TY 2019 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
BRIGHTREE LLC, PO BOX 101513 ATLANTA,GA303921513	NONEMPLOYEE COMP	144,759
COURIER CONCEPTS, 5062 S 108TH ST 142 OMAHA,NE68137	NONEMPLOYEE COMP	120,801
MAXWELL HEALTHCARE ASSOCIATES LLC, 5910 RICE ROAD SUITE 450 SHOREVIEW,MN551265041	MEDICAL PAYMENTS	267,834


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 3

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

Attach to Form 990 or Form 990-EZ.
right arrow

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

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

CHI National Home Care

Employer identification number

45-1261716

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

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

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 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)		(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.") .	345,642	244,800	175,626	215,415	49,827	1,031,310
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	86,049,136	84,493,634	92,205,423	106,840,487	110,743,468	480,332,148
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....						0
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...						0
5	The value of services or facilities furnished by a governmental unit to the organization without charge						0
6	Total. Add lines 1 through 5	86,394,778	84,738,434	92,381,049	107,055,902	110,793,295	481,363,458
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons						0
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.						0
c	Add lines 7a and 7b..						0
8	Public support. (Subtract line 7c from line 6.)						481,363,458

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...	86,394,778	84,738,434	92,381,049	107,055,902	110,793,295	481,363,458
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..			14,038	118,132	95,366	227,536
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.			2,317			2,317
c	Add lines 10a and 10b.			16,355	118,132	95,366	229,853
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.						0
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..	362,447	26,842	86,727	22,404	14,797	513,217
13	Total support. (Add lines 9, 10c, 11, and 12.)..	86,757,225	84,765,276	92,484,131	107,196,438	110,903,458	482,106,528

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

99.846 %

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

99.670 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

0.048 %

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

0.030 %

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

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

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 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 (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2019

Name of the organization

CHI National Home Care

Employer identification number

45-1261716

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization CHI National Home Care

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization CHI National Home Care		Employer identification number 45-1261716

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 National Home Care			Employer identification number 45-1261716
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

CHI National Home Care

Employer identification number

45-1261716

Part I

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

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under 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.

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

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:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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

Part VI

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

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

1a	Land .....
b	Buildings ....
c	Leasehold improvements	2,244,695	1,208,463	1,036,232
d	Equipment ....	6,692,752	6,130,849	561,903
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,598,135

Schedule D (Form 990) 2019

Page 3

Part VII

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

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

Part VIII

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

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1)INVESTMENTS IN UNCONS. ORGS				15,772,225
(2)LEASE ASSETS				3,999,761
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				19,771,986

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
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	5,712,493
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

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference

Explanation

SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE

CHI NATIONAL HOME CARE'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH'S FIN 48 (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 THE 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 JUDGEMENT 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 BENEFITS 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:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

CHI National Home Care

Employer identification number

45-1261716

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes 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 .........

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? ..

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1DEAN SWINDLE CPA BOARD CHAIR (THRU AUG 2019)	(i) (ii)	0 ------------- 1,287,313	0 ------------- 1,597,821	0 ------------- 347,874	0 ------------- 16,397	0 ------------- 26,937	0 ------------- 3,276,342	0 ------------- 0
2DANIEL S DIETZ VICE CHAIR	(i) (ii)	0 ------------- 582,101	0 ------------- 711,340	0 ------------- 13,722	0 ------------- 8,400	0 ------------- 20,383	0 ------------- 1,335,946	0 ------------- 0
3MITCH MELFI ESQ TREASURER	(i) (ii)	0 ------------- 856,473	0 ------------- 624,970	0 ------------- 159,547	0 ------------- 15,625	0 ------------- 21,909	0 ------------- 1,678,524	0 ------------- 0
4CLIFF ROBERTSON MD SECRETARY	(i) (ii)	0 ------------- 1,062,248	0 ------------- 848,919	0 ------------- 360,407	0 ------------- 16,675	0 ------------- 29,608	0 ------------- 2,317,857	0 ------------- 136,676
5W SCOTT HERDTNER CHS CFO	(i) (ii)	0 ------------- 328,067	0 ------------- 279,270	0 ------------- 9,454	0 ------------- 8,428	0 ------------- 2,256	0 ------------- 627,475	0 ------------- 0
6ARTHUR RUNGE AREA DIRECTOR	(i) (ii)	154,331 ------------- 0	20,061 ------------- 0	429 ------------- 0	3,793 ------------- 0	1,642 ------------- 0	180,256 ------------- 0	0 ------------- 0
7JUDITH JOHNSON-KEYT AREA DIRECTOR	(i) (ii)	141,557 ------------- 0	12,892 ------------- 0	1,872 ------------- 0	4,876 ------------- 0	13,324 ------------- 0	174,521 ------------- 0	0 ------------- 0
8REBECCA OLIVA DIRECTOR, REHAB SERVICES	(i) (ii)	120,255 ------------- 0	29,505 ------------- 0	554 ------------- 0	4,746 ------------- 0	18,070 ------------- 0	173,130 ------------- 0	0 ------------- 0
9PAUL EDGETT BOARD CHAIR (AS OF OCT. 2019)	(i) (ii)	0 ------------- 848,293	0 ------------- 608,753	0 ------------- 174,561	0 ------------- 14,455	0 ------------- 32,663	0 ------------- 1,678,725	0 ------------- 0
10ANDREW ROBINSON AREA DIRECTOR	(i) (ii)	101,241 ------------- 0	48,405 ------------- 0	3,915 ------------- 0	6,415 ------------- 0	18,251 ------------- 0	178,227 ------------- 0	0 ------------- 0
11BENJAMIN BROWN DIRECTOR OF OPERATIONS	(i) (ii)	156,388 ------------- 0	8,387 ------------- 0	970 ------------- 0	0 ------------- 0	3,334 ------------- 0	169,079 ------------- 0	0 ------------- 0

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 - METHODS USED TO ESTABLISH CEO COMPENSATION

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 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 THE CHI DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAD MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION WERE ELIGIBLE TO RECEIVE THEIR 2019 CONTRIBUTIONS IN CASH DURING THE CALENDAR YEAR. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2019, THE FOLLOWING CONTRIBUTIONS AND ANY ASSOCIATED INVESTMENT INCOME, GAIN OR LOSS THAT WOULD HAVE BEEN MADE BY CHI TO THE DEFERRED COMPENSATION PLAN WERE PAID IN CASH: DEAN SWINDLE - $322,862 MITCH MELFI - $141,771

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

CHI National Home Care

Employer identification number

45-1261716

Return Reference	Explanation
FORM 990, PART I, LINE 1, CONT.	IN UNDESERVED AREAS. FORM 990, PART III, LINE 1 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. FORM 990, PART III, LINE 3 Effective June 30, 2020 the Home Medical Equipment service line was sold to Aerocare. CHI NHC no longer has any active HME locations.
FORM 990, PART III, LINE 4A	CHI NATIONAL HOME CARE IS PART OF COMMONSPIRIT HEALTH, AN IRC SEC. 501(C)(3) ORGANIZATION. COMMONSPIRIT HEALTH ("CSH"), A VALUES-BASED ORGANIZATION, IS THE ULTIMATE PARENT TO A HEALTHCARE SYSTEM COMPRISED OF 142 HOSPITALS; 31 CRITICAL ACCESS FACILITIES AND NUMEROUS LONG-TERM CARE, ASSISTED AND RESIDENTIAL LIVING FACILITIES, COMMUNITY HEALTH SYSTEMS AND HOSPITAL-BASED FOUNDATIONS LOCATED IN 21 STATES. IN THAT ROLE, CSH IS CHARGED WITH DEVELOPMENT OF NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL AND SOCIAL SERVICES; PROMOTING LEADERSHIP DEVELOPMENT AND FORMATION FOR THE MINISTRY THROUGHOUT THE ORGANIZATION; ADVOCATING FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED AND UNDERSERVED; AND STEWARDING RESOURCES BY PROVIDING COORDINATED MANAGEMENT AND STRATEGIC PLANNING SERVICES ALONG WITH CENTRALIZED SHARED SERVICES (E.G. PAYROLL, HUMAN RESOURCES, ACCOUNTS PAYABLE AND PURCHASING) FOR THE CSH HEALTHCARE MINISTRY. THE PURPOSE OF CHI NATIONAL HOME CARE WILL BE TO HOUSE COMMONSPIRIT HEALTH'S TAX-EXEMPT HOME HEALTH ACTIVITIES. AS CSH ACQUIRES FUTURE-TAX EXEMPT NATIONAL HOME CARE BUSINESS LINES, THE PARTNERSHIP OR MEMBERSHIP INTERESTS IN, OR ASSETS OF THOSE BUSINESSES, WOULD BE HELD BY CHI NATIONAL HOME CARE. THE CONSOLIDATION OF THE HOME CARE OPERATIONS WILL REDUCE VARIATION IN CLINICAL OUTCOMES, LOWER THE COST OF ADMINISTRATIVE AND BACK OFFICE SERVICES, ENHANCE GROWTH THROUGH THE STANDARDIZED MARKETING PROGRAM, AND ENHANCE OVERALL CORPORATE COMPLIANCE THROUGH STANDARDIZATION AND REVIEW. COMMONSPIRIT HEALTH HAS BEGUN TRANSITIONING EXISTING TAX-EXEMPT HOME HEALTH OPERATIONS ACROSS THE HEALTH CARE SYSTEM INTO AND UNDER THE COORDINATED MANAGEMENT OF CHI NATIONAL HOME CARE WHEREBY CSH HAS BEEN AVAILED OF EFFICIENCIES THROUGH CENTRALIZED MANAGEMENT AND STANDARDIZATION OF VARIOUS PRACTICE AND SUPPORT METHODOLOGIES. IN THE FUTURE, CHI NATIONAL HOME CARE WILL GRADUALLY TRANSITION MORE EXISTING HOME HEALTH CARE OPERATIONS, AS WELL AS ANY NEW HOME HEALTH OPERATIONS TO CHI NATIONAL HOME CARE, PROVIDED THE OPERATIONS ARE COMPATIBLE WITH THE MISSION, STRUCTURE AND CLINICAL TARGETED GOALS. THIS TRANSITION WILL ALLOW COMMONSPIRIT HEALTH TO ACHIEVE ECONOMIES OF SCALE IN ITS HOME CARE OPERATIONS AND INCREASE THE REACH OF HOME HEALTH OPERATIONS IN AREAS NOT CURRENTLY SERVED.
FORM 990, PART VI, LINE 1A	PURSUANT TO SECTION 8.1 OF THE BYLAWS OF CHI NATIONAL HOME CARE, THE BOARD OF DIRECTORS MAY, BY RESOLUTION ADOPTED BY A MAJORITY OF THE DIRECTORS THEN IN OFFICE, ESTABLISH ONE OR MORE COMMITTEES, AS NEEDED OR REQUIRED TO CONDUCT AND TRANSACT THE BUSINESS OF THE CORPORATION. EXCEPT AS OTHERWISE PROVIDED IN THIS CODE OF REGULATIONS, THE BOARD OF DIRECTORS MAY SET THE QUALIFICATIONS FOR MEMBERSHIP ON ANY COMMITTEE IT MAY ESTABLISH; PROVIDED THAT EACH COMMITTEE SHALL CONSIST OF AT LEAST TWO (2) DIRECTORS OF THE CORPORATION. COMMITTEES MAY INCLUDE PERSONS OTHER THAN DIRECTORS, EXCEPT THAT A COMMITTEE THAT HAS THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MUST INCLUDE ONLY DIRECTORS OF THE CORPORATION. MINUTES OF ALL COMMITTEE MEETINGS SHALL BE RECORDED AND COPIES OF SUCH MINUTES SHALL BE PROVIDED TO THE BOARD OF DIRECTORS. ACTIONS OF COMMITTEES SHALL BE REPORTED TO THE FULL BOARD OF DIRECTORS, BUT ACTIONS OF COMMITTEES WHICH INCLUDE PERSONS OTHER THAN DIRECTORS, SHALL BE SUBJECT TO RATIFICATION BY THE FULL BOARD OF DIRECTORS. PURSUANT TO SECTION 8.4 OF THE CORPORATION'S BYLAWS, STANDING COMMITTEES OF THE BOARD OF DIRECTORS MAY INCLUDE AN EXECUTIVE COMMITTEE AND SUCH OTHER STANDING COMMITTEES AS MAY BE ESTABLISHED BY THE BOARD OF DIRECTORS FROM TIME TO TIME. SPECIAL OR AD HOC COMMITTEES MAY BE ESTABLISHED BY THE BOARD OF DIRECTORS FOR SUCH FINITE TASKS AS CIRCUMSTANCES WARRANT. A SPECIAL OR AD HOC COMMITTEE SHALL LIMIT ITS ACTIVITIES TO THE ACCOMPLISHMENT OF THE TASKS FOR WHICH IT WAS APPOINTED AND SHALL HAVE NO POWER TO ACT EXCEPT AS SPECIFICALLY CONFERRED BY ACTION OF THE BOARD OF DIRECTORS. UPON COMPLETION OF THE TASKS FOR WHICH IT WAS CREATED AND AFTER MAKING A FINAL REPORT TO THE BOARD OF DIRECTORS, SPECIAL AND AD HOC COMMITTEES SHALL STAND DISCHARGED.
FORM 990, PART VI, LINE 6	THE ORGANIZATION'S SOLE CORPORATE MEMBER IS CHI NATIONAL SERVICES, A COLORADO NONPROFIT ORGANIZATION.
FORM 990, PART VI, LINE 7A	ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. (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. 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	THE ORGANIZATION'S CORPORATE MEMBER IS CHI NATIONAL SERVICES. PURSUANT TO SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, BOTH CHI NATIONAL SERVICES AND COMMONSPIRIT HEALTH (CHI NATIONAL SERVICES'S SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE COMMONSPIRIT HEALTH GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE CHI NATIONAL SERVICES BOARD: APPROVE MEMBERS OF CHI NATIONAL HOME CARE BOARD AMENDMENT OF THE CORPORATE DOCUMENTS OF CHI NATIONAL HOME CARE APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF CHI NATIONAL HOME CARE ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR CHI NATIONAL HOME CARE 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 NATIONAL HOME CARE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF CHI NATIONAL HOME CARE APPROVAL OF ISSUANCE OF DEBT BY CHI NATIONAL HOME CARE APPROVAL OF PARTICIPATION OF CHI NATIONAL HOME CARE IN A JOINT VENTURE APPROVAL OF FORMATION OF A NEW CORPORATION BY CHI NATIONAL HOME CARE APPROVAL OF A MERGER INVOLVING CHI NATIONAL HOME CARE APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHI NATIONAL HOME CARE TO REQUIRE THE TRANSFER OF ASSETS BY CHI NATIONAL HOME CARE TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, CHI NATIONAL SERVICES OR COMMONSPIRIT HEALTH MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE." (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	ONCE THE RETURN IS PREPARED, THE FORM 990 AND ACCOMPANYING SCHEDULES WERE MADE AVAILABLE TO ALL TRUSTEES EITHER ELECTRONICALLY OR BY HARD COPY, DEPENDING UPON THE TRUSTEES PREFERENCE, BEFORE THE COMPANY FINALIZED AND SENT THE DOCUMENTS TO THE IRS. THIS DRAFT WAS ALSO AVAILABLE AT THE ADMINISTRATIVE OFFICES OF THE REPORTING ENTITY FOR TRUSTEES' REVIEW BEFORE THE FINAL FORM 990 AND ACCOMPANYING SCHEDULES WERE FINALIZED AND SENT TO THE IRS. THE REVIEW WAS UNDER THE DIRECTION OF THE CFO AND/OR EXTERNAL TAX RETURN PREPARERS IF REQUESTED BY THE TRUSTEES. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX RETURN PREPARER FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
FORM 990, PART VI, LINE 12C	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	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 DURING THE TAX YEAR ENDED 6/30/2020, NO OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A.
FORM 990, PART VI, LINE 16B	CHI NATIONAL HOME CARE HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER COMMONSPIRIT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL OPERATING AGREEMENT INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; AND (4) RETURNS OF CAPITAL, ALLOCATIONS, AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNERS' RESPECTIVE OWNERSHIP INTERESTS. ANY JOINT VENTURE AGREEMENTS THAT DO NOT CONFORM TO THE MODEL AGREEMENT ARE GENERALLY REVIEWED BY COUNSEL.
FORM 990, PART VI, LINE 19	THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE COLORADO SECRETARY OF STATE'S WEBSITE. 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. FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG OR WWW.CATHOLICHEALTHINITIATIVES.ORG.
FORM 990, PART IX, LINE 9	Description of "other changes in Net Assets": Cumulative Effects of Changes: $(15,590)

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:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

CHI National Home Care

Employer identification number

45-1261716

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA,NE68154 47-0765154	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 LIVING COMMUNITIES 5942 RENAISSANCE PLACE STE A TOLEDO,OH43623 34-1892096	HEALTHCARE	OH	501(c)(3)	12 Type 1	SFH		No
(34)CHI Memorial Hospital - Georgia 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE,GA30742 82-2748395	HOSPITAL	GA	501(c)(3)	3	MHCS		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		No
(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		No
(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		No
(133)PROVIDENCE CARE CTRS 2025 HAYES AVE SANDUSKY,OH44870 34-1826099	HOLDING CO	OH	501(c)(3)	12 Type 1	CHILC		No
(134)PROVIDENCE RESIDENTIAL COMMUNITY CORP 5055 PROVIDENCE DR SANDUSKY,OH44870 34-1896807	LIVING COMM	OH	501(c)(3)	10	CHILC		No
(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		No
(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		No
(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		No
(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

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) 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	N/A	0	0		No			No	0 %
(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	RELATED	-78,742	1,117,629		No			No	50.000 %
(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	RELATED	3,704,951	28,542,201		No			No	96.900 %
(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) 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

Page 3

Part V

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

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

Yes

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

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

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

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

Yes

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

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

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

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

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

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

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

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

Yes

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

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

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

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

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

Yes

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

Yes

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

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

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

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

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

Schedule R (Form 990) 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

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: CHI NATIONAL HOME CARE WAS ORGANIZED TO MAXIMIZE THE EFFICIENCES OF CENTRALIZED MANAGEMENT FOR CHI'S SYSTEM-WIDE OPERATIONS TO INCREASE THE REACH OF HOME HEALTH OPERATIONS
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	3
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	834
6	Total number of volunteers (estimate if necessary) .............	6	95
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	215,415	2,199,535
9	Program service revenue (Part VIII, line 2g) .........	106,840,487	110,743,468
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	118,132	3,237,537
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	22,404	14,797
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	107,196,438	116,195,337
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	8,550	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	51,727,851	52,497,185
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	46,079,913	48,576,648
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	97,816,314	101,073,833
19	Revenue less expenses. Subtract line 18 from line 12.......	9,380,124	15,121,504
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	21,673,197	51,666,560
21	Total liabilities (Part X, line 26).............	21,811,949	36,699,398
22	Net assets or fund balances. Subtract line 21 from line 20.....	-138,752	14,967,162

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 89,933,159 including grants of $ ) (Revenue $ 110,758,265 )
	SEE SCHEDULE O

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 expenses89,933,159

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) DEAN SWINDLE CPA...................................................................... BOARD CHAIR (THRU AUG 2019)	1.0 ................. 49.0	X	X		0	3,233,008	43,334
(2) CLIFF ROBERTSON MD...................................................................... SECRETARY	1.0 ................. 49.0	X	X		0	2,271,574	46,283
(3) PAUL EDGETT...................................................................... BOARD CHAIR (AS OF OCT. 2019)	1.0 ................. 49.0	X	X		0	1,631,607	47,118
(4) MITCH MELFI ESQ...................................................................... TREASURER	1.0 ................. 49.0	X	X		0	1,640,990	37,534
(5) DANIEL S DIETZ...................................................................... VICE CHAIR	20.0 ................. 40.0	X	X		0	1,307,163	28,783
(6) W SCOTT HERDTNER...................................................................... CHS CFO	10.0 ................. 40.0		X		0	616,791	10,684
(7) ARTHUR RUNGE...................................................................... AREA DIRECTOR	40.0 ................. 0.0			X	174,821	0	5,435
(8) ANDREW ROBINSON...................................................................... AREA DIRECTOR	40.0 ................. 0.0			X	153,561	0	24,666
(9) JUDITH JOHNSON-KEYT...................................................................... AREA DIRECTOR	40.0 ................. 0.0			X	156,321	0	18,200
(10) REBECCA OLIVA...................................................................... DIRECTOR, REHAB SERVICES	40.0 ................. 0.0			X	150,314	0	22,816
(11) BENJAMIN BROWN...................................................................... DIRECTOR OF OPERATIONS	40.0 ................. 0.0			X	165,745	0	3,334

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	800,762	10,701,133	288,187

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	48,505
e	Government grants (contributions)		1e	2,149,708

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,322

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		2,199,535

		Business Code
2a	PATIENT SERVICES	900099	107,661,164	107,661,164	0	0
b	EQUITY CHANGES OF UNCONSOLIDATED ORGS	900099	3,082,304	3,082,304	0	0
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		110,743,468

3 Investment income (including dividends, interest, and othersimilar amounts) ......			95,366			95,366
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	0	6c
d	Net rental income or (loss).......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	3,142,171		7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)	3,142,171		7c
d	Net gain or (loss).........			3,142,171
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..			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..			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..			0
Business Code			Miscellaneous Revenue
11a	REIMBURSEMENT OF EXPENSES		900099	7,298	7,298	0	0
b	MISCELLANEOUS		900099	7,499	7,499	0	0
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			14,797
12	Total revenue. See instructions.....			116,195,337	110,758,265	0	95,366

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	42,747,299	39,914,614	2,832,685	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	347,326	347,326	0	0
9	Other employee benefits .......	6,372,711	5,189,519	1,183,192	0
10	Payroll taxes ...........	3,029,849	2,423,880	605,969	0
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	324,814	0	324,814	0
c	Accounting ...........	0
d	Lobbying ...........	0
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)	7,163,992	6,713,900	450,092	0
12	Advertising and promotion ....	144,736	0	144,736	0
13	Office expenses .......	1,830,460	733,458	1,097,002	0
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	1,685,283	104,728	1,580,555	0
17	Travel ............	2,092,913	2,092,913	0	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	21,135	0	21,135	0
21	Payments to affiliates .......	861,492	0	861,492	0
22	Depreciation, depletion, and amortization ..	516,115	346,817	169,298	0
23	Insurance ...	182,019	0	182,019	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	22,291,096	21,176,541	1,114,555	0
b	MISCELLANEOUS EXPENSES	10,546,175	10,018,866	527,309	0
c	REPAIRS & MAINTENANCE	514,931	489,184	25,747	0
d	RESTRUCTURING/IMP. LOSS	286,529	272,203	14,326	0
e	All other expenses	114,958	109,210	5,748
25	Total functional expenses. Add lines 1 through 24e	101,073,833	89,933,159	11,140,674	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			0	1	0
2	Savings and temporary cash investments .........			0	2	13,480,879
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			13,423,381	4	14,580,631
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 ............			1,527,680	8	1,847,032
9	Prepaid expenses and deferred charges ......			438,514	9	372,403
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	8,937,446
b	Less: accumulated depreciation	10b	7,339,311	1,642,538	10c	1,598,135
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			17,138	14	15,494
15	Other assets. See Part IV, line 11 ...........			4,623,946	15	19,771,986
16	Total assets. Add lines 1 through 15 (must equal line 33)...			21,673,197	16	51,666,560

17	Accounts payable and accrued expenses .....	17,296,996	17	22,311,661
18	Grants payable ...	0	18	0
19	Deferred revenue .........	2,881,661	19	8,675,244
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	1,633,292	25	5,712,493
26	Total liabilities. Add lines 17 through 25..	21,811,949	26	36,699,398

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	-138,752	27	14,967,162
28	Net assets with donor restrictions ...........	0	28	0
	Organizations that do not follow FASB ASC 958, check here 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 ...........	-138,752	32	14,967,162
33	Total liabilities and net assets/fund balances ........	21,673,197	33	51,666,560