENTER	M	224,218	Accrual
(2) ALAMO HEIGHTS SURGERY CENTER	O	544,639	Accrual
(3) ALAMO HEIGHTS SURGERY CENTER	Q	259,163	ACCRUAL
(4) C H WILKINSON PHYSICIAN NETWORK	L	5,407,029	ACCRUAL
(5) C H WILKINSON PHYSICIAN NETWORK	M	5,407,029	ACCRUAL
(6) CHRISTUS PEDIATRIC PHYSICIAN GROUP	J	856,243	ACCRUAL
(7) CHRISTUS PEDIATRIC PHYSICIAN GROUP	L	80,770	ACCRUAL
(8) CHRISTUS PEDIATRIC PHYSICIAN GROUP	M	80,770	ACCRUAL
(9) CHRISTUS PEDIATRIC PHYSICIAN GROUP	Q	856,243	ACCRUAL
(10) DEDICATED SYSTEM SUPPORT INC	O	145,762	ACCRUAL
(11) DEDICATED SYSTEM SUPPORT INC	Q	90,719	ACCRUAL
(12) FRIENDS OF SANTA ROSA FOUNDATION	C	130,223	ACCRUAL
(13) SANTA ROSA FAMILY HEALTH CENTER	A(IV)	28,500	ACCRUAL
(14) SANTA ROSA FAMILY HEALTH CENTER	J	1,119,236	ACCRUAL
(15) SANTA ROSA FAMILY HEALTH CENTER	L	175,000	ACCRUAL
(16) SANTA ROSA FAMILY HEALTH CENTER	M	235,000	ACCRUAL
(17) SANTA ROSA FAMILY HEALTH CENTER	O	1,317,602	ACCRUAL
(18) SANTA ROSA FAMILY HEALTH CENTER	P	642,471	ACCRUAL
(19) SANTA ROSA FAMILY HEALTH CENTER	Q	1,090,736	ACCRUAL
(20) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION	M	641,987	ACCRUAL
(21) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION	O	1,320,382	ACCRUAL
(22) CHRISTUS SPOHN HEALTH SYSTEM CORPORATION	Q	275,896	ACCRUAL
(23) CH SANTA ROSA PHYSICIAN AMBULATORY SURG CNTR	A(IV)	9,747	ACCRUAL
(24) DEDICATED SYSTEM SUPPORT INC	A(IV)	19,494	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	Briefly describe the organization’s mission or most significant activities: SUPPORTING THE HEALTH CARE MINISTRIES OF THE SPONSORING CONGREGATIONS IN EXTENDING THE HEALTH 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	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	4,404
6	Total number of volunteers (estimate if necessary) .............	6	773
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	390,162
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	352,221

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	10,720,076	9,204,418
9	Program service revenue (Part VIII, line 2g) .........	647,835,411	691,384,823
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-577,371	8,500
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,986,188	1,710,903
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	659,964,304	702,308,644
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	20,081,553	25,984,208
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)	236,541,120	242,108,414
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 1,728,675
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	430,654,660	447,212,848
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	687,277,333	715,305,470
19	Revenue less expenses. Subtract line 18 from line 12.......	-27,313,029	-12,996,826
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	609,493,776	606,609,494
21	Total liabilities (Part X, line 26).............	508,908,329	526,218,896
22	Net assets or fund balances. Subtract line 21 from line 20.....	100,585,447	80,390,598

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 212,600,788 including grants of $ 0 ) (Revenue $ 353,233,130 )
	COMMITMENT TO BENEFITING OUR COMMUNITIES - PATIENT CARE SERVICES CHRISTUS SANTA ROSA HEALTH CARE CORPORATION, FOUNDED IN 1869 BY THE SISTERS OF CHARITY OF THE INCARNATE WORD, IS THE ONLY CATHOLIC FAITH-BASED, NON-PROFIT HEALTH CARE SYSTEM IN SAN ANTONIO AND NEW BRAUNFELS. WITH THE MISSION "TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST," CHRISTUS HEALTH IS CHALLENGED TO REACH OUT TO, AND BEYOND, MORE THAN 18 COMMUNITIES WE SERVE TO HELP THOSE IN NEED. THE VISION OF CHRISTUS HEALTH, AS A CATHOLIC, FAITH-BASED MINISTRY, IS TO BE A LEADER, A PARTNER AND AN 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. ONE OF THE TOP HEALTH CARE ORGANIZATIONS IN SOUTH TEXAS, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS HEADQUARTERED IN SAN ANTONIO, TEXAS, IN THE SOUTH CENTRAL AREA OF THE STATE. IT HAS SIX HOSPITAL CAMPUSES. IT SERVICES THE SOUTHWESTERN BORDER OF TEXAS AND INTO THE CENTRAL TEXAS HILL COUNTRY. THE AREA COMPRISES A POPULATION OF MORE THAN 3.2 MILLION INDIVIDUALS. THE POPULATION CONSISTS OF 63.20% HISPANIC AND 36.80% NON-HISPANIC. THE MEDIAN INCOME FOR THE CITY OF SAN ANTONIO IS $49,711, AND HIGH SCHOOL GRADUATES REPRESENT 81.99% OF THE POPULATION. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION HAS SIX HOSPITAL CAMPUSES: (1) CHRISTUS SANTA ROSA MEDICAL CENTER, LOCATED IN THE SOUTH TEXAS MEDICAL CENTER; (2) CHILDREN'S HOSPITAL OF SAN ANTONIO, LOCATED IN DOWNTOWN SAN ANTONIO; (3) CHRISTUS SANTA ROSA -WESTOVER HILLS IN THE WESTOVER HILLS AREA OF SAN ANTONIO; (4) CHRISTUS SANTA ROSA ALAMO HEIGHTS; (5) CHRISTUS SANTA ROSA NEW BRAUNFELS, LOCATED IN NEW BRAUNFELS, TEXAS; (6) CHRISTUS SANTA ROSA EMERGENCY CENTER - ALON CHRISTUS SANTA ROSA HEALTH CARE CORPORATION'S OTHER HEALTH FACILITIES INCLUDE CHRISTUS SANTA ROSA FAMILY HEALTH CENTER, A CERTIFIED 162.001(B) NON-PROFIT HEALTH ORGANIZATION THAT PROVIDES THE COMMUNITY WITH A FAMILY MEDICINE RESIDENCY PROGRAM, SPORTS MEDICINE FELLOWSHIP, AND A PATIENT CENTERED MEDICAL HOME WITH A TOTAL OF 29 RESIDENTS. IN ADDITION, THE ORGANIZATION OWNS A MAJORITY INTEREST IN TWO JOINT VENTURES - CHRISTUS SANTA ROSA PHYSICIANS AMBULATORY SURGERY CENTER - NEW BRAUNFELS AND CHRISTUS SANTA ROSA PHYSICIAN AMBULATORY SURGERY CENTER - SAN ANTONIO. BOTH HAVE 2 LOCATIONS FOR A TOTAL OF 4 IN THE CHRISTUS SANTA ROSA AREA. THERE ARE OVER 200 SURGEONS WHO UTILIZE THE PHYSICIAN AMBULATORY SURGERY CENTER. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS ALSO ONE OF THE COLLABORATING PARTNERS IN BEXAR COUNTY CLINICAL SERVICES, INC. WHICH PROVIDES PHYSICIAN AND OTHER CLINICAL HEALTH CARE SERVICES TO MEDICAID AND INDIGENT PATIENTS. EACH OF THE FACILITIES OF CHRISTUS SANTA ROSA SHARES ONE OBJECTIVE -- WHICH IS TO LEAD THE WAY TO A HEALTHIER COMMUNITY. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS HEADQUARTERED IN SAN ANTONIO, TEXAS, IN THE SOUTH CENTRAL AREA OF THE STATE. ITS SERVICE TO THE SOUTHERN AND WESTERN BORDERS OF TEXAS AND INTO THE CENTRAL TEXAS HILL COUNTRY AREA COVERS A POPULATION OF MORE THAN 3.2 MILLION INDIVIDUALS. IN FISCAL YEAR 2019 ALONE, WE WERE PRIVILEGED TO SERVE HUNDREDS OF THOUSANDS OF INDIVIDUALS IN VARIOUS WAYS INCLUDING 200,262 VISITS TO OUR EMERGENCY DEPARTMENT; 6,642 INPATIENT SURGERY PROCEDURES; 38,601 OUTPATIENT SURGERY VISITS; 26,628 PATIENTS WHO WERE ADMITTED TO OUR HOSPITALS FOR CARE; AND 606,017 PATIENTS WHO RECEIVED OUTPATIENT CARE AT OUR FACILITIES. TOUCHING THE LIVES OF THE PEOPLE AROUND US IS WHAT MAKES CHRISTUS SANTA ROSA HEALTH CARE CORPORATION STAND APART. ALLOWING OTHERS TO TOUCH US GIVES US 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 TO HER FIRST CHILD, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION WORKS TO 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 SANTA ROSA HEALTH CARE CORPORATION'S VARIOUS ENTITIES HAVE STRENGTHENED THEIR ROLES AS MAJOR PROVIDERS OF COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES. THESE PARTNERSHIPS WITH THE COMMUNITY HAVE BEEN A BLESSING BY HELPING CHRISTUS SANTA ROSA HEALTH CARE CORPORATION EXTEND SERVICES TO THOSE IN NEED. FURTHERMORE, INVESTMENT IN COMMUNITY SERVICES WOULD NOT BE POSSIBLE WITHOUT DEDICATED EMPLOYEES AND VOLUNTEERS. THEY HELP TO BUILD STRONG RELATIONSHIPS BETWEEN THE HOSPITALS, OTHER HEALTH CARE MINISTRIES AND THE COMMUNITIES WHICH NURTURE CHRISTUS HEALTH'S MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST. OUR EMPLOYEES WORK BOTH INSIDE THE WALLS OF OUR HEALTH CARE FACILITIES AND IN THE COMMUNITY 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 THE PUBLIC AS POSSIBLE, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS, INCLUDING MEDICAID, MEDICARE, CHAMPUS, TRICARE AND OTHERS. IN ADDITION, WE OFFER SPECIFIC PROGRAMS TO PROVIDE DISCOUNTED SERVICES TO THOSE IN NEED WHO DO NOT HAVE MEDICAL INSURANCE OR WHO DO NOT PARTICIPATE IN GOVERNMENT-SPONSORED PROGRAMS. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE FROM THE COMMUNITIES IT SERVES, INCLUDING FOUR AMBULATORY SURGICAL CENTERS THAT OFFER AN ARRAY OF SERVICES. IT CONDUCTS ITS ACTIVITIES AND SERVES ITS PURPOSE WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER, ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION OFFERS SERVICES SUCH AS: COMPREHENSIVE PEDIATRIC CARE, INCLUDING A NEONATAL INTENSIVE CARE UNIT; A LEVEL IV NURSERY PROVIDING BOTH INTENSIVE AND INTERMEDIATE CARE TO CRITICALLY ILL INFANTS REQUIRING MEDICAL AND/OR SURGICAL INTERVENTIONS SUCH AS THE NEONATAL ECMO PROGRAM THAT PROVIDES VENO-VENOUS OR VENO-ARTERIAL EXTRACORPOREAL LIFE SUPPORT AND A WOUND CARE AND HYPERBARIC CENTER. IN ADDITION, WE OFFER THE FOLLOWING: CARDIAC CARE THAT IS NATIONALLY CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR) AND ACCREDITED AS A CHEST PAIN CENTER WITH PERCUTANEOUS CORONARY INTERVENTION (PCI) DESIGNATION FROM THE SOCIETY OF CHEST PAIN CENTERS (SCPC); COMPLETE OBSTETRICAL AND NEWBORN SERVICES; SURGICAL UNITS; A DIABETES CARE PROGRAM; AND STATE-OF-THE-ART MEDICAL CARE FOR CHILDREN WITH AN ARRAY OF SPECIALTY SERVICES AND ORTHOPEDIC SERVICES. WE ALSO OFFER REHABILITATION TREATMENT FOR THOSE WHO HAVE EXPERIENCED A STROKE, A SPINAL CORD INJURY, CLOSED HEAD INJURIES AND MORE. EACH CAMPUS OF CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES A 24-HOUR EMERGENCY ROOM THAT IS OPEN TO SERVE ALL THOSE IN NEED OF EMERGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY. AS A NOT-FOR-PROFIT ORGANIZATION AND AS PART OF CHRISTUS HEALTH, A REGIONAL GOVERNING BOARD COMPRISED LARGELY OF INDEPENDENT COMMUNITY MEMBERS REPRESENTING THE AREA WE SERVE GUIDES CHRISTUS SANTA ROSA HEALTH CARE CORPORATION. WE HAVE AN OPEN MEDICAL STAFF COMPRISED OF QUALIFIED PHYSICIANS WHO WORK WITH US TO PROVIDE CARE TO OUR COMMUNITIES. ALL QUALIFIED PHYSICIANS GRANTED PRIVILEGES TO SERVE WITH US IN OUR HOSPITALS MUST UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING PROCESS. THE PHYSICIANS ASSIST OUR CONTINUOUS EFFORTS TO IMPROVE SERVICE TO OUR PATIENTS, QUALITY OF CARE, AND HOSPITAL EFFICIENCY.

4b	(Code: ) (Expenses $ 187,972,634 including grants of $ 0 ) (Revenue $ 157,575,779 )
	COMMUNITY BENEFIT REPORTING - CHARITY CARE AND MEDICAID CHRISTUS ADHERES TO THE CATHOLIC HEALTH ASSOCIATION'S A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT (2012), AND COMPLIES WITH THE STATE OF TEXAS REQUIREMENTS FOR REPORTING. COMMUNITY BENEFIT, REPORTED AS UNPAID COSTS, INCLUDES BOTH CHARITY CARE AND COMMUNITY SERVICES. TO THE LIMITS OF ITS RESOURCES, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS AN INSTITUTION OF PURELY PUBLIC CHARITY; THUS, THE MOST TANGIBLE EXPRESSION OF CHARITABLE PURPOSE IS THE PROVISION OF HEALTH CARE SERVICES TO THOSE PERSONS WHO ARE UNABLE TO PAY. THIS FALLS INTO TWO CATEGORIES: CHARITY CARE AND UNPAID GOVERNMENT INDIGENT CARE. IN KEEPING WITH THE MISSION, VALUES, AND VISION OF CHRISTUS HEALTH, CHRISTUS SANTA ROSA HEALTH CARE CORPORATION PROVIDES CHARITY CARE SERVICES IN A MANNER THAT RESPECTS THE DIGNITY OF THE PATIENTS AND THEIR FAMILIES. CHARITY CARE IS PROVIDED WITHOUT CHARGE OR AT A CHARGE THAT IS LESS THAN THE USUAL CHARGE FOR SUCH SERVICES. THE DETERMINATION AS TO THE AMOUNT TO BE CHARGED, IF ANY, IS MADE ACCORDING TO A PATIENT'S ABILITY TO PAY AS DETERMINED BY ESTABLISHED ELIGIBILITY CRITERIA. FOR UNINSURED PATIENTS WHOSE ECONOMIC CIRCUMSTANCES PLACE THEM AT OR UNDER 200 PERCENT OF THE FEDERAL POVERTY LEVEL (FPL), SERVICES ARE PROVIDED WITHOUT ANY EXPECTATION OF PAYMENT. UNINSURED PATIENTS WHOSE ECONOMIC CIRCUMSTANCES PLACE THEM BETWEEN 200 AND 400 PERCENT OF FPL ARE CHARGED BASED ON A SLIDING SCALE, AND THOSE ABOVE 400 PERCENT RECEIVE DISCOUNTS BASED ON THE UNINSURED FEE SCHEDULE. NO PATIENT IS REFUSED NECESSARY MEDICAL CARE BASED ON THE INABILITY TO PAY. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION IS AN ACTIVE PARTICIPANT IN THE STATE OF TEXAS MEDICAID PROGRAMS AND WORKS WITH OTHER STATE MEDICAID PROGRAMS TO ENSURE PATIENTS HAVE FULL ACCESS TO THEIR BENEFITS. THOSE PROGRAMS SEEK TO PROVIDE PAYMENT FOR HEALTH CARE SERVICES TO INDIVIDUALS WHO MEET CERTAIN FINANCIAL AND OTHER REQUIREMENTS. FINANCIAL REQUIREMENTS INCLUDE EVALUATION OF BOTH ASSETS AND INCOME.

4c	(Code: ) (Expenses $ 221,185,650 including grants of $ 0 ) (Revenue $ 182,263,211 )
	OTHER GOVERNMENT SPONSORED 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 AND TRICARE. THE COSTS NOT REIMBURSED FOR THESE SERVICES ARE REPORTED TO THE STATE OF TEXAS. THEY ARE NOT INCLUDED IN REPORTS PREPARED FOLLOWING CATHOLIC HEALTH ASSOCIATION GUIDELINES. CHRISTUS SANTA ROSA HEALTH CARE CORPORATION 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 HOSPITAL. 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. MEDICARE REIMBURSES OUTPATIENT SERVICES BASED ON ITS FEE SCHEDULE.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 29,898,768 including grants of $ 25,984,208 ) (Revenue $ 0 )
4e	Total program service expenses651,657,840

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	986,706	10,846,594	1,691,347

1a	Federated campaigns..		1a	639,776
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	2,445,455
e	Government grants (contributions)		1e	5,964,813

f	All other contributions, gifts, grants, and similar amounts not included above		1f	154,374

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		9,204,418

		Business Code
2a	NET PATIENT SERVICE REVENUE	621110	686,311,243	685,919,420	391,823	0
b	RENT RELATED TO EXEMPT PURPOSE	531120	4,033,632	4,033,632	0	0
c	SUPPORT SERVICES REVENUE	900099	141,686	141,686	0	0
d	REBATE	900099	898,262	898,262	0	0
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		691,384,823

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,474			3,474
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			328		328
		(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	68,916
b	Less: cost or other basis and sales expenses	63,890
c	Gain or (loss)	5,026
d	Net gain or (loss).....			5,026			5,026
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		0
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CLINICAL RESEARCH		900099	1,400,660	1,400,660	0	0
b	BAR TRANSACTION		900099	292,303	292,303	0	0
c	PARKING SERVICES		900099	25,267	0	0	25,267
d	All other revenue ....			-7,655	-5,666	-1,989
e	Total. Add lines 11a–11d ......			1,710,575
12	Total revenue. See Instructions......			702,308,644	692,680,297	390,162	33,767

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	133,208	133,208
2	Grants and other assistance to domestic individuals. See Part IV, line 22	25,851,000	25,851,000
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	64,843	58,443	5,908	492
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	195,439,478	176,150,966	17,806,558	1,481,954
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,518,036	1,514,046	3,990	0
9	Other employee benefits .......	30,574,208	25,453,989	4,999,100	121,119
10	Payroll taxes ...........	14,511,849	13,372,940	1,038,829	100,080
11	Fees for services (non-employees):
a	Management ......	179,583	179,583	0	0
b	Legal .........	12,604	7,093	5,511	0
c	Accounting ...........	1,930,486	53,949	1,876,537	0
d	Lobbying ...........	67,173	0	67,173	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	0	0	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	99,594,649	89,272,626	10,322,023	0
12	Advertising and promotion ....	2,138,076	20,389	2,117,687	0
13	Office expenses .......	83,206,595	64,279,581	18,904,640	22,374
14	Information technology ......	26,781,634	26,781,634	0	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	8,009,409	7,486,419	522,990	0
17	Travel ............	639,201	315,878	323,323	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 ....	1,642,295	748,236	894,059	0
20	Interest ...........	17,880,451	17,880,444	7	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	35,880,527	35,038,699	841,828	0
23	Insurance ...	5,027,057	5,027,057	0	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	MEDICAL SUPPLIES	90,944,926	90,707,080	237,846	0
b	PROV FOR UNCOLLECT ACCTS	71,059,283	71,059,283	0	0
c	DUES/MEMBERSHIP&SPONSORSHIP	905,191	203,799	701,392	0
d	UBI TAX EXPENSE	107,824	107,824	0	0
e	All other expenses	1,205,884	-46,326	1,249,554	2,656
25	Total functional expenses. Add lines 1 through 24e	715,305,470	651,657,840	61,918,955	1,728,675
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

1	Cash–non-interest-bearing ........			16,685	1	2,943
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			84,044,821	4	84,476,584
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 ....			913,035	7	1,082,798
8	Inventories for sale or use ........			20,929,145	8	19,181,392
9	Prepaid expenses and deferred charges ......			2,682,092	9	2,754,886
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	752,283,642
b	Less: accumulated depreciation	10b	354,477,153	399,703,793	10c	397,806,489
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			3,302,732	13	3,926,135
14	Intangible assets ...............			2,926,272	14	1,876,124
15	Other assets. See Part IV, line 11 ...........			94,975,201	15	95,502,143
16	Total assets. Add lines 1 through 15 (must equal line 34)...			609,493,776	16	606,609,494

17	Accounts payable and accrued expenses .....	56,926,556	17	41,707,594
18	Grants payable ...	0	18	0
19	Deferred revenue .........	13,737	19	467,175
20	Tax-exempt bond liabilities .........	0	20	0
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 ..	252,350	23	265,801
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	451,715,686	25	483,778,326
26	Total liabilities. Add lines 17 through 25..	508,908,329	26	526,218,896

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	8,129,965	27	-12,878,933
28	Temporarily restricted net assets ...........	87,229,514	28	88,041,668
29	Permanently restricted net assets	5,225,968	29	5,227,863
	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 ...........	100,585,447	33	80,390,598
34	Total liabilities and net assets/fund balances ........	609,493,776	34	606,609,494