Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2019 , and ending 06-30-2020
BCheck if applicable:
CName of organization
CHI LIVING COMMUNITIES
 
% ALISA IFFLAND
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
5942 RENAISSANCE PLACE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
TOLEDO, OH43623
D Employer identification number

34-1892096
E Telephone number

G Gross receipts $ 66,920,229
F Name and address of principal officer:
AARON WEBB
5942 RENAISSANCE PLACE
TOLEDO,OH43623
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
HTTP://HOMEISHERE.ORG/
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:  
L Year of formation: 1998
M State of legal domicile: OH
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: CHI LIVING COMMUNITIES PROVIDES CHI LIVING COMMUNITIES PROVIDES CONSULTATION, SUPPORT AND OVERSIGHT TO ITS MEMBER THROUGH EFFECTIVE LEADERSHIP AND (CONTINUED ON SCHEDULE O)
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 4
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 0
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 1,433
6 Total number of volunteers (estimate if necessary) ............. 6 100
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 14,335
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 11,901
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 362,073 1,857,914
9 Program service revenue (Part VIII, line 2g) ......... 54,586,553 60,887,447
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,539,698 2,528,102
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,832,800 1,645,921
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 59,321,124 66,919,384
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 7,178 14,160
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) 34,741,205 37,007,622
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 22,732,801 24,826,051
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 57,481,184 61,847,833
19 Revenue less expenses. Subtract line 18 from line 12....... 1,839,940 5,071,551
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 123,442,586 133,109,899
21 Total liabilities (Part X, line 26)............. 21,162,939 27,127,408
22 Net assets or fund balances. Subtract line 21 from line 20..... 102,279,647 105,982,491
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 48,954,635 including grants of $ 14,160 ) (Revenue $ 60,887,447 )
CHI LIVING COMMUNITIES PROVIDES HEALTHCARE SERVICES AND MANAGEMENT SUPPORT TO ITS AFFILIATED ORGANIZATIONS. DURING THIS REPORTING PERIOD: BISHOP DRUMM RETIREMENT CENTER PROVIDING 92,200 DAYS OF CARE TO AN AVERAGE OF 253 RESIDENTS ON A DAILY BASIS. NAMASTE ALZHEIMER CENTER PROVIDED 22,650 DAYS OF SKILLED NURSING CARE TO AN AVERAGE 62 RESIDENTS ON A DAILY BASIS. GARDENS AT ST. ELIZABETH PROVIDED 55,064 DAYS OF CARE TO AN AVERAGE OF 151 RESIDENTS ON A DAILY BASIS. LINUS OAKES PROVIDED 41,031 DAYS OF CARE TO AN AVERAGE OF 112 RESIDENTS ON A DAILY BASIS. RIVERVIEW PROVIDED 39,526 DAYS OF CARE TO AN AVERAGE OF 108 RESIDENTS ON A DAILY BASIS. FRANSICAN VILLA AND ITS AFFILIATES PROVIDED 93,196 DAYS OF CARE TO AN AVERAGE OF 255 RESIDENTS ON A DAILY BASIS. THE GARDENS OF ST. FRANCIS PROVIDED 24,504 DAYS OF CARE TO AN AVERAGE OF 67 RESIDENTS ON A DAILY BASIS.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet48,954,635
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
112
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,433
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
4
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
0
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
OH
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletALISA IFFLAND5942 RENAISSANCE PLACE SUITE A   TOLEDO,OH43623 (567) 455-0414
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) DEAN SWINDLE CPA......................................................................
DIRECTOR (Thru Oct 2019)
1.0
.................
49.0
X           0 3,233,008 43,334
(2) PAUL EDGETT III......................................................................
DIRECTOR
1.0
.................
49.0
X           0 1,631,607 47,118
(3) MITCH MELFI ESQ......................................................................
VICE CHAIRMAN
1.0
.................
49.0
X   X       0 1,640,990 37,534
(4) RICK G RYAN......................................................................
PRESIDENT/CEO CHI LIVING COM
40.0
.................
0.0
X   X       0 660,491 33,543
(5) WENDY DOLYK......................................................................
SECRETARY
40.0
.................
0.0
    X       0 346,819 27,748
(6) TIMOTHY DRESSMAN......................................................................
VP OF BUSINESS DEVELOPMENT
40.0
.................
0.0
        X   234,206 0 25,844
(7) MARY BETH BOUHALL......................................................................
REGIONAL ADMINISTRATOR
40.0
.................
0.0
        X   238,911 0 18,322
(8) JOAN LONGHIN-HOWARD......................................................................
VP OF HR
40.0
.................
0.0
        X   232,020 0 21,774
(9) ALISA IFFLAND......................................................................
VP OF FINANCE/TREASURER
40.0
.................
0.0
    X       232,020 0 13,275
(10) STACI LEHMKUHL......................................................................
PROVIDENCE CARE CENTER ED
40.0
.................
0.0
        X   178,505 0 4,728
(11) Michael Gulock......................................................................
Exec Dir. of Franc. Village
40.0
.................
0.0
        X   169,259 0 5,158
(12) AARON WEBB......................................................................
CEO
40.0
.................
0.0
X   X       0 0 0










Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 1,284,921 7,512,915 278,378
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet34
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
Catamount Constructors,
1527 Cole Blvd Suite 100
LAKEWOOD,CO80401
Construction 7,021,660
Ridge Ston General Contractors,
7015 Lighthouse Way Suite 500
PERRYSBURG,OH43551
Architectural consul 2,240,498
Concept Rehab,
7150 Granite Cir Ste 200
TOLEDO,OH43617
THERAPY SERVICES 1,751,625
Prelude Services,
5095 Ritter Road Suite 112
MECHANICSBURG,PA17055
IT CONSULTING 851,923
RICHTER HEALTHCARE CONSULTANTS,
8948 Canyon Falls Blvd Suite 400
TWINSBURG,OH44087
Healthcare Consult 710,143
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet13
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 7,622
e Government grants (contributions)1e 1,473,127
f All other contributions, gifts, grants, and similar amounts not included above1f 377,165
g Noncash contributions included in lines 1a - 1f:$ 1g 24,879
h Total. Add lines 1a-1f.......MediumBullet 1,857,914
 Program Service RevenueAmt Business Code
2a NET RETIREMENT COMMUNITIES 623311 33,850,020 33,850,020    
b MANAGEMENT FEES 541610 6,181,542 6,181,542    
c RENTAL INCOME 900099 20,855,885 20,855,885    
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 60,887,447
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 981,784   14,335 967,449
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   27,801 6a
b Less: rental expenses     6b
c Rental income or (loss) 0 27,801 6c
d Net rental income or (loss).......MediumBullet 27,801     27,801
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   1,547,163 7a
b Less: cost or other basis and sales expenses 845   7b
c Gain or (loss) -845 1,547,163 7c
d Net gain or (loss).........MediumBullet 1,546,318     1,546,318
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a SERVICES SOLD 900099 790,682     790,682
b CAFETERIA 722100 356,378     356,378
c APPLICATION FEES 900099 95,075     95,075
d All other revenue .... 375,985     375,985
e Total. Add lines 11a–11d ...... MediumBullet 1,618,120
12 Total revenue. See instructions.....MediumBullet 66,919,384 60,887,447 14,335 4,159,688
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 14,160 14,160
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 0  
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 231,322 173,491 57,831  
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........ 29,340,275 22,117,343 7,222,932  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 0      
9 Other employee benefits ....... 5,179,857 3,989,339 1,190,518  
10 Payroll taxes ........... 2,256,168 1,741,325 514,843  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 103,374   103,374  
c Accounting ........... 34,234   34,234  
d Lobbying ........... 1,911   1,911  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 7,391,991 7,022,391 369,600  
12 Advertising and promotion .... 247,927   247,927  
13 Office expenses ....... 4,462,912 4,298,670 164,242  
14 Information technology ...... 965,063   965,063  
15 Royalties .. 0      
16 Occupancy ........... 3,070,174 2,916,665 153,509  
17 Travel ............ 213,053 12,575 200,478  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 50,054   50,054  
20 Interest ........... 140,912   140,912  
21 Payments to affiliates ....... 955,506   955,506  
22 Depreciation, depletion, and amortization .. 2,642,106 2,510,001 132,105  
23 Insurance ... 169,284   169,284  
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 1,375,686 1,306,902 68,784  
b MISCELLANEOUS EXPENSES 1,123,678 1,067,494 56,184  
c REPAIRS AND MAINTENANCE 1,036,519 984,693 51,826  
d RECRUITMENT AND RELOCATION 547,744 520,357 27,387  
e All other expenses 293,923 279,229 14,694  
25 Total functional expenses. Add lines 1 through 24e 61,847,833 48,954,635 12,893,198 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 8,662 1 8,915
2 Savings and temporary cash investments ......... 15,371,849 2 19,389,043
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 12,692,622 4 12,718,788
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 0 7 0
8 Inventories for sale or use ............ 113,905 8 201,660
9 Prepaid expenses and deferred charges ...... 202,258 9 251,341
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 104,442,994
b Less: accumulated depreciation 10b 56,778,410 38,103,966 10c 47,664,584
11 Investments—publicly traded securities . 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 47,550,425 12 48,958,450
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 916,829 14 916,829
15 Other assets. See Part IV, line 11 ........... 8,482,070 15 3,000,289
16 Total assets. Add lines 1 through 15 (must equal line 33)... 123,442,586 16 133,109,899
Liabilities 17 Accounts payable and accrued expenses ..... 5,801,150 17 6,927,258
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 1,651,046 19 2,255,279
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 13,710,743 25 17,944,871
26 Total liabilities. Add lines 17 through 25.. 21,162,939 26 27,127,408
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 101,103,353 27 104,742,749
28 Net assets with donor restrictions ........... 1,176,294 28 1,239,742
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 102,279,647 32 105,982,491
33 Total liabilities and net assets/fund balances ........ 123,442,586 33 133,109,899
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
66,919,384
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
61,847,833
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
5,071,551
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
102,279,647
5
Net unrealized gains (losses) on investments ...............
5
-1,113,849
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-254,858
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
105,982,491
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
CHI LIVING COMMUNITIES
 
Employer identification number

34-1892096
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................7
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
(A) FRANCISCAN CARE CENTER
 
341931806 10   No 0 0
(B) MADONNA MANOR INC
 
610654635 10   No 0 0
(C) PROVIDENCE CARE CENTER
 
341658625 10   No 0 0
(D) PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION
 
341896807 10   No 0 0
(E) ST CLARE COMMONS
 
270163752 10   No 0 0
(F) ST LEONARD
 
341940863 10   No 0 0
(G) THE COMMONS OF PROVIDENCE
 
341826097 10   No 0 0
Total
7
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
No
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
No
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
No
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
No
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
No
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
No
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
No
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
No
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
No
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
No
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
No
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
 
No
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
No
b
A family member of a person described in (a) above?
11b
 
No
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
No
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
Yes
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019
(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, 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 2019. 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 2020. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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, PART IV, SECTION A, LINE 1 - SUPPORTED ORGS LISTED BY NAME CHI LIVING COMMUNITIES' SUPPORTED ORGANIZATIONS ARE DESIGNATED BY PURPOSE IN ITS GOVERNING DOCUMENTS. PURSUANT TO ARTICLE IV OF ITS ARTICLES OF INCORPORATION CHI LIVING COMMUNITIES' PURPOSES INCLUDE THE FOLLOWING: (A) TO ENGAGE IN AND PROMOTE THE DELIVERY OF HEALTH CARE SERVICES OF ALL AND EVERY KIND, NATURE AND DESCRIPTION IN ANY APPROPRIATE MANNER AND IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS, AND WITH THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES OF THE NATIONAL CONFERENCE OF CATHOLIC BISHOPS; AS THEY MAY BE AMENDED FROM TIME TO TIME; (B) TO EMBRACE AND UPHOLD THE MORAL, ETHICAL AND RELIGIOUS DOCTRINES AND TEACHINGS OF THE ROMAN CATHOLIC CHURCH; TO ASSURE THAT THE PHYSICAL, PSYCHOLOGICAL, AND SPIRITUAL CARE PROVIDED RESIDENTS AND PATIENTS IS WITHIN THE CONTEXT OF THE CHURCH'S DOCTRINE THAT ALL PERSONS HAVE AN INHERENT DIGNITY BY VIRTUE OF THEIR CREATION BY GOD; TO UNIFORMLY APPLY THIS RESPONSIBILITY TO THE CARE OF ALL RESIDENTS AND PATIENTS REGARDLESS OF THEIR INDIVIDUAL THEOLOGICAL ORIENTATION; TO PROVIDE THIS CARE IN ACCORD WITH THE TRADITIONS, TEACHINGS AND CANON LAW OF THE ROMAN CATHOLIC CHURCH AND THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES, PROMULGATED BY THE NATIONAL CONFERENCE OF CATHOLIC BISHOPS; AS THEY MAY BE AMENDED FROM TIME TO TIME; (C) TO ESTABLISH, OWN, OPERATE, SUPPORT, MAINTAIN AND PROMOTE HOSPITALS, CLINICS, RESIDENTIAL CARE FACILITIES, NURSING CENTERS, NURSING HOMES, INDEPENDENT RESIDENTIAL LIVING FACILITIES FOR THE ELDERLY, AND OTHER LIKE FACILITIES, INCLUDING INPATIENT AND OUTPATIENT FACILITIES, UNDER THE DIRECTION OF PROPERLY QUALIFIED PHYSICIANS, HEALTH PROFESSIONALS AND OTHERS, FOR THE SICK, INFIRM, CONVALESCENT AND AGED, WITHOUT REGARD TO THE COLOR, RACE, NATIONAL ORIGIN, CREED, SEX, AGE OR PHYSICAL OR MENTAL HANDICAP OF THE RECIPIENT; (D) TO PERFORM AND TO FOSTER AND SUPPORT ACTS OF CHRISTIAN CHARITY, INCLUDING SPIRITUAL AND CORPORAL WORKS OF MERCY, PARTICULARLY AMONG THE SICK AND AILING; TO PRACTICE, FOSTER AND ENCOURAGE RELIGIOUS BELIEFS AND ACTIVITIES, PARTICULARLY THOSE OF THE ROMAN CATHOLIC CHURCH; AND TO HOUSE AND CARE FOR UNPROTECTED AND INDIGENT SICK, AGED AND INFIRM PERSONS REGARDLESS OF COLOR, RACE, NATIONAL ORIGIN, CREED, SEX, AGE OR PHYSICAL OR MENTAL HANDICAP; (E) TO CONTRACT WITH ANY PERSON FOR THE PERFORMANCE OF HEALTH CARE AND RESIDENTIAL LIVING FUNCTIONS, SUCH AS PLANNING, MARKETING, AND ADMINISTRATION; (F) TO PROMOTE EDUCATION AND THE GENERAL DISSEMINATION OF KNOWLEDGE, AND TO ESTABLISH, OWN, OPERATE, SUPPORT, MAINTAIN AND PROMOTE EDUCATIONAL INSTITUTIONS IN ALL DEPARTMENTS OF LEARNING AND KNOWLEDGE, AND ESPECIALLY IN THOSE BRANCHES USUALLY COMPREHENDED IN ACADEMIC AND COLLEGIATE COURSES; (G) TO RECEIVE AND ADMINISTER FUNDS FOR THE BENEFIT OF THE CORPORATION, OR ITS SUCCESSOR, AND TO THAT END TO TAKE AND HOLD, BY BEQUEST, DEVISE, GIFT, PURCHASE OR LEASE, EITHER ABSOLUTELY OR IN TRUST, ANY PROPERTY, REAL, PERSONAL OR MIXED, WITHOUT LIMITATION AS TO AMOUNT OR VALUE, EXCEPT SUCH LIMITATIONS, IF ANY, AS MAY BE IMPOSED BY LAW OR BY THE CANON LAW OF THE ROMAN CATHOLIC CHURCH; (H) TO SELL, LEASE, BORROW, ENCUMBER, CONVEY AND DISPOSE OF ANY SUCH PROPERTY AND TO INVEST AND REINVEST PRINCIPAL AND INCOME THEREOF AND TO DEAL WITH AND EXPEND PRINCIPAL AND INCOME THEREFROM FOR THE PURPOSES SET FORTH ABOVE WITHOUT LIMITATION, EXCEPT SUCH LIMITATIONS, IF ANY, AS MAY BE CONTAINED IN THE INSTRUMENT UNDER WHICH SUCH PROPERTY IS RECEIVED OR SUCH LIMITATIONS, IF ANY, AS MAY BE IMPOSED BY LAW OR BY THE CANON LAW OF THE ROMAN CATHOLIC CHURCH; (I) TO CARRY ON ANY OR ALL OF ITS OPERATIONS AND TO PROMOTE ITS OBJECTIVES WITHIN THE STATE OF OHIO OR ELSEWHERE WITHOUT RESTRICTIONS AS TO PLACE OR AMOUNT; AND (J) TO DO ANY OR ALL OF THE THINGS HEREIN SET FORTH TO THE SAME EXTENT AS NATURAL PERSONS MIGHT OR COULD DO, AND IN ANY PART OF THE WORLD AS PRINCIPALS, AGENTS, CONTRACTORS, TRUSTEES OR OTHERWISE, ALONE OR IN COMPANY WITH OTHERS, AND THE CORPORATION WITHOUT FURTHER AUTHORITY MAY DO ANY AND ALL THINGS NECESSARY OR INCIDENT THERETO SUBJECT TO THE CODE OF REGULATIONS OF THE CORPORATION.
Schedule A (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
CHI LIVING COMMUNITIES
 
Employer identification number

34-1892096
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that 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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
CHI LIVING COMMUNITIES
 
Employer identification number
34-1892096
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
CHI LIVING COMMUNITIES
 
Employer identification number

34-1892096
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
CHI LIVING COMMUNITIES
 
Employer identification number

34-1892096
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data


Software ID:  
Software Version:  
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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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
CHI LIVING COMMUNITIES
 
Employer identification number

34-1892096
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2019

Schedule C (Form 990 or 990-EZ) 2019
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2016 (b) 2017 (c) 2018 (d) 2019 (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) 2019


Schedule C (Form 990 or 990-EZ) 2019
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|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
1,911
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
 
No
 
j
Total. Add lines 1c through 1i ....................................................................................................
1,911
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
SCHEDULE C, PART II-B, LINE 1f - DETAILED DESCRIPTION OF THE LOBBYING BISHOP DRUMM RETIREMENT CENTER HAS PAID DUES TO LEADING AGE IOWA. 8.8 % OF $21,720 DUES PAID RELATED TO LOBBYING ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2019


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
CHI LIVING COMMUNITIES
 
Employer identification number

34-1892096
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance .... 1,006,732 870,333 786,412 0  
b Contributions ... 24,400 118,725 49,578 745,187  
c Net investment earnings, gains, and losses 3,137 27,487 38,632 41,725  
d Grants or scholarships ... 8,000 2,000      
e Other expenditures for facilities
and programs ...
         
f Administrative expenses .... 11,764 7,813 4,289 500  
g End of year balance ...... 1,014,505 1,006,732 870,333 786,412  
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100.000 %
c
Term endowment SchDMd Bullet0 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   2,973,360 2,973,360
b Buildings ....   79,045,043 44,370,229 34,674,814
c Leasehold improvements        
d Equipment ....   11,918,806 9,041,818 2,876,988
e Other .....   10,505,785 3,366,363 7,139,422
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 47,664,584
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3) Other
(A) CHI OPERATING INVESTMENT PROGR
48,958,450 F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 48,958,450
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 17,944,871
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) 2019

Schedule D (Form 990) 2019
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCHEDULE D, PART V, LINE 4 - INTENDED USES OF ENDOWMENT FUNDS CHI LIVING COMMUNITIES USES ENDOWMENT FUNDS AS DIRECTED BY THE ENDOWMENT DOCUMENTS. THESE ENDOWMENT FUNDS FURTHER THE EXEMPT PURPOSE OF THE ORGANIZATION BY ASSISTING RESIDENTS OF LONG-TERM CARE FACILITIES. CERTAIN FUNDS ARE TO PROVIDE SCHOLARSHIPS FOR EMPLOYEES.
SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE CHI LIVING COMMUNITIES' FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH'S ASC 740 FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2020, READS AS FOLLOWS: COMMONSPIRIT HAS ESTABLISHED ITS STATUS AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE LAWS OF THE STATES IN WHICH IT OPERATES, AND AS SUCH, IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, COMMONSPIRIT'S EXEMPT ORGANIZATIONS ARE SUBJECT TO INCOME TAXES ON NET INCOME DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, WHICH DOES NOT FURTHER THE ORGANIZATIONS' EXEMPT PURPOSES. NO SIGNIFICANT INCOME TAX PROVISION HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR NET INCOME DERIVED FROM UNRELATED TRADE OR BUSINESS. COMMONSPIRIT'S FOR-PROFIT SUBSIDIARIES ACCOUNT FOR INCOME TAXES RELATED TO THEIR OPERATIONS. THE FOR-PROFIT SUBSIDIARIES RECOGNIZE DEFERRED TAX ASSETS AND LIABILITIES FOR TEMPORARY DIFFERENCES BETWEEN THE FINANCIAL REPORTING BASIS AND THE TAX BASIS OF THEIR ASSETS AND LIABILITIES, ALONG WITH NET OPERATING LOSS AND TAX CREDIT CARRYOVERS, FOR TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION CRITERIA. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. INCOME TAX INTEREST AND PENALTIES ARE RECORDED AS INCOME TAX EXPENSE. FOR THE YEARS ENDED JUNE 30, 2020 AND 2019, COMMONSPIRIT'S TAXABLE ENTITIES RECORDED AN IMMATERIAL AMOUNT OF INTEREST AND PENALTIES AS PART OF THE PROVISION FOR INCOME TAXES. COMMONSPIRIT'S TAXABLE ENTITIES DID NOT HAVE ANY MATERIAL UNRECOGNIZED INCOME TAX EXPENSE AS OF JUNE 30, 2020 AND 2019. COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.
Schedule D (Form 990) 2019


Additional Data


Software ID:  
Software Version:  




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
2019
Open to Public Inspection
Name of the organization
CHI LIVING COMMUNITIES
 
Employer identification number

34-1892096
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1RICK G RYAN
PRESIDENT/CEO CHI LIVING COM
(i)

(ii)
 
-------------
526,876
 
-------------
115,781
 
-------------
17,834
0
-------------
16,675
0
-------------
16,868
0
-------------
694,034
0
-------------
0
2MITCH MELFI ESQ
VICE CHAIRMAN
(i)

(ii)
 
-------------
856,473
 
-------------
624,970
 
-------------
159,547
0
-------------
15,625
0
-------------
21,909
0
-------------
1,678,524
0
-------------
0
3DEAN SWINDLE CPA
DIRECTOR (Thru Oct 2019)
(i)

(ii)
 
-------------
1,287,313
 
-------------
1,597,821
 
-------------
347,874
0
-------------
16,397
0
-------------
26,937
0
-------------
3,276,342
0
-------------
0
4ALISA IFFLAND
VP OF FINANCE/TREASURER
(i)

(ii)
192,331
-------------
0
30,979
-------------
0
8,710
-------------
0
0
-------------
0
13,275
-------------
0
245,295
-------------
0
0
-------------
0
5WENDY DOLYK
SECRETARY
(i)

(ii)
0
-------------
294,732
0
-------------
30,790
0
-------------
21,297
0
-------------
16,675
0
-------------
11,073
0
-------------
374,567
0
-------------
0
6TIMOTHY DRESSMAN
VP OF BUSINESS DEVELOPMENT
(i)

(ii)
194,199
-------------
 
31,280
-------------
 
8,727
-------------
 
0
-------------
0
25,844
-------------
0
260,050
-------------
0
0
-------------
0
7JOAN LONGHIN-HOWARD
VP OF HR
(i)

(ii)
192,331
-------------
 
30,979
-------------
 
8,710
-------------
 
0
-------------
0
21,774
-------------
0
253,794
-------------
0
0
-------------
0
8MARY BETH BOUHALL
REGIONAL ADMINISTRATOR
(i)

(ii)
184,871
-------------
 
37,443
-------------
 
16,597
-------------
 
0
-------------
0
18,322
-------------
0
257,233
-------------
0
0
-------------
0
9STACI LEHMKUHL
PROVIDENCE CARE CENTER ED
(i)

(ii)
139,930
-------------
 
36,923
-------------
 
1,652
-------------
 
0
-------------
0
4,728
-------------
0
183,233
-------------
0
0
-------------
0
10Michael Gulock
Exec Dir. of Franc. Village
(i)

(ii)
153,384
-------------
 
13,805
-------------
 
2,070
-------------
 
0
-------------
0
5,158
-------------
0
174,417
-------------
0
0
-------------
0
11PAUL EDGETT III
DIRECTOR
(i)

(ii)
 
-------------
848,293
 
-------------
608,753
 
-------------
174,561
0
-------------
14,455
0
-------------
32,663
0
-------------
1,678,725
0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
SCHEDULE J, PART I, LINE 3 - ARRANGEMENT USED TO ESTABLISH THE TOP MGT. DURING THE CALENDAR YEAR 2019, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
SCHEDULE J, PART I, LINE 4A - SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS FOR REPORTABLE INDIVIDUALS EMPLOYED PRIOR TO 2019, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. OFFICERS, KEY EMPLOYEES AND CERTAIN HIGHLY COMPENSATED EMPLOYEES WHO BEGAN EMPLOYMENT AFTER NOVEMBER 1ST OF 2019 ARE COVERED BY A SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY.
SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE 2019 CALENDAR YEAR, COMMONSPIRIT MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/HOSPITAL PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2019 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. INCLUDE IF APPLICABLE: DURING 2019, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: MITCH MELFI - $141,771 DEAN SWINDLE - $322,862
Schedule J (Form 990) 2019

Additional Data


Software ID:  
Software Version:  
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
2019
Open to Public
Inspection
Name of the organization
CHI LIVING COMMUNITIES
 
Employer identification number

34-1892096
Return Reference Explanation
FORM 990, PART I, LINE 1 - BRIEF MISSION ORGANIZATION VALUES. CHI LIVING COMMUNITIES WILL SEEK OUT AND PURSUE OPPORTUNITIES FOR GROWTH OF THE ORGANIZATION.
FORM 990, PART VI, LINE 1A - DELEGATE BROAD AUTHORITY TO A COMMITTEE PURSUANT TO SECTION 8.6 OF THE CODE OF REGULATIONS OF CHI LIVING COMMUNITIES, THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, AND THE PRESIDENT, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.6 OF THE CORPORATION'S CODE OF REGULATIONS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 6 - CLASSES OF MEMBERS OR STOCKHOLDERS According to the bylaws of CHI Living Communities, the entity's sole member is COMMONSPIRIT HEALTH, A COLORADO NONPROFIT ORGANIZATION.
FORM 990, PART VI, LINE 7A - MEMBERS OR STOCKHOLDERS ELECTING DIRECTORS ACCORDING TO THE ORGANIZATION'S CODE OF REGULATIONS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S CODE OF REGULATIONS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX.
FORM 990, PART VI, LINE 7B - DECISIONS REQUIRING APPROVAL BY MEMBERS The organization's corporate member is COMMONSPIRIT HEALTH. PURSUANT TO SECTION 5.4 of the organization's bylaws, the Corporate Member shall have the specific rights set forth in the governance matrix. Pursuant to the governance matrix the following rights are reserved to the CommonSpirit Health Board directly or through powers delegated to the CommonSpirit Health Chief Executive Officer: *SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF CHI LIVING COMMUNITIES *AMENDMENT OF THE CORPORATE DOCUMENTS OF CHI LIVING COMMUNITIES *APPROVE MEMBERS OF THE CHI LIVING COMMUNITIES BOARD *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF CHI LIVING COMMUNITIES *APPROVAL OF ISSUANCE OF DEBT BY CHI LIVING COMMUNITIES *APPROVAL OF PARTICIPATION OF CHI LIVING COMMUNITIES IN A JOINT VENTURE *APPROVAL OF FORMATION OF A NEW CORPORATION BY CHI LIVING COMMUNITIES *APPROVAL OF A MERGER INVOLVING CHI LIVING COMMUNITIES *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHI LIVING COMMUNITIES *TO REQUIRE THE TRANSFER OF ASSETS BY CHI LIVING COMMUNITIES TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. *ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR CHI LIVING COMMUNITIES PURSUANT TO SECTION 5.5 of the organization's bylaws, CommonSpirit Health may, in exercise of its approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and the President and Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX.
FORM 990, PART VI, LINE 11B - REVIEW OF FORM 990 BY GOVERNING BODY THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW PRIOR TO FILING WITH THE IRS. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE BOARD.
FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST POLICY THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO MAINTAIN THE INTEGRITY OF ITS ACTIVITIES. THE POLICY APPLIES TO THE FOLLOWING PERSONS ("COVERED PERSONS"): MEMBERS OF THE COMMONSPIRIT HEALTH ("COMMONSPIRIT") BOARD OF STEWARDSHIP TRUSTEES AND ITS COMMITTEES; COMMONSPIRIT HEALTH CORPORATE OFFICERS; MEMBERS OF THE DIGNITY HEALTH BOARD OF STEWARDSHIP TRUSTEES AND ITS COMMITTEES. IN ADDITION, THE POLICY APPLIES TO ORGANIZATIONS THAT WERE AFFILIATES AND SUBSIDIARIES OF COMMONSPIRIT HEALTH PRIOR TO ITS AFFILIATION WITH DIGNITY HEALTH ("CHI ENTITIES"). COVERED PERSONS OF CHI ENTITIES INCLUDE: MEMBERS OF ANY CHI ENTITY DIRECT AFFILIATE OR SUBSIDIARY BOARD AND THEIR COMMITTEES; EMPLOYEES OF CHI ENTITIES; AND CHI ENTITY RESEARCHERS (AS DEFINED BY THE POLICY). DISCLOSURE, REVIEW AND MANAGEMENT OF PERCEIVED, POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. ALL COVERED PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS AND MUST DISCLOSE THAT CONFLICT TO HIS/HER DIRECT MANAGER (OR OTHER PERSON AS IS APPROPRIATE PER POLICY). SUCH DISCLOSURE IS REQUIRED ON A TRANSACTIONAL BASIS AT THE TIME SUCH CONFLICTS ARISE, WHEN AN INDIVIDUAL BECOMES A COVERED PERSON (E.G. UPON HIRING OR BOARD APPOINTMENT), AND ANNUALLY THEREAFTER. DISCLOSURES OF PERCEIVED, POTENTIAL OR ACTUAL CONFLICTS ARE INITIALLY REVIEWED BY NATIONAL OR REGIONAL LEGAL OR CORPORATE RESPONSIBILITY TEAM MEMBERS TO DETERMINE WHETHER AN ACTUAL OR POTENTIAL CONFLICT MAY EXIST. IF IT IS DETERMINED THAT A POTENTIAL OR ACTUAL CONFLICT EXISTS, ISSUES ARE ELEVATED TO THE BOARD EXECUTIVE COMMITTEE OR BOARD CHAIR (FOR BOARD OR OFFICER CONFLICTS), OR THE CONFLICTS OF INTEREST REVIEW COMMITTEE (FOR ANY OTHER CONFLICT). THE PROCEDURES FOR ADDRESSING A CONFLICT RELATED TO A PROPOSED TRANSACTION IN THE CASE OF GOVERNING BODIES OR A CORPORATE OFFICER INCLUDE, BUT ARE NOT LIMITED TO 1) DISCLOSURE TO THE BOARD, 2) THE TRUSTEE OR CORPORATE OFFICER BEING EXCUSED FROM THE MEETING DURING DISCUSSION AND VOTE ON THE CONFLICT OF INTEREST (ALTHOUGH HE OR SHE MAY RESPOND TO PERTINENT QUESTIONS IF THE KNOWLEDGE IS RELEVANT), AND 3) BOARD APPROVAL OF THE TRANSACTION BY A MAJORITY OF DISINTERESTED MEMBERS. IN ADDITION, BOARDS CAREFULLY REVIEW AND SCRUTINIZE ANY NON-TRANSACTIONAL CONFLICTS OF INTEREST. IN SUCH CIRCUMSTANCES, BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES, THE BOARD TAKES WHATEVER ACTION IS DEEMED APPROPRIATE. FOR CONFLICTS NOT INVOLVING A BOARD MEMBER OR OFFICER, THE CONFLICTS OF INTEREST REVIEW COMMITTEE ("C-CIRC") WILL FACILITATE A COI MANAGEMENT PLAN TO MITIGATE THE CONFLICT IF ADEQUATE CONTROLS AREN'T ALREADY IN PLACE. NOTWITHSTANDING THE FOREGOING, AT ITS SOLE DISCRETION, AN ENTITY MAY REJECT A PERSON'S REQUEST TO ENTER INTO THE RELATIONSHIP IN QUESTION, OR REQUIRE THE RELATIONSHIP BE SUFFICIENTLY ALTERED TO AVOID A POTENTIAL CONFLICT OF INTEREST.
FORM 990, PART VI, LINE 15A - PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION WAS PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. THE COMMONSPIRIT HEALTH BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR APPROVING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EMPLOYEES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES OUTSIDE LEGAL COUNSEL AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF STEWARDSHIP TRUSTEES. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED.
FORM 990, PART VI, LINE 15B - PROCESS TO ESTABLISH COMPENSATION DURING THE TAX YEAR ENDED 06/30/2020 ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY THE ORGANIZATION WAS SET BY THE ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THE BOARD OF DIRECTORS OVERSEES THE COMPENSATION SETTING PROCESS AND ENSURES REASONABLENESS AND COMPLIANCE WITH THE ORGANIZATION'S COMPENSATION PHILOSOPHY.
FORM 990, PART VI, LINE 19 - REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG OR WWW.CATHOLICHEALTHINITIATIVES.ORG.
FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS OR FUND BALANCES Transfer to affiliates $(259,800) Bishop Drumm - Endowment Interest $4,945 Capital Resource Pool Contribution $(80,418) Equity Contribution from SFH $80,415 Total change in Net Assets: $(254,858)
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:3550360
FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES FOR SERVICES TOTAL FEES:2454932
FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:1121254
FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:265445
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
CHI LIVING COMMUNITIES
 
Employer identification number

34-1892096
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) FRANCISCAN HOMECARE SERV OF MIAMI VALLY
5942 RENAISSANCE PLACE SUITE A
TOLEDO,OH43623
45-5700700
HOME HEALTH OH     CHILC
 
(2) FRANCISCAN HOMECARE SERVICES OF NW OHIO
5942 RENAISSANCE PLACE SUITE A
TOLEDO,OH43623
46-5714658
HOME HEALTH OH     CHILC
 








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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

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

OMAHA,NE68154
47-0765154
HOSPITAL NE 501(c)(3) 3 ACH
 
 
No
(2)ALEGENT CREIGHTON HEALTH
12809 W DODGE RD

OMAHA,NE68154
47-0757164
HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(3)ALEGENT HEALTH - BERGAN MERCY HEALTH SYS
7500 MERCY RD

OMAHA,NE68124
47-0484764
HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(4)Allegent Health -Comm Memorial HSP IA
631 N 8TH ST

MISSOURI VALLEY,IA51555
42-0776568
HOSPITAL IA 501(c)(3) 3 CHI NEBRASKA
 
 
No
(5)ALEGENT HEALTH - IMMANUEL MED CTR
6901 N 72ND ST

OMAHA,NE68122
47-0376615
HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(6)ALEGENT HEALTH - MEMORIAL HOSP SCHUYLER
104 W 17TH ST

SCHUYLER,NE68661
47-0399853
HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(7)ALEGENT HEALTH - MERCY HOSP CORNING IA
PO BOX 368

CORNING,IA50841
42-0782518
HOSPITAL IA 501(c)(3) 3 CHI NEBRASKA
 
 
No
(8)ALVERNA APARTMENTS
300 SE 8TH AVE

LITTLE FALLS,MN56345
41-1351177
LTERM CARE MN 501(c)(3) 10 CSH
 
 
No
(9)APPLETREE COURT
601 OAK ST

BRECKENRIDGE,MN56520
41-1850500
SENIOR LIVING MN 501(c)(3) 10 SFH
 
 
No
(10)Arroyo Grande Community Hospital FDN
345 S Halcyon Rd

Arroyo Grande,CA93420
20-3256066
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(11)Bakersfield Memorial Hospital
420 34TH Street

Bakersfield,CA93301
95-1802779
HOSPITAL CA 501(c)(3) 3 DCC
 
 
No
(12)Barrow Neurological FDN
350 West Thomas Rd

Phoenix,AZ85013
86-0174371
FUND. FDN AZ 501(c)(3) 7 DH
 
 
No
(13)BAYLOR ST LUKE'S HEALTH VENTURES
17200 ST LUKES WAY STE 170

THE WOODLANDS,TX77384
27-4499340
PHYSICIANS TX 501(c)(3) 12 Type 1 SLCHS
 
 
No
(14)BAYLOR ST LUKE'S MEDGROUP
6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0458535
PHYSICIANS TX 501(c)(3) 3 SLHS
 
 
No
(15)BORNEMANN HEALTHCARE CORPORATION
198 INVERNESS DR WEST

ENGLEWOOD,CO80112
23-2187242
HEALTHCARE PA 501(c)(3) 12 Type 1 CSH
 
 
No
(16)BRAZOSPORT HEALTH FDN INC
1 West Way Ct

LAKE JACKSON,TX77566
76-0080110
FUND. FDN TX 501(c)(3) 12 Type 1 BRHS
 
 
No
(17)BRAZOSPORT REGIONAL PHYSICIAN SRVS
100 MEDICAL DR

LAKE JACKSON,TX77566
80-0240261
PHYSICIANS TX 501(c)(3) 3 BRHS
 
 
No
(18)BURLESON ST JOSEPH HEALTH CTR
2801 FRANCISCAN DR

BRYAN,TX77802
74-2759890
HOSPITAL TX 501(c)(3) 3 SJSC
 
 
No
(19)BURLESON ST JOSEPH MANOR
2801 FRANCISCAN DR

BRYAN,TX77802
74-2913931
HEALTHCARE TX 501(c)(3) 10 SJSC
 
 
No
(20)California Hospital MED CTR FDN
1401 South Grand AVE

Los Angeles,CA90015
95-4000909
FUND. FDN CA 501(c)(3) 12 Type 1 DCC
 
 
No
(21)CARRINGTON HEALTH CTR
800 N 4TH ST

CARRINGTON,ND58421
45-0227311
HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(22)CATHOLIC HEALTH INITIATIVES - COLORADO
9100 East Mineral Circle

Centennial,CO80112
84-0405257
HOSPITAL CO 501(c)(3) 3 CSH
 
 
No
(23)CATHOLIC HEALTH INITIATIVES - IOWA CORP
1111 6TH AVE

DES MOINES,IA50314
42-0680448
HOSPITAL IA 501(c)(3) 3 CSH
 
 
No
(24)CATHOLIC HEALTH INITIATIVES COLORADO FDN
1150 Kelly Johnson Blvd 204

COLORADO SPRINGS,CO80920
84-0902211
FUND. FDN CO 501(c)(3) 7 CHIC
 
 
No
(25)CATHOLIC HEALTH INITIATIVES NATIONAL FDN
1150 Kelly Johnson Blvd 204

COLORADO SPRINGS,CO80920
27-0930004
HEALTHCARE CO 501(c)(3) 12 Type 1 CSH
 
 
No
(26)CHI VIRTUAL HEALTH SERVICES
198 INVERNESS DR WEST

ENGLEWOOD,CO80112
46-0992796
PHYSICIANS CO 501(c)(3) 12 Type 1 CHINS
 
 
No
(27)CENTENNIAL MEDGROUP INC
2700 STEWART PKWY

ROSEBURG,OR97471
26-3946191
SURGERY CTR OR 501(c)(3) 10 MMC
 
 
No
(28)CENTRAL CALIFORNIA HEALTH CTRS
300 OLD RIVER Rd STE 200

BAKERSFIELD,CA93311
84-4171789
CLINIC CA 501(c)(3) 3 DCC
 
 
No
(29)CENTRAL KANSAS MED CTR
3515 BRdWAY

GREAT BEND,KS67530
48-0543724
HOSPITAL KS 501(c)(3) 3 CSH
 
 
No
(30)CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PKWY S

FARGO,ND58104
27-1966847
FUND. FDN MN 501(c)(3) 10 CSH
 
 
No
(31)CHI HEALTH FDN
12809 W DODGE RD

OMAHA,NE68154
47-0648586
FUND. FDN NE 501(c)(3) 7 ACH
 
 
No
(32)CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400

ERLANGER,KY41018
20-2741651
HEALTHCARE KY 501(c)(3) 12 Type 1 CSH
 
 
No
(33)CHI Memorial Hospital - Georgia
100 GROSS CRESCENT CIRCLE

FORT OGLETHORPE,GA30742
82-2748395
HOSPITAL GA 501(c)(3) 3 MHCS
 
 
No
(34)CHI NATIONAL HOME CARE
198 INVERNESS DR WEST

ENGLEWOOD,CO80112
45-1261716
HEALTHCARE CO 501(c)(3) 10 CHI NS
 
 
No
(35)CHI NATIONAL SERVICES
198 INVERNESS DR WEST

ENGLEWOOD,CO80112
45-2532084
HEALTHCARE CO 501(c)(3) 12 Type 1 CSH
 
 
No
(36)CHI NEBRASKA
12809 West Dodge Rd

Omaha,NE68510
36-3233121
HEALTHCARE NE 501(c)(3) 12 Type 1 CSH
 
 
No
(37)CHI ST JOSEPH CHILDREN'S HEALTH
1929 LINCOLN HWY E STE 150

LANCASTER,PA17602
23-2342997
HEALTHCARE PA 501(c)(3) 12 Type 1 CSH
 
 
No
(38)CHI ST JOSEPH'S CHILDREN
1516 5TH ST NW

ALBUQUERQUE,NM87102
71-0897107
COMMUNITY NM 501(c)(3) 12 Type 1 CSH
 
 
No
(39)CHI ST VINCENT HOSPITAL HOT SPRINGS
300 WERNER ST

HOT SPRINGS,AR71913
71-0236913
HOSPITAL AR 501(c)(3) 3 CHISVHS
 
 
No
(40)CHI ST VINCENT HOT SPRINGS
300 WERNER ST

HOT SPRINGS,AR71913
26-1125064
HOLDING CO AR 501(c)(3) 12 Type 1 SVIMC
 
 
No
(41)CHI ST VINCENT MED GROUP HOT SPRINGS
300 WERNER ST

HOT SPRINGS,AR71913
26-1125131
PHYSICIANS AR 501(c)(3) 3 CHISVHS
 
 
No
(42)COMMONSPIRIT HEALTH
198 INVERNESS DR WEST

ENGLEWOOD,CO80112
47-0617373
HEALTHCARE CO 501(c)(3) 12 Type 1 NA
 
 
No
(43)COMMONSPIRIT HEALTH OPER INV POOL LLC
185 BERRY STREET STE 300

SAN FRANCISCO,CA94107
85-0919176
INVESTMENTS CA 501(c)(3) 12 Type 1 CSH
 
 
No
(44)COMMONSPIRIT HEALTH RESEARCH INSTITUTE
198 INVERNESS DR WEST

ENGLEWOOD,CO80112
27-1050565
HEALTHCARE CO 501(c)(3) 12 Type 1 CSH
 
 
No
(45)Community Hospital of San Bernardino
1805 Medical CTR DR

San Bernardino,CA92411
95-1643373
HOSPITAL CA 501(c)(3) 3 DCC
 
 
No
(46)COMMUNITY LIMITED CARE DIALYSIS CTR
619 OAK ST ACCOUNTING-3 W

CINCINNATI,OH45206
23-7419853
HOLDING CO OH 501(c)(4) NONE GSH
 
 
No
(47)COMMUNITY MEMORIAL HPL MED SERVICE FDN
631 N 8TH ST

MISSOURI VALLEY,IA51555
42-1294399
FUND. FDN IA 501(c)(3) 12 Type 1 AH-CMHMV
 
 
No
(48)CONTINUING CARE HOSPITAL
One Saint Joseph DR

LEXINGTON,KY40504
61-1400619
HOSPITAL KY 501(c)(3) 3 SJHS
 
 
No
(49)Dignity Community Care
185 Berry Street Ste 300

San Francisco,CA94107
81-5009488
HOSPITAL CO 501(c)(3) 3 CSH
 
 
No
(50)DIGNITY HEALTH
185 BERRY STREET STE 300

SAN FRANCISCO,CA94107
94-1196203
HOSPITAL CA 501(c)(3) 3 CSH
 
 
No
(51)Dignity Health Connected Living
200 Mercy Oaks DR

Redding,CA96003
23-7115371
Senior CTR SR CA 501(c)(3) 7 DH
 
 
No
(52)Dignity Health FDN
185 Berry Street

San Francisco,CA94107
46-2037641
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(53)Dignity Health FDN - Inland Empire
2101 N Waterman AVE

San Bernardino,CA92404
23-7440086
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(54)Dignity Health FDN East Valley
475 South Dobson Rd

Chandler,AZ85224
74-2418514
FUND. FDN AZ 501(c)(3) 12 Type 1 DH
 
 
No
(55)Dignity Health HPL Self-Insurance Trust
185 Berry Street

San Francisco,CA94107
94-3006034
Self Insuranc CA 501(c)(3) 12 Type 1 DH
 
 
No
(56)Dignity Health Insurance Nevada Ltd
185 Berry Street

San Francisco,NV94107
81-3800752
Self Insuranc NV 501(c)(3) 12 Type 1 DH
 
 
No
(57)Dignity Health MEDFDN
3400 Data DR

Rancho Cordova,CA95670
68-0220314
M/S OUTP. MED CA 501(c)(3) 12 Type 1 DCC
 
 
No
(58)DH Workers' Comp Self-Insurance Trust
185 Berry Street

San Francisco,CA94107
94-6612446
Self Insuranc CA 501(c)(3) 12 Type 1 DH
 
 
No
(59)Dominican Health Services
1555 Soquel DR

Santa Cruz,CA95065
77-0056778
Community Hea CA 501(c)(3) 12 Type 1 DH
 
 
No
(60)Dominican Hospital FDN
1555 Soquel DR

Santa Cruz,CA95065
94-2450442
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(61)Dominican Oaks Corporation
1555 Soquel DR

Santa Cruz,CA95065
77-0127719
Op&M of housi CA 501(c)(3) 10 DHS
 
 
No
(62)East Texas Clinical Services
2801 VIA FORTUNA Ste 500

AUSTIN,TX78746
45-4736213
HEALTHCARE TX 501(c)(3) 12 Type 1 SLHS
 
 
No
(63)ENUMCLAW REGIONAL HOSPITAL ASSN
1455 BATTERSBY AVE

ENUMCLAW,WA98022
91-0715805
HOSPITAL WA 501(c)(3) 3 FHS
 
 
No
(64)FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE RD

BARDSTOWN,KY40004
61-1345363
HOSPITAL KY 501(c)(3) 3 KOH
 
 
No
(65)FLAGET MEMORIAL HOSPITAL FDN INC
4305 NEW SHEPHERDSVILLE RD

BARDSTOWN,KY40004
56-2351341
FUND. FDN KY 501(c)(3) 12 Type 1 FH
 
 
No
(66)FRANCISCAN CARE CTR
4111 N HOLLAND-SYLVANIA RD

TOLEDO,OH43623
34-1931806
HEALTHCARE OH 501(c)(3) 10 CHILC
 
Yes
 
(67)FRANCISCAN FDN
1717 SOUTH J ST

TACOMA,WA98405
91-1145592
FUND. FDN WA 501(c)(3) 10 FHS
 
 
No
(68)FRANCISCAN HEALTH SYSTEM
1717 SOUTH J ST

TACOMA,WA98405
91-0564491
HOSPITAL WA 501(c)(3) 3 CSH
 
 
No
(69)FH VENTURES FKA SJMGROUP
TACOMA FNC CTR BLDG 1145 BRdWAY

TACOMA,WA98402
43-1882377
PHYSICIANS MO 501(c)(3) 10 CSH
 
 
No
(70)FRANCISCAN MEDGROUP
1313 BRdWAY STE 200

TACOMA,WA98402
91-1939739
HEALTHCARE WA 501(c)(3) 10 FHS
 
 
No
(71)FRANCISCAN VILLA OF S MILWAUKEE INC
3601 S CHICAGO AVE

SOUTH MILWAUKEE,WI53172
39-1093829
HEALTHCARE WI 501(c)(3) 10 CSH
 
 
No
(72)French Hospital MED CTR FDN
1911 Johnson AVE

San Luis Obispo,CA93401
20-3256125
FUND. FDN CA 501(c)(3) 12 Type 1 DCC
 
 
No
(73)GARRISON MEMORIAL HOSPITAL
407 THIRD AVE SOUTHEAST

GARRISON,ND58540
45-0227752
HOSPITAL ND 501(c)(3) 3 SAMC
 
 
No
(74)Glendale Memorial Health FDN
1420 South Central AVE

Glendale,CA91204
95-3625651
FUND. FDN CA 501(c)(3) 12 Type 1 DCC
 
 
No
(75)GLOBAL HEALTH INITIATIVES
198 INVERNESS DR WEST

ENGLEWOOD,CO80112
20-1536108
MINISTRIES CO 501(c)(3) 12 Type 1 CSH
 
 
No
(76)GSC OF NURSING & HEALTH SCIENCE
619 OAK ST ACCOUNTING-3 W

CINCINNATI,OH45206
31-1778403
EDUCATION OH 501(c)(3) 2 GSH
 
 
No
(77)GOOD SAMARITAN FDN OF CINCINNATI INC
619 OAK ST ACCOUNTING-3 W

CINCINNATI,OH45206
31-1206047
FUND. FDN OH 501(c)(3) 12 Type 1 GSH
 
 
No
(78)GOOD SAMARITAN HOSPITAL
PO BOX 1990

KEARNEY,NE68848
47-0379755
HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(79)GOOD SAMARITAN HOSP FDN
111 W 31ST ST

KEARNEY,NE68847
47-0659443
FUND. FDN NE 501(c)(3) 7 GSH
 
 
No
(80)HARRISON MED CTR
2520 CHERRY AVE

BREMERTON,WA98310
91-0565546
HOSPITAL WA 501(c)(3) 3 FHS
 
 
No
(81)HARRISON MED CTR FDN
2520 CHERRY AVE

BREMERTON,WA98310
91-1197626
FUND. FDN WA 501(c)(3) 7 HMC
 
 
No
(82)HEALTH FDN OF KY ONE INC
1451 HARRODSBURG RD STE D-308

LEXINGTON,KY40504
83-2170324
FUND. FDN KY 501(c)(3) 12 Type 1 KOH
 
 
No
(83)HEALTHCARE AND WELLNESS FDN
2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
76-0761782
FUND. FDN MN 501(c)(3) 12 Type 1 SFMC
 
 
No
(84)HIGHLINE MED CTR
16251 SYLVESTER RD SW

BURIEN,WA98166
91-0712166
HOSPITAL WA 501(c)(3) 3 FHS
 
 
No
(85)HOUSE OF MERCY
1111 6TH AVE

DES MOINES,IA50314
42-1323808
SHELTER IA 501(c)(3) 7 CHI-IA CORP
 
 
No
(86)JEWISH HOSP& ST MARY'S HEALTHCARE INC
250 E Liberty St Ste 500

LOUISVILLE,KY40202
61-1029768
HOSPITAL KY 501(c)(3) 3 KOH
 
 
No
(87)KENTUCKYONE HEALTH MEDGROUP INC
100 E Liberty St Ste 800

LOUISVILLE,KY40202
61-1352729
HEALTHCARE KY 501(c)(3) 10 JHSMH
 
 
No
(88)KENTUCKYONE HEALTH INC
200 ABRAHAM FLEXNER WAY

LOUISVILLE,KY40202
61-1029769
HEALTHCARE KY 501(c)(3) 12 Type 1 CSH
 
 
No
(89)LAKEWOOD HEALTH CTR
600 MAIN AVE S

BAUDETTE,MN56623
41-0758434
HOSPITAL MN 501(c)(3) 3 CSH
 
 
No
(90)LAKEWOOD REGIONAL HEALTHCARE FDN
600 MAIN AVE S

BAUDETTE,MN56623
41-1893795
FUND. FDN ND 501(c)(3) 7 LHC
 
 
No
(91)LISBON AREA HEALTH SERVICES
905 MAIN ST

LISBON,ND58054
82-0558836
HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(92)LUFKIN VISION ACQUISITIONS
PO BOX 1447

LUFKIN,TX75901
82-0563768
PROPERTY MGMT TX 501(c)(3) 12 Type 1 MHSET
 
 
No
(93)MADISON ST JOSEPH HEALTH CTR
2801 FRANCISCAN DR

BRYAN,TX77802
74-2761145
HOSPITAL TX 501(c)(3) 3 SJSC
 
 
No
(94)MADONNA MANOR INC
2344 AMSTERDAM Rd

VILLA HILLS,KY51017
61-0654635
LIVING ASSIST KY 501(c)(3) 10 CHILC
 
Yes
 
(95)Marian Regional MED CTR FDN
1400 E Church Street

Santa Maria,CA93454
95-3818027
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(96)Mark Twain MED CTR
768 Mountain Ranch Rd

San Andreas,CA95249
68-0127677
HOSPITAL CA 501(c)(3) 3 DCC
 
 
No
(97)MEMORIAL HEALTH CARE SYSTEM FDN INC
2525 DE SALES AVE

CHATTANOOGA,TN37404
62-1839548
FUND. FDN TN 501(c)(3) 7 MHCS
 
 
No
(98)MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVE

CHATTANOOGA,TN37404
62-0532345
HOSPITAL TN 501(c)(3) 3 CSH
 
 
No
(99)MEMORIAL HEALTH PARTNERS FDN INC
5600 BRAINERD RD STE 500

CHATTANOOGA,TN37411
03-0417049
HEALTHCARE TN 501(c)(3) 10 MHCS
 
 
No
(100)MEMORIAL HEALTH SYS OF EAST TX
PO BOX 1447

LUFKIN,TX75902
75-0755367
HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(101)MEMORIAL MED CTR - LIVINGSTON
PO BOX 1447

LUFKIN,TX75902
76-0436439
HOSPITAL TX 501(c)(3) 3 MHSET
 
 
No
(102)MEMORIAL MED CTR - SAN AUGUSTINE
PO BOX 1447

LUFKIN,TX75902
75-2663904
HOSPITAL TX 501(c)(3) 3 MHSET
 
 
No
(103)MEMORIAL MULTISPECIALTY ASSOCIATES
1201 FRANK AVE

LUFKIN,TX95904
75-2721155
PHYSICIANS TX 501(c)(3) 12 Type 1 MHSET
 
 
No
(104)MEMORIAL SPECIALTY HOSPITAL
PO BOX 1447

LUFKIN,TX95902
75-2492741
HOSPITAL TX 501(c)(3) 3 MHSET
 
 
No
(105)MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVE

DES MOINES,IA50314
42-6076069
AUXILIARY IA 501(c)(3) 12 Type 1 MF-DM IA
 
 
No
(106)MERCY CLINICS INC
1111 6TH AVE

DES MOINES,IA50314
42-1193699
PHYSICIANS IA 501(c)(3) 10 CHI-IA CORP
 
 
No
(107)MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVE

DES MOINES,IA50314
42-1511682
EDUCATION IA 501(c)(3) 2 CHI-IA CORP
 
 
No
(108)Mercy FDN Bakersfield
PO Box 119

Bakersfield,CA93302
77-0201321
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(109)MERCY FDN OF DES MOINES IA
1111 6TH AVE

DES MOINES,IA50314
23-7358794
FUND. FDN IA 501(c)(3) 7 CHI-IA CORP
 
 
No
(110)MERCY FDN INC
2700 STEWART PKWY

ROSEBURG,OR97471
93-6088946
FUND. FDN OR 501(c)(3) 7 MMC
 
 
No
(111)MERCY HEALTH CARE FDN
PO BOX 368

CORNING,IA50841
42-1461064
FUND. FDN IA 501(c)(3) 12 Type 1 AHMH-Corning
 
 
No
(112)MERCY HEALTHCARE FDN
570 CHAUTAUQUA BLVD

VALLEY CITY,ND58072
45-0435338
FUND. FDN ND 501(c)(3) 12 Type 1 MHVC
 
 
No
(113)MERCY HOSPITAL FDN COUNCIL BLUFFS
800 MERCY DR

COUNCIL BLUFFS,IA51503
42-1178204
FUND. FDN IA 501(c)(3) 12 Type 1 AHBMHS
 
 
No
(114)MERCY HOSPITAL OF DEVILS LAKE
1031 7TH ST NE

DEVILS LAKE,ND58301
45-0227012
HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(115)MERCY HOSPITAL OF DEVILS LAKE FDN
1031 7TH ST NE

DEVILS LAKE,ND58301
35-2367360
FUND. FDN ND 501(c)(3) 7 MHDL
 
 
No
(116)MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BLVD

VALLEY CITY,ND58072
45-0226553
HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(117)Mercy McMahon Terrace
3865 J Street

Sacramento,CA95816
68-0117340
Senior Hous/R CA 501(c)(3) 10 DH
 
 
No
(118)MERCY MED CTR
1301 15TH AVE WEST

WILLISTON,ND58801
45-0231183
HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(119)MERCY MED CTR - CTRVILLE
ONE ST JOSEPHS DR

CTRVILLE,IA52544
42-0680308
HOSPITAL IA 501(c)(3) 3 CHI-IA CORP
 
 
No
(120)MERCY MED CTR - NEWTON DBA SKIFF MED CTR
204 N 4th Ave E

Newton,IA50314
42-1470935
HOSPITAL IA 501(c)(3) 3 CHI-IA CORP
 
 
No
(121)Mercy MED CTR Merced FDN
301 E 13th Street

Merced,CA95340
77-0035928
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(122)MERCY MED CTR INC
2700 STEWART PKWY

ROSEBURG,OR97471
93-0386868
HOSPITAL OR 501(c)(3) 3 CSH
 
 
No
(123)MERCY MED FDN
1301 15TH AVE WEST

WILLISTON,ND58801
45-0381803
FUND. FDN ND 501(c)(3) 12 Type 1 MMC
 
 
No
(124)NEBRASKA HEART HOSPITAL
7500 S 91ST ST

LINCOLN,NE68526
39-2031968
HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(125)Northland Healthcare Alliance
2223 East Rosser AVE

Bismarck,ND58501
91-1845296
MANAGEMENT ND 501(c)(3) 7 NCHA
 
 
No
(126)Northridge Hospital FDN
18300 Roscoe Blvd

Northridge,CA91328
23-7444901
FUND. FDN CA 501(c)(3) 12 Type 1 DCC
 
 
No
(127)OAKES COMMUNITY HOSPITAL
1200 N 7TH ST

OAKES,ND58474
45-0231675
HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(128)OAKES COMMUNITY HOSPITAL FDN
1200 N 7TH ST

OAKES,ND58474
71-0966606
FUND. FDN ND 501(c)(3) 12 Type 1 OCH
 
 
No
(129)Pacific Central Coast Health CTRs
1400 E Church Street

Santa Maria,CA93454
77-0447575
Clinic CA 501(c)(3) 3 DCC
 
 
No
(130)PINEYWOODS MEDDEVELOPMENT CORP
PO BOX 1447

LUFKIN,TX75902
75-2493116
PROPERTY MGMT TX 501(c)(3) 12 Type 1 MHSET
 
 
No
(131)Port City Operating Company LLC
3400 Data DR

Rancho Cordova,CA95670
46-5322209
HOSPITAL CA 501(c)(3) 3 DH
 
 
No
(132)PROVIDENCE CARE CTR
2025 HAYES AVE

SANDUSKY,OH44870
34-1658625
HEALTHCARE OH 501(c)(3) 10 CHILC
 
Yes
 
(133)PROVIDENCE CARE CTRS
2025 HAYES AVE

SANDUSKY,OH44870
34-1826099
HOLDING CO OH 501(c)(3) 12 Type 1 CHILC
 
Yes
 
(134)PROVIDENCE RESIDENTIAL COMMUNITY CORP
5055 PROVIDENCE DR

SANDUSKY,OH44870
34-1896807
LIVING COMM OH 501(c)(3) 10 CHILC
 
Yes
 
(135)PUEBLO STEPUP
1925 E ORMAN AVE STE G52

PUEBLO,CO81004
84-1234295
COMMUNITY CO 501(c)(3) 7 CHIC
 
 
No
(136)REGIONAL HPL FOR RESP & COMPLEX CARE
16251 Sylvester Rd SW

Burien,WA98166
91-1170040
HOSPITAL WA 501(c)(3) 3 FHS
 
 
No
(137)SET OF COLORADO SPRINGS INC
9100 E Mineral Circle

Centennial,CO80112
84-1183335
Senior CTR SR CO 501(c)(3) 7 CHIC
 
 
No
(138)SAINT CLARE'S COMMUNITY CARE INC
25 POCONO RD

DENVILLE,NJ07834
22-2876836
HEALTHCARE NJ 501(c)(3) 10 SCHS
 
 
No
(139)SAINT CLARE'S HEALTH SERVICES INC
25 POCONO RD

DENVILLE,NJ07834
22-3639733
MANAGEMENT NJ 501(c)(3) 10 CSH
 
 
No
(140)SAINT CLARE'S HOSPITAL INC
25 POCONO RD

DENVILLE,NJ07834
22-3319886
HEALTHCARE NJ 501(c)(3) 3 SCHS
 
 
No
(141)SAINT ELIZABETH FDN
555 S 70TH ST

LINCOLN,NE68510
47-0625523
FUND. FDN NE 501(c)(3) 7 SERMC
 
 
No
(142)SAINT ELIZABETH HEALTH SERVICES
555 S 70TH ST

LINCOLN,NE68510
36-3233120
HOSPITAL NE 501(c)(3) 3 SERMC
 
 
No
(143)SAINT ELIZABETH REGIONAL MED CTR
555 S 70TH ST

LINCOLN,NE68510
47-0379836
HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(144)SAINT FRANCIS MED CTR
2620 W FAIDLEY

GRAND ISLAND,NE68803
47-0376601
HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(145)SAINT FRANCIS MED CTR FDN
PO BOX 9804

GRAND ISLAND,NE68802
47-0630267
FUND. FDN NE 501(c)(3) 7 SFMC
 
 
No
(146)Saint Francis Memorial Hospital
900 Hyde Street

San Francisco,CA94109
94-1156295
HOSPITAL CA 501(c)(3) 3 DCC
 
 
No
(147)SAINT JOSEPH BEREA HOSPITAL FDN INC
305 ESTILL ST

BEREA,KY40403
26-0152877
FUND. FDN KY 501(c)(3) 7 SJHS
 
 
No
(148)SAINT JOSEPH HEALTH SYSTEM INC
200 ABRAHAM FLEXNER WAY

LOUISVILLE,KY40202
61-1334601
HOSPITAL KY 501(c)(3) 3 KOH
 
 
No
(149)SAINT JOSEPH HOSPITAL FDN INC
701 Bob Olink Dr 200

LEXINGTON,KY40504
61-1159649
FUND. FDN KY 501(c)(3) 12 Type 1 SJHS
 
 
No
(150)SAINT JOSEPH LONDON FDN INC
1001 SAINT JOSEPH LANE

LONDON,KY40741
26-0438748
FUND. FDN KY 501(c)(3) 7 SJHS
 
 
No
(151)SAINT JOSEPH MOUNT STERLING FDN INC
225 FALCON DR

MOUNT STERLING,KY40353
27-2884584
FUND. FDN KY 501(c)(3) 7 SJHS
 
 
No
(152)SAINT JOSEPH'S HOSPITAL FDN
2500 Fairway Street

DICKINSON,ND58601
36-3418207
FUND. FDN ND 501(c)(3) 12 Type 1 SJHHC
 
 
No
(153)San Gabriel Valley MED CTR FDN
438 West Las Tunas DR

San Gabriel,CA91776
95-3430341
INACTIVE CA 501(c)(3) 12 Type 1 DH
 
 
No
(154)SCHUYLER MEMORIAL HOSPITAL FDN INC
104 W 17TH ST

SCHUYLER,NE68661
36-3630014
FUND. FDN NE 501(c)(3) 12 Type 1 AHMHS
 
 
No
(155)Sierra Nevada Memorial-Miners Hosp
155 Glasson Way

Grass Valley,CA95945
94-1439787
HOSPITAL CA 501(c)(3) 3 DCC
 
 
No
(156)SJRMC JOPLIN MISSOURI
198 INVERNESS DR WEST

ENGLEWOOD,CO80112
44-0545809
HOSPITAL MO 501(c)(3) 3 CSH
 
 
No
(157)St Francis FDN of Santa Barbara
2323 De La Vina St Ste 104

Santa Barbara,CA93105
23-7137119
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(158)St Francis Hospital Support Corp
601 E Micheltorena Street

Santa Barbara,CA93103
77-0022302
INACTIVE CA 501(c)(3) 12 Type 1 DH
 
 
No
(159)St John's Healthcare FDN
1600 North Rose AVE

Oxnard,CA93030
20-2865781
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(160)St Joseph's FDN (Phoenix)
350 West Thomas Rd

Phoenix,AZ85013
94-2941245
FUND. FDN AZ 501(c)(3) 12 Type 1 DH
 
 
No
(161)St Joseph's FDN of San Joaquin
1800 N California Street

Stockton,CA95204
51-0432777
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(162)St Mary MED CTR FDN
1050 Linden AVE

Long Beach,CA90813
23-7153876
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(163)St Mary Professional Building Inc
1050 Linden AVE

Long Beach,CA90813
23-7373088
INACTIVE CA 501(c)(3) 12 Type 1 DH
 
 
No
(164)St Mary's MED CTR FDN
450 Stanyan Street

San Francisco,CA94117
94-3336143
FUND. FDN CA 501(c)(3) 12 Type 1 DH
 
 
No
(165)St Rose Dominican Health FDN
3001 St Rose Parkway

Henderson,NV89052
88-0349432
FUND. FDN NV 501(c)(3) 12 Type 1 DH
 
 
No
(166)ST ALEXIUS MED CTR
900 EAST BRdWAY AVE

BISMARCK,ND58501
45-0226711
HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(167)ST ANTHONY HOSPITAL
2801 St Anthony Way

PENDLETON,OR97801
93-0391614
HOSPITAL OR 501(c)(3) 3 CSH
 
 
No
(168)ST ANTHONY HOSPITAL FDN
2801 St Anthony Way

PENDLETON,OR97801
93-0992727
FUND. FDN OR 501(c)(3) 12 Type 1 SAH
 
 
No
(169)ST ANTHONY'S HOSPITAL ASSN
FOUR HOSPITAL DR

MORRILTON,AR72110
71-0245507
HOSPITAL AR 501(c)(3) 3 SVIMC
 
 
No
(170)ST CATHERINE HOSPITAL
401 EAST SPRUCE ST

GARDEN CITY,KS67846
48-0543721
HOSPITAL KS 501(c)(3) 3 CSH
 
 
No
(171)ST CATHERINE HOSP DEVELOPMENT FDN
401 EAST SPRUCE ST

GARDEN CITY,KS67846
20-0598702
FUND. FDN KS 501(c)(3) 12 Type 1 SCH
 
 
No
(172)ST CLARE COMMONS
12469 Five Point Rd

TOLEDO,OH43551
27-0163752
LIVING COMM OH 501(c)(3) 10 CHILC
 
Yes
 
(173)ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DR WEST

ENGLEWOOD,CO80112
93-0433692
HEALTHCARE OR 501(c)(4) NONE CSH
 
 
No
(174)ST FRANCIS HOME
2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
41-0729978
LTERM CARE MN 501(c)(3) 10 CSH
 
 
No
(175)ST FRANCIS LIFE CARE CORPORATION
19 POCONO RD

DENVILLE,NJ07834
22-2536017
ELDERLY CARE NJ 501(c)(3) 8 SCHS
 
 
No
(176)ST FRANCIS MED CTR
2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
41-0695598
HOSPITAL MN 501(c)(3) 3 CSH
 
 
No
(177)ST JOSEPH FDN OF BRYAN TEXAS
2801 FRANCISCAN DR

BRYAN,TX77802
74-2351158
FUND. FDN TX 501(c)(3) 12 Type 1 SJSC
 
 
No
(178)ST JOSEPH MANOR
2801 FRANCISCAN DR

BRYAN,TX77802
74-2847594
HEALTHCARE TX 501(c)(3) 10 SJSC
 
 
No
(179)ST JOSEPH MED CTR INC
201 INTERNATIONAL CIRCLE STE 212

HUNT VALLEY,MD21030
52-0591461
HOSPITAL MD 501(c)(3) 3 CSH
 
 
No
(180)ST JOSEPH PHYSICIAN ASSOCIATES
2801 FRANCISCAN DR

BRYAN,TX77802
20-3159302
PHYSICIANS TX 501(c)(3) 3 SJSC
 
 
No
(181)ST JOSEPH PHYSICIAN ENTERPRISE INC
201 INTERNATIONAL CIRCLE STE 212

HUNT VALLEY,MD21030
52-1311775
PHYSICIANS MD 501(c)(3) 12 Type 1 SJMC
 
 
No
(182)ST JOSEPH REGIONAL HEALTH CTR
2801 FRANCISCAN DR

BRYAN,TX77802
74-1282696
HOSPITAL TX 501(c)(3) 3 SJSC
 
 
No
(183)ST JOSEPH REGIONAL HEALTH PARTNERS
2801 FRANCISCAN DR

BRYAN,TX77802
45-4088170
HOSPITAL TX 501(c)(3) 3 SJSC
 
 
No
(184)ST JOSEPH REGIONAL HEALTH PARTNERS ACO
2801 FRANCISCAN DR

BRYAN,TX77802
46-3265423
HEALTHCARE TX 501(c)(3) 10 SJSC
 
 
No
(185)ST JOSEPH SERVICES CORPORATION
2801 FRANCISCAN DR

BRYAN,TX77802
74-2455161
MANAGEMENT TX 501(c)(3) 12 Type 1 SLHS
 
 
No
(186)ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVE

PARK RAPIDS,MN56470
41-0695603
HOSPITAL MN 501(c)(3) 3 CSH
 
 
No
(187)ST JOSEPH'S HOSPITAL AND HEALTH CTR
2500 Fairway St

DICKINSON,ND58601
45-0226429
HOSPITAL ND 501(c)(3) 3 CSH
 
 
No
(188)ST LEONARD
8100 CLYO Rd

CTRVILLE,OH45458
34-1940863
LIVING COMM OH 501(c)(3) 10 CHILC
 
Yes
 
(189)ST LUKE'S COMM DEVELOPMENT CORP - PMC
6624 FANNIN ST STE 2505

HOUSTON,TX77030
27-3733278
HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(190)ST LUKE'S COMM DEVELOPM CORP - SUGAR
6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-1947374
HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(191)ST LUKE'S COMM DEVELOP CORP - THE WOO
6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-0335902
HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(192)ST LUKE'S COMMUNITY HEALTH SRVS
6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0536234
HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(193)ST LUKE'S FDN
1213 HERMANN DR STE 855

HOUSTON,TX77004
45-3811485
FUND. FDN TX 501(c)(3) 7 SLHS
 
 
No
(194)ST LUKE'S HEALTH SYSTEM CORP
PO Box 20269

HOUSTON,TX77225
76-0536232
MANAGEMENT TX 501(c)(3) 12 Type 1 CSH
 
 
No
(195)ST LUKE'S HOSPITAL AT THE VINTAGE
6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-3734606
HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(196)ST LUKE'S PROPERTIES CORP
1213 Hermann DR Ste 855

HOUSTON,TX77004
76-0531716
PROPERTY MGMT TX 501(c)(3) 12 Type 1 SLHS
 
 
No
(197)ST LUKE'S SUGAR LAND PROPERTIES CORP
6624 FANNIN ST STE 2505

HOUSTON,TX77030
45-4120549
PROPERTY MGMT TX 501(c)(3) 12 Type 1 SLCDC-SL
 
 
No
(198)ST MARY'S COMMUNITY HOSPITAL
1301 Grundman Boulevard

NEBRASKA CITY,NE68410
47-0443636
HOSPITAL NE 501(c)(3) 3 CHI NEBRASKA
 
 
No
(199)ST MARY'S HOSPITAL FDN
1314 3RD AVE

NEBRASKA CITY,NE68410
47-0707604
FUND. FDN NE 501(c)(3) 7 SMCH
 
 
No
(200)ST VINCENT FDN
TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
51-0169537
FUND. FDN AR 501(c)(3) 12 Type 1 SVIMC
 
 
No
(201)ST VINCENT INFIRMARY MED CTR
TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
71-0236917
HOSPITAL AR 501(c)(3) 3 CSH
 
 
No
(202)ST VINCENT MEDGROUP
TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
71-0830696
HEALTHCARE AR 501(c)(3) 10 SVIMC
 
 
No
(203)SYLVANIA FRANCISCAN HEALTH
1715 INDIAN WOOD CIR 200

MAUMEE,OH43537
34-1412964
HEALTHCARE OH 501(c)(3) 12 Type 1 CSH
 
 
No
(204)SYLVANIA FRANCISCAN HEALTH FDN
1715 INDIAN WOOD CIR 200

MAUMEE,OH43537
45-5357161
FUND. FDN OH 501(c)(3) 12 Type 1 SFH
 
 
No
(205)THE COMMONS OF PROVIDENCE
5000 PROVIDENCE DR

SANDUSKY,OH44870
34-1826097
ASSIST LIVING OH 501(c)(3) 10 CHILC
 
Yes
 
(206)THE COMMUNITY HOSP OF BRAZOSPORT
100 MEDICAL DR

LAKE JACKSON,TX77566
74-1385192
HOSPITAL TX 501(c)(3) 3 SLHS
 
 
No
(207)THE GOOD SAMARITAN HPL OF CINCINNATI OH
619 OAK ST ACCOUNTING-3 W

CINCINNATI,OH45206
31-0537486
HOSPITAL OH 501(c)(3) 3 CSH
 
 
No
(208)THE PHYSICIAN NETWORK
2000 Q ST STE 500

LINCOLN,NE68503
47-0780857
PHYSICIANS NE 501(c)(3) 12 Type 1 CHI NEBRASKA
 
 
No
(209)TOTAL HEALTHCARE
9100 E Mineral Circle

Centennial,CO80112
84-0927232
HOSPITAL CO 501(c)(3) 3 CHIC
 
 
No
(210)TRINITY HEALTH FDN
380 SUMMIT AVE

STEUBENVILLE,OH43952
31-1329423
FUND. FDN OH 501(c)(3) 12 Type 1 THS
 
 
No
(211)TRINITY HEALTH SYSTEM
380 SUMMIT AVE

STEUBENVILLE,OH43952
34-1818681
HEALTHCARE OH 501(c)(3) 12 Type 1 NA
 
 
No
(212)TRINITY HOSPITAL TWIN CITY
819 NORTH FIRST STREET

DENNISON,OH44621
27-5401105
HOSPITAL OH 501(c)(3) 3 THS
 
 
No
(213)TRI-STATE HEALTH SERVICES INC
ONE ROSS PARK BLVD

STEUBENVILLE,OH43952
34-1522484
ASSIST LIVING OH 501(c)(3) 7 THS
 
 
No
(214)UNITY FAMILY HEALTHCARE
815 SE 2ND ST

LITTLE FALLS,MN56345
41-0721642
HOSPITAL MN 501(c)(3) 3 CSH
 
 
No
(215)VILLA NAZARETH INC
801 PAGE DR

FARGO,ND58103
45-0226714
LTERM CARE ND 501(c)(3) 10 CSH
 
 
No
(216)VISITING NURSE ASSN OF ST CLARE'S INC
191 WOODPORT RD

SPARTA,NJ07871
22-1768334
HOME HEALTH NJ 501(c)(3) 10 SCHS
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) American Mercy Home Care LLC

1700 EDISON DR
MILFORD,OH45150
83-0486150
HOME HEALTH OH NA
 
N/A 0 0   No     No 0 %
(2) ARIZONA CARE NETWORK - NEXT LLC

350 W Thomas Rd
Phoenix,AZ85018
47-4696671
Care Network AZ DCC
 
N/A 0 0   No     No 0 %
(3) Arizona Care Network LLC (ACN LLC)

350 W Thomas Rd
Phoenix,AZ85013
45-4494682
Care Network AZ DCC
 
N/A 0 0   No     No 0 %
(4) Audubon Land Company LLC

630 Spointe Court 200
COLORADO SPRINGS,CO80906
84-1513085
Real Estate CO CHIC
 
N/A 0 0   No     No 0 %
(5) AVON EMERGENCY & URGENT CARE CTR LLC

9100 E Mineral Circle
Centennial,CO80112
81-1727282
HC SRVC CO CHIC
 
N/A 0 0   No     No 0 %
(6) BAYLOR CHI ST LUKES HEALTH SrvC LLC

6624 Fannin St Ste 1100
HOUSTON,TX77030
47-2079184
HC SRVC TX SLHS
 
N/A 0 0   No     No 0 %
(7) BERGAN MERCY SURGERY CTR LLC

7710 Mercy Rd Ste 200
OMAHA,NE68124
20-8671994
AMBUL SURG CTR NE ACH
 
N/A 0 0   No     No 0 %
(8) BERYWOOD OFFICE PROPERTIES LLC

2501 Citico ave
CHATTANOGA,TN37404
62-1875199
PHYS OFFICE TN MHCS
 
N/A 0 0   No     No 0 %
(9) BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD

709 Wing on Plza 62 Mody RD TST E
Kowloon Hong Kong    
CH
Health SRVC CH DHI LLC
 
N/A 0 0   No     No 0 %
(10) BLUEGRASS REGIONAL IMAGING CTR

1218 S BRoDWAY STE 310
LEXINGTON,KY40504
61-1386736
DIAG IMAGING KY SJHS
 
N/A 0 0   No     No 0 %
(11) CBCC Outsmarting Cancer LLC

6501 Truxtun ave
Bakersfield,CA93309
46-1602286
Rad/Onc/Cyberknif CA DH
 
N/A 0 0   No     No 0 %
(12) CENTRAL NEBRASKA REHAB SRVC LLC

3004 W FAIDLEY ave
GRAND ISLAND,NE68803
81-0653461
Physical Therapy NE SFMC
 
N/A 0 0   No     No 0 %
(13) CENTURA-SCA HOLDINGS LLC

569 BROOK VILLAGE STE 901
BIRMINGHAM,AL35209
47-4823023
OP SURGERY CTR AL CHIC
 
N/A 0 0   No     No 0 %
(14) CHI OPERATING INVESTMENT PROGRAM LP

198 INVERNESS DR WEST
ENGLEWOOD,CO80112
47-0727942
INVESTMENTS CO CSH
 
EXCLUDED 6,125,529 44,213,277   No 14,335   No 0.776 %
(15) CHICAMSURG Surgery CTRs LLC

1A Burton Hills Blvd
Nashville,TN37215
46-5683027
SURGERY CTR CO CHIC
 
N/A 0 0   No     No 0 %
(16) Colorado Springs CK Leasing LLC

630 Spointe Court 200
COLORADO SPRINGS,CO80906
26-2982714
REAL ESTATE CO CHIC
 
N/A 0 0   No     No 0 %
(17) CM HOME CARE SRVC of Springfield LLC

1700 EDISON DR
MILFORD,OH45150
31-1746556
HOME HEALTH OH NA
 
N/A 0 0   No     No 0 %
(18) DE JV LLC

8686 New Trails DR
The Woodlands,TX77381
32-0496548
Emergency Care NV DH
 
N/A 0 0   No     No 0 %
(19) DHHP Surgery CTRs LLC

1513 S Grand ave Ste 350
Los Angeles,CA90015
83-1847466
SURGERY CA DCC
 
N/A 0 0   No     No 0 %
(20) DHRT Holdings LLC

185 Berry Street STE 300
San Francisco,CA94107
35-2484591
Holding Company DE DHHC
 
N/A 0 0   No     No 0 %
(21) Dignity- GoHealthUrgent Care MGT LLC

5555 Glenridge Connector STE 700
Atlanta,GA30342
35-2548698
mgt SRVC DE DCC
 
N/A 0 0   No     No 0 %
(22) Dignity Health at Home LLC

1700 EDISON DR
MILFORD,OH45150
82-4674115
HC SRVC DE NA
 
N/A 0 0   No     No 0 %
(23) Dignity Health Specialty Pharmacy LLC

185 Berry Street STE 300
San Francisco,CA94107
32-0589462
Spec. Pharm SRVC DE DCC
 
N/A 0 0   No     No 0 %
(24) Dignity Home Recovery Care LLC

49 Music SQ West STE 401
Nashville,TN37203
83-2832522
Home Recov. Prgm DE DCC
 
N/A 0 0   No     No 0 %
(25) DIGNITYUSP LAS VEGAS SURG CTRS LLC

15305 Dallas PKWY STE 1600 LB 28
Addison,TX75001
20-2999237
Surgery TX DCC
 
N/A 0 0   No     No 0 %
(26) DignityUSP NorCal Surgery CTRs LLC

15305 Dallas PKWY STE 1600 LB 28
Addison,TX75001
20-2468509
SURGERY TX DHMF
 
N/A 0 0   No     No 0 %
(27) DIGNITYUSP PHOENIX SURGERY CTRS LLC

15305 Dallas PKWY STE 1600 LB 28
Addison,TX75001
13-4248908
Surgery TX DCC
 
N/A 0 0   No     No 0 %
(28) DignityUSPJohn Muir East Bay Surg Ctrs

15305 Dallas PKWY STE 1600 LB 28
Addison,TX75001
35-2584991
SURGERY TX DHMF
 
N/A 0 0   No     No 0 %
(29) Dignity-Abrazo Health Network LLC

3030 N Central ave STE 1402
Phoenix,AZ85012
46-5477985
mgt SRVC AZ DCC
 
N/A 0 0   No     No 0 %
(30) Dominican Magnetic Resonance Imaging CTR

1545 Soquel DR
Santa Cruz,CA94065
77-0095477
Imaging CTR CA DH
 
N/A 0 0   No     No 0 %
(31) ECCS ACQUISITION COMPANY LLC

2940 N CIRCLE DR
COLORADO SPRINGS,CO80909
35-2656413
AMBUL SURG CTR CO CHIC
 
N/A 0 0   No     No 0 %
(32) Folsom Sierra Endoscopy CTR LP

1650 Creekside DR 1600
Folsom,CA95630
68-0482416
Endoscopy CA DH
 
N/A 0 0   No     No 0 %
(33) Franciscan Med Pavilion Bonney Lake LLC

6622 Wollochet Dr NW
Gig Harbor,WA98335
46-3494108
Real Estate WA NA
 
N/A 0 0   No     No 0 %
(34) FRANCISCAN SPECIALTY CARE LLC

680 S FOURTH STREET
LOUISVILLE,KY40202
81-3725123
HC SRVC WA FHS
 
N/A 0 0   No     No 0 %
(35) GS HOME CARE Srvc of Vincenne IN LLC

1700 EDISON DR
MILFORD,OH45150
20-1792869
HOME HEALTH OH NA
 
N/A 0 0   No     No 0 %
(36) HC SL VINTAGE I LLC

18000 W SARAH LANE STE 250
BROOKFIELD,WI53045
27-0453767
PROPERTY HLDG WI SL HOSP-VINTAGE
 
N/A 0 0   No     No 0 %
(37) HC SUPPORT SERVICES LLC

PO BOX 9804
GRAND ISLAND,NE68802
72-1546196
LAUNDRY NE na
 
N/A 0 0   No     No 0 %
(38) Heartland Oncology LLC

2337 E Crawford St
Salina,KS67401
46-4265403
ONCOLOGY KS SCH
 
N/A 0 0   No     No 0 %
(39) LAKESIDE AMBULATORY SURG CTR LLC

17031 LAKESIDE HILLS DR
OMAHA,NE68130
20-4267902
AMBUL SURG CTR NE ACH
 
N/A 0 0   No     No 0 %
(40) LAKESIDE ENDOSCOPY CTR LLC

17001 LAKESIDE HILLS PLZ STE 201
OMAHA,NE68130
20-5544496
ENDOSCOPY SRVC NE ACH
 
N/A 0 0   No     No 0 %
(41) LINCOLN CK LEASING LLC

555 S 70TH STREET
Lincoln,NE68510
26-2496856
Real Estate NE SERMC
 
N/A 0 0   No     No 0 %
(42) Memorial Medical Plaza

3838 San Dimas STE B 201
Bakersfield,CA93301
36-4510880
Real estate CA BMH
 
N/A 0 0   No     No 0 %
(43) Mercy Davis Cancer CTR MGT Co LLC

2740 M Street
Merced,CA95340
94-3358445
mgt of Cancer CTR CA DH
 
N/A 0 0   No     No 0 %
(44) Mercy Rehabilitation Hospital LLC

680 S FOURTH STREET
LOUISVILLE,KY40202
81-4437201
HC SRVC TX CHI IA
 
N/A 0 0   No     No 0 %
(45) Military Road Properties LLC

181 S 333rd Street STE 250
Federal Way,WA98003
91-2067879
Real Estate WA NA
 
N/A 0 0   No     No 0 %
(46) NEBRASKA SPINE HOSPITAL LLC

6901 N 72ND ST STE 20300
OMAHA,NE68122
27-0263191
SPINE HOSPITAL NE ACH
 
N/A 0 0   No     No 0 %
(47) NICU Operating CO of Santa Cruz LLC

1555 Soquel DR
Santa Cruz,CA95065
46-0502935
Neonatal HC CA DH
 
N/A 0 0   No     No 0 %
(48) NORTH RIVER SURGERY CTR LLC

2209 WILDWOOD AVE
SHERWOOD,AR72120
71-0799771
AMBUL SURG CTR AR SVIMC
 
N/A 0 0   No     No 0 %
(49) NORTHERN PLAINS LABORATORY LLC

401 N 9 STREET
BISMARK,ND58501
84-1641341
Diagnostic SRVC ND SAMC
 
N/A 0 0   No     No 0 %
(50) NSC Channel Islands LLC

3000 Riverchase Galleria STE 500
Birmingham,AL35244
77-0418197
Ambul SURG CTR CA DCC
 
N/A 0 0   No     No 0 %
(51) OMG Arizona LLC

130 Sutter Street 2nd Flr
San Francisco,CA94104
47-1708588
Med Office AZ DCC
 
N/A 0 0   No     No 0 %
(52) ORTHOCOLORADO LLC

11650 WEST 2ND PLACE
LAKEWOOD,CO80228
37-1577105
ORTHO HOSPITAL CO CHIC
 
N/A 0 0   No     No 0 %
(53) Park Rapids Area Health Care

600 Pleasant ave S
Park Rapids,MN56470
20-4926259
HC SRVC MN NA
 
N/A 0 0   No     No 0 %
(54) Pasadena Urgency CTR LLC

4600 E SAM HOUSTON PKWY South
PASADENA,TX77505
81-2482854
URGENT CARE TX SLHS
 
N/A 0 0   No     No 0 %
(55) Patient Transport Services of Columbus

1700 EDISON DR
MILFORD,OH45150
26-4601285
Ambulance OH NA
 
N/A 0 0   No     No 0 %
(56) PENINSULA RADIATION ONCOLOGY LLC

314 MLK JR WAY STE 11
TACOMA,WA98405
87-0808610
HC SRVC WA FHS
 
N/A 0 0   No     No 0 %
(57) Penrad Imaging LLC

1390 Kelly Johnson Blvd
COLORADO SPRINGS,CO80920
84-1072619
Med Imaging CO CHIC
 
N/A 0 0   No     No 0 %
(58) Performance Med Equip & Respir SRVC LL

19625 62nd ave S STE 101
Kent,WA98032
45-2901632
Holding Company WA NA
 
N/A 0 0   No     No 0 %
(59) Plaza Surgery CTR LP

525 E Plaza DR STE 100
Santa Maria,CA93454
77-0573567
Surgery CA HSPCC Inc
 
N/A 0 0   No     No 0 %
(60) PMC HOSPITAL LLC

3100 MAIN ST STE 500
HOUSTON,TX77002
27-3280598
HOSPITAL TX SLHS
 
N/A 0 0   No     No 0 %
(61) Precision Medicine Alliance LLC

198 INVERNESS DR WEST
ENGLEWOOD,CO80112
35-2569159
Diag. SRVC CO NA
 
N/A 0 0   No     No 0 %
(62) Pueblo Ambulatory Surgery CTR LLC

25 Montebello Rd
Pueblo,CO81003
62-1488737
SURGERY CTR CO CHIC
 
N/A 0 0   No     No 0 %
(63) Radiation Oncology CTRs of Ventura Count

1700 N ROSE ave STE 120
OXNARD,CA93030
77-0191706
IMAGING CA DH
 
N/A 0 0   No     No 0 %
(64) RBR Management LLC

91 Corporate Park DR STE 120
Henderson,NV89074
27-1466450
Ambulance NV DH
 
N/A 0 0   No     No 0 %
(65) Reid-ANC Home Care Services LLC

1700 EDISON DR
MILFORD,OH45150
37-1454747
HOME HEALTH IN NA
 
N/A 0 0   No     No 0 %
(66) SAINT JOSEPH - SCA HOLDINGS LLC

1451 Harrodsburg RD
LEXINGTON,KY40503
45-3801157
OP SURGERY DE SJHS
 
N/A 0 0   No     No 0 %
(67) SAINT JOSEPH-ANC HOME CARE SERVICES

1700 EDISON DR
MILFORD,OH45150
26-3330545
HOME HEALTH KY CHINHC
 
N/A 0 0   No     No 0 %
(68) Santa Cruz Comprehensive Imaging LLC

1661 Soquel DR STE G
Santa Cruz,CA95065
01-0550623
Imaging CA DH
 
N/A 0 0   No     No 0 %
(69) Santa Cruz Land & Building LP

1555 Soquel DR
Santa Cruz,CA95065
77-0285236
REAL ESTATE CA DHS
 
N/A 0 0   No     No 0 %
(70) Santa Cruz Surgery CTR LLC

3003 PAUL SWEET RD
SANTA CRUZ,CA95065
77-0194916
SURGERY CA DH
 
N/A 0 0   No     No 0 %
(71) Southeastern Home Care LLC

1700 EDISON DR
MILFORD,OH45150
27-1219638
HOME HEALTH OH NA
 
N/A 0 0   No     No 0 %
(72) St Joseph's Surgery CTR LP

15305 Dallas PKWY STE 1600 LB 28
Addison,TX75001
20-1019390
Surgery TX Port City Op
 
N/A 0 0   No     No 0 %
(73) St Elizabeth Home Care Services LLC

1700 EDISON DR
MILFORD,OH45150
26-1236191
HOME HEALTH KY NA
 
N/A 0 0   No     No 0 %
(74) ST FRANCIS LAND COMPANY

5390 N ACADEMY BLVD STE 300
COLORADO SPRINGS,CO80918
26-3134100
REAL ESTATE CO CHIC
 
N/A 0 0   No     No 0 %
(75) ST LUKE'S DIAGNOSTIC CATH LAB LLP

6624 FANNIN ST STE 800
HOUSTON,TX77030
71-0959365
DIAGNOSTICS TX SLHS HOLDINGS
 
N/A 0 0   No     No 0 %
(76) ST LUKE'S LAKESIDE HOSPITAL LLC

6624 FANNIN STE 2505
HOUSTON,TX77030
30-0427437
HOSPITAL TX SL CDC-W
 
N/A 0 0   No     No 0 %
(77) ST LUKE'S THE WOODLANDS SLEEP CTR LLC

6624 FANNIN STE 800
HOUSTON,TX77030
46-2795726
DIAGNOSTICS TX SLHSH
 
N/A 0 0   No     No 0 %
(78) Templeton Surgery CTR LLC

1310 Las Tablas RD STE 104
Templeton,CA94365
20-2246616
Surgery CA DCC
 
N/A 0 0   No     No 0 %
(79) The Medical Pavilion at St John's

1700 Rose ave
Oxnard,CA93030
77-0332349
Real Estate CA DH
 
N/A 0 0   No     No 0 %
(80) THREE SPRING IMAGING LLC

1 Mercado St STE 200A
DURANGO,CO81301
81-3571570
HC SRVC CO CHIC
 
N/A 0 0   No     No 0 %
(81) Valley Phys SURG CTR At Northridge LLC

18330 Roscoe Blvd
Northridge,CA91328
80-0864336
Surgery CA DCC
 
N/A 0 0   No     No 0 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) AHCreighton St Joseph Mnged Care SRVC

12809 West Dodge Rd
Omaha,NE68154
47-0802396
Managed Care NE CHI Nebraska
 
C Corp 0 0 0 %   No
(2) All Saints Insurance Company SPC Ltd

PO BOX 10073 APO
Georgetown,GRAND CAYMANKY1-1001
CJ
98-0556913
Insurance CJ CSH
 
C Corp 0 0 0 %   No
(3) AH PROVIDERS OF BRAZOS Valley Inc

2801 FRANCISCAN DRIVE
BRYAN,TX77802
74-2466914
Healthcare TX SJSC
 
C Corp 0 0 0 %   No
(4) Alternative Insurance MGT SRVC Inc

3900 OLYMPIC BLVD STE 400
Erlanger,KY41018
84-1112049
MGT Services CO CSH
 
C Corp 0 0 0 %   No
(5) AMERICAN NURSING CARE Inc

1700 EDISON DR
MILFORD,OH45150
31-1085414
HOME HEALTH OH CHS
 
C Corp 0 0 0 %   No
(6) AMERIMED INC

1700 EDISON DR
MILFORD,OH45150
31-1158699
HOME HEALTH OH ANC
 
C Corp 0 0 0 %   No
(7) BC HOLDING COMPANY INC

1850 BLUEGRASS AVE
LOUISVILLE,KY40215
31-1542851
Fitness Club KY JHSMH
 
C Corp 0 0 0 %   No
(8) BrazoSport Health Alliance

1 WEST WAY COURT
LAKE JACKSON,TX77566
76-0518376
Health Care TX BRHS
 
C Corp 0 0 0 %   No
(9) Caduceus Medical Associates INC

5600 Brainerd Road Ste 500
Chattanooga,TN37411
62-1570736
Healthcare TN MHCS
 
C Corp 0 0 0 %   No
(10) Captive MGT Initiatives Ltd

PO BOX 10073 APO
Georgetown,GRAND CAYMANKY1-1001
CJ
98-0663022
Captive MGT CJ CSH
 
C Corp 0 0 0 %   No
(11) CHI CTR for Translational Research

198 INVERNESS DRIVE WEST
Englewood,CO80112
27-2269511
Research CO CSHRI
 
C Corp 0 0 0 %   No
(12) CHI SLH - Memor Condominium Assn Inc

1201 W Frank Ave
Lufkin,TX75904
83-4184717
Condo Assoc TX MHSET
 
C Corp 0 0 0 %   No
(13) ClearRiver Health

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-4495960
Insurance TN QCHPS
 
C Corp 0 0 0 %   No
(14) Coastal Surgical Specialists Inc

921 Oak Park Blvd Suite 101
Pismo Beach,CA93449
74-3000596
Healthcare CA DCC
 
S Corp 0 0 0 %   No
(15) Comcare SRVC Inc

5570 DTC Parkway
Englewood,CO80111
84-0904813
Inactive CO CHIC
 
C Corp 0 0 0 %   No
(16) Consolidated Health SRVC

1700 EDISON DR
MILFORD,OH45150
31-1378212
HOME HEALTH OH CSH
 
C Corp 0 0 0 %   No
(17) Des Moines Medical CTR Inc

1111 6TH AVE
Des Moines,IA50314
42-0837382
Real Estate IA CHI-IA Corp
 
C Corp 0 0 0 %   No
(18) Dignity Health Holding Corp

185 Berry Street Suite 300
San Francisco,CA94107
46-0675371
Holding Co NV DCC
 
C Corp 0 0 0 %   No
(19) DH Insurance Ltd (Cayman Island Corp)

PO Box 1051 KY1-1102
Grand Cayman Islands,Grand CaymanKY1-1001
CJ
98-1065338
Insurance CJ DH
 
C Corp 0 0 0 %   No
(20) Dignity Health Provider Resources Inc

185 Berry Street Suite 300
San Francisco,CA94107
47-3366764
Health Plan CA DCC
 
C Corp 0 0 0 %   No
(21) Diversified Health Resources Inc

100 MEDICAL DRIVE
LAKE JACKSON,TX77566
76-0222679
Health Care TX BRHS
 
C Corp 0 0 0 %   No
(22) First Initiatives Insurance LTD

PO BOX 10073 APO
Georgetown,GRAND CAYMANKY1-1001
CJ
98-0203038
Insurance CJ CSH
 
C Corp 0 0 0 %   No
(23) Franciscan City Urgent Care SRVS PS

C/O CPGUSA 1345 AVE OF THE AMERICAS
NEW YORK,NY10105
81-2174959
Healthcare NY FHS
 
C Corp 0 0 0 %   No
(24) Franciscan SRVC Inc

198 INVERNESS DRIVE WEST
Englewood,CO80112
23-2487967
Healthcare CO CSH
 
C Corp 0 0 0 %   No
(25) Good Samaritan Outreach SRVC

PO Box 1990
Kearney,NE68848
47-0659440
Medical Clinic NE CHI Nebraska
 
C Corp 0 0 0 %   No
(26) HarvestPlains Health of Iowa

32129 Weyerhaeuser Way S STE 201
FEDERAL WAY,WA98001
47-3451750
Insurance WA QCHPS
 
C Corp 0 0 0 %   No
(27) Health SRVC of the Pacific Cntrl Coast

1400 E Church Street
Santa Maria,CA93454
77-0074057
Healthcare CA DCC
 
C Corp 0 0 0 %   No
(28) Health Systems Enterprises Inc

PO BOX 1990
Kearney,NE68848
47-0664558
MGMT NE GSH
 
C Corp 0 0 0 %   No
(29) Healthcare MGMT SRVC Organization INC

1149 MARKET ST
Tacoma,WA98402
91-1865474
Health Org. WA FHS
 
C Corp 0 0 0 %   No
(30) HeartlandPlains Health

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-4368223
Insurance NE QCHPS
 
C Corp 0 0 0 %   No
(31) Highline Medical Group

1717 S J Street
Tacoma,WA98405
91-1407026
Medical SRVC WA HMC
 
C Corp 0 0 0 %   No
(32) Integrated Medical SRVC

9250 N 3rd Street Suite 4010
Phoenix,AZ85020
86-0783428
M/S phys. group AZ DCC
 
C Corp 0 0 0 %   No
(33) KOMG-Louisville Region Inc

201 Abraham Flexner Way
Louisville,KY40202
83-2481198
Healthcare KY JHSMH
 
C Corp 0 0 0 %   No
(34) MGT SRVC Organization of Santa Maria Inc

1400 E Church Street
Santa Maria,CA93454
77-0318135
Health Care Mgt CA DH
 
C Corp 0 0 0 %   No
(35) Med Office Bld Horizontal Prop Regime

300 Werner St
Hot Springs,AR71913
71-0720429
Real Estate AR CHI-SVHS
 
C Corp 0 0 0 %   No
(36) Medquest

1301 15TH AVENUE WEST
Williston,ND58801
45-0392137
Sale of DME ND MMC Williston
 
C Corp 0 0 0 %   No
(37) Memorial CV SRVC Line MGT Company LLC

1201 W Frank Ave
Lufkin,TX75904
46-3622849
Heath Care TX MHSET
 
C Corp 0 0 0 %   No
(38) Mercy Park Apartments LTD

1111 6th AVE
Des Moines,IA50314
42-1202422
Housing IA CHI-IA Corp
 
C Corp 0 0 0 %   No
(39) Mercy SRVC Corp

2700 STEWART PARKWAY
Roseburg,OR97471
93-0824308
Retail Sales OR MMC
 
C Corp 0 0 0 %   No
(40) MHI Clinical SRVC

1201 W Frank Ave
Lufkin,TX75904
46-1967952
Healthcare TX MHSET
 
C Corp 0 0 0 %   No
(41) Millennium Surgery CTR Inc

9300 Stockdale Hwy 200
Bakersfield,CA93311
77-0513445
Healthcare CA BMH
 
S Corp 0 0 0 %   No
(42) Mountain MGT SRVC Inc

6028 Shallowford Rd
Chattanooga,TN37421
62-1570739
MGT SVC ORG TN MHCS
 
C Corp 0 0 0 %   No
(43) North Central Health Care Alliance

PO Box 5538
Bismark,ND58506
45-0439894
Healthcare ND SAMC
 
C Corp 0 0 0 %   No
(44) PATIENT TRANSPORT SRVC INC

1700 EDISON DR
MILFORD,OH45150
31-1100798
HOME HEALTH OH ANC
 
C Corp 0 0 0 %   No
(45) QualChoice Advantage

32129 WEYERHAEUSER WAY S STE 201
FEDERAL WAY,WA98001
47-3433912
Insurance WA QCHPS
 
C Corp 0 0 0 %   No
(46) QualChoice Health Plan Services Inc

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-1224037
Admin SRVC CO QCHI
 
C Corp 0 0 0 %   No
(47) QCH Inc (fka CH Managed Solutions Inc

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-1222808
Holding Co CO CSH
 
C Corp 0 0 0 %   No
(48) QualChoice Holdings Inc

198 INVERNESS DRIVE WEST
Englewood,CO80112
27-4075520
Holding Co AR QCHPS
 
C Corp 0 0 0 %   No
(49) QualChoice of Nebraska

2401 S 73rd St
Omaha,NE68124
81-0738827
Inactive NE QCHPS
 
C Corp 0 0 0 %   No
(50) RiverLink Health

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-4380824
Insurance OH QCHPS
 
C Corp 0 0 0 %   No
(51) RiverLink Health of Kentucky Inc

198 INVERNESS DRIVE WEST
Englewood,CO80112
46-4828332
Insurance KY QCHPS
 
C Corp 0 0 0 %   No
(52) Ross Park Pharmacy Inc

380 SUMMIT AVE
STEUBENVILLE,OH43952
34-1832654
Pharmacy OH TSHS
 
C Corp 0 0 0 %   No
(53) Saint Clare's Primary Care Inc

198 INVERNESS DRIVE WEST
Englewood,CO80112
22-2441202
Billing SRVC NJ SCCC
 
C Corp 0 0 0 %   No
(54) SJH SRVC Corp

198 INVERNESS DRIVE WEST
Englewood,CO80112
23-2307408
Healthcare CO FSI
 
C Corp 0 0 0 %   No
(55) SJL PHYSICIAN MGT SRVC INC

424 LEWIS HARGETT CR STE 160
Lexington,KY40503
27-0164198
Management KY SJHS
 
C Corp 0 0 0 %   No
(56) SoundPath Health Inc

32129 Weyerhaeuser Way S STE 201
Federal Way,WA98001
42-1720801
Insurance WA QCHPS
 
C Corp 0 0 0 %   No
(57) St Mary Health Ventures Inc

1050 Linden Avenue
Long Beach,CA90813
95-1912528
Retail Pharm. CA DH
 
C Corp 0 0 0 %   No
(58) St Anthony Development Company

1415 Southgate
Pendleton,OR97801
93-1216943
Athletic Club OR SAH
 
C Corp 0 0 0 %   No
(59) St Joseph Development Company Inc

1717 SOUTH J ST
Tacoma,WA98405
91-1480569
Rental WA FSI
 
C Corp 0 0 0 %   No
(60) St Luke's Health System Holdings Inc

6624 Fannin STE 800
Houston,TX77030
76-0637138
Holding Co TX SLHS
 
C Corp 0 0 0 %   No
(61) St Vincent Community Health SRVC Inc

TWO ST VINCENT CIRCLE
Little Rock,AR72205
71-0710785
Healthcare AR SVIMC
 
C Corp 0 0 0 %   No
(62) STE Holdings

12809 West Dodge Rd
Omaha,NE68154
82-2383629
Holding Co NE SERMC
 
C Corp 0 0 0 %   No
(63) Sugar Land Doctor Group

1317 Lake Point Parkway
Sugar Land,TX77478
45-4270163
Medical Clinic TX SLCDC-SL
 
C Corp 0 0 0 %   No
(64) Towson MGT Inc

7601 OSLER DR
Towson,MD21204
52-1710750
Mgmt SRVC MD FSI
 
C Corp 0 0 0 %   No
(65) TRINITY MGT SRVC ORGANIZATION

380 SUMMIT AVE
STEUBENVILLE,OH43952
34-1471026
Mgmt SRVC OH THS
 
C Corp 0 0 0 %   No
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) ST CLARE COMMONS

L 4,061,392 BOOK
(2) FRANCISCAN CARE CENTER

L 2,798,554 BOOK
(3) MADONNA MANOR

L 207,213 BOOK
(4) PROVIDENCE CARE CENTER

L 200,592 BOOK
(5) ST LEONARD

L 384,692 BOOK

Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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


Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 2019

Additional Data


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