TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) MICHAEL WEGNER...................................................................... DIRECTOR/MERCY ONE INTERIM PRESIDENT	1.00 ................. 40.00	X	X	1,286,950	39,835
(2) KARL KEELER...................................................................... PRESIDENT, CHI IOWA CORP (PARTIAL YEAR)	0.00 ................. 45.00		X	875,021	46,745
(3) RANDALL RUBIN...................................................................... SVP, CFO CHI IOWA CORP	0.00 ................. 55.00		X	582,795	43,599
(4) SHANNON COFIELD...................................................................... DIRECTOR/MERCYONE FOUNDATION PRESIDENT	1.00 ................. 40.00	X		322,969	28,350
(5) LAURA WENMAN...................................................................... BOARD MEMBER/MKT VP MISSION, CHI IA	1.00 ................. 40.00	X		301,058	45,779
(6) SOPHIA AHMAD...................................................................... DIRECTOR/MERCYONE FOUNDATION-DEV DIR	1.00 ................. 40.00	X		111,395	32,125
(7) REBECCA PETERSON...................................................................... DIRECTOR, HOM; TREASURER / SECRETARY	1.00 ................. 40.00	X	X	106,680	20,890
(8) JEFFREY BLOSSER...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(9) DENIS FRISCHMEYER...................................................................... DIRECTOR (PARTIAL YEAR)	1.00 ................. 0.00	X		0	0
(10) TRACI GALLIGAN...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(11) BRENDA KRUMEL...................................................................... BOARD CHAIR	1.00 ................. 0.00	X	X	0	0
(12) JANA RIEKER...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(13) TIMOTHY VINYARD MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(14) EDEN PEARSON...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(15) ERIK SORENSEN...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(16) MATT GUNS...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(17) ANTHONY FERGUSON...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0

- TIN:

SCHEDULE A
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

HOUSE OF MERCY

Employer identification number

42-1323808

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	4,616,326	3,220,033	5,123,539	6,018,531	3,715,052	22,693,481
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	4,616,326	3,220,033	5,123,539	6,018,531	3,715,052	22,693,481
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.						22,693,481

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
7	Amounts from line 4..	4,616,326	3,220,033	5,123,539	6,018,531	3,715,052	22,693,481
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	9,270	29,957	27,970	25,165	37,646	130,008
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.)..	190,333	195,591	129,510	137,827	110,789	764,050
11	Total support. Add lines 7 through 10						23,587,539

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

8,547,261

First 5 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 2021 (line 6, column (f) divided by line 11, column (f)) .........

96.210 %

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

96.020 %

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2021

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

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 0.015 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 0.035	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) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation
SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:	LABORATORY SERVICES - 2017 AMOUNT: $ 41,253. 2018 AMOUNT: $ 71,443. CAFETERIA - 2017 AMOUNT: $ 149,080. 2018 AMOUNT: $ 124,148. 2019 AMOUNT: $ 129,510. 2020 AMOUNT: $ 137,827. 2021 AMOUNT: $ 110,789.

Schedule A (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

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

2021

Name of the organization

HOUSE OF MERCY

Employer identification number

42-1323808

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) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization HOUSE OF MERCY

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) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization HOUSE OF MERCY		Employer identification number 42-1323808

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) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization HOUSE OF MERCY			Employer identification number 42-1323808
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) (2021)

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

2021

Open to Public Inspection

Name of the organization

HOUSE OF MERCY

Employer identification number

42-1323808

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) 2021

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 ....	23,121,637	20,253,704	20,152,279	19,731,576	2,819,520
b	Contributions ...					16,069,932
c	Net investment earnings, gains, and losses	-872,584	3,658,351	793,321	1,112,599	1,534,020
d	Grants or scholarships ...	691,895	790,418	691,896	691,896	691,896
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	21,557,158	23,121,637	20,253,704	20,152,279	19,731,576

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

Board designated or quasi-endowment SchDMd Bullet

93.000 %

Permanent endowment SchDMd Bullet

0 %

Term endowment SchDMd Bullet

7.000 %

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)

Yes

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

Yes

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

Part VI

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

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

1a	Land .....	4,250		4,250
b	Buildings ....	973,366	121,163	852,203
c	Leasehold improvements	2,109,492	1,926,746	182,746
d	Equipment ....	565,758	218,922	346,836
e	Other .....	245,352		245,352
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,631,387

Schedule D (Form 990) 2021

Page 3

Part VII

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

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

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	31,594
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) 2021

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
PART V, LINE 4:	MERCY FOUNDATION, A RELATED ORGANIZATION, HOLDS THE ENDOWMENTS FUNDS ON BEHALF OF HOUSE OF MERCY. MERCY FOUNDATION USES ENDOWMENT FUNDS AS DIRECTED BY THE ENDOWMENT DOCUMENTS. THE ENDOWMENTS FUND EQUIPMENT PURCHASES FOR TAX-EXEMPT HEALTHCARE NEEDS.
PART X, LINE 2:	HOUSE OF MERCY'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: 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) 2021

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

2021

Open to Public Inspection

Name of the organization

HOUSE OF MERCY

Employer identification number

42-1323808

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? .........

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) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1MICHAEL WEGNER DIRECTOR/MERCY ONE INTERIM PRESIDENT	(i) (ii)	0 ------------- 776,342	0 ------------- 487,996	0 ------------- 22,612	0 ------------- 17,275	0 ------------- 22,560	0 ------------- 1,326,785	0 ------------- 0
2KARL KEELER PRESIDENT, CHI IOWA CORP (PARTIAL YE	(i) (ii)	0 ------------- 566,383	0 ------------- 287,706	0 ------------- 20,932	0 ------------- 18,307	0 ------------- 28,438	0 ------------- 921,766	0 ------------- 0
3RANDALL RUBIN SVP, CFO CHI IOWA CORP	(i) (ii)	0 ------------- 465,287	0 ------------- 94,704	0 ------------- 22,804	0 ------------- 17,911	0 ------------- 25,688	0 ------------- 626,394	0 ------------- 0
4SHANNON COFIELD DIRECTOR/MERCYONE FOUNDATION PRESIDE	(i) (ii)	0 ------------- 254,584	0 ------------- 51,947	0 ------------- 16,438	0 ------------- 14,923	0 ------------- 13,427	0 ------------- 351,319	0 ------------- 0
5LAURA WENMAN BOARD MEMBER/MKT VP MISSION, CHI IA	(i) (ii)	0 ------------- 237,370	0 ------------- 47,583	0 ------------- 16,105	0 ------------- 18,431	0 ------------- 27,348	0 ------------- 346,837	0 ------------- 0

Schedule J (Form 990) 2021

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

PART 1, LINE 3:

COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CATHOLIC HEALTH INITIATIVES-IOWA CORP (CHI-IOWA CORP), A RELATED ORGANIZATION. CHI IOWA CORP USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) WRITTEN EMPLOYMENT CONTRACTS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.

PART 1, LINE 4A:

CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY.

Schedule J (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

HOUSE OF MERCY

Employer identification number

42-1323808

Return Reference	Explanation
FORM 990, PART III, LINE 4A:	I. INTRODUCTION: ORGANIZATION'S MISSION, VISION, AND TAX-EXEMPT PURPOSE IN 1988, IOWA RESIDENTS WERE CONFRONTED WITH DATA SHOWING A HIGH RATE OF INFANT MORTALITY IN DES MOINES AND POLK COUNTY. MANY CAUSES WERE CITED: SUBSTANCE ABUSE; PHYSICAL ABUSE; HOMELESSNESS; LACK OF PRENATAL CARE; LACK OF INSURANCE; AND, ALL TOO OFTEN, SIMPLY A LACK OF HOPE. IN RESPONSE TO THIS SITUATION, MERCY MEDICAL CENTER - DES MOINES AND THE SISTERS OF MERCY, FOUNDED "HOUSE OF MERCY." SISTER MARY BRIGID CONDON LED THE CHARGE, MODELING IT AFTER THE FIRST "HOUSE OF MERCY" FOUNDED IN DUBLIN, IRELAND BY SISTER CATHERINE MCCAULEY, FOUNDER OF THE SISTERS OF MERCY. LOCATED ON SIX ACRES OF LAND IN DES MOINES' INNER CITY, A FEDERALLY DESIGNATED ENTERPRISE COMMUNITY, HOUSE OF MERCY'S INITIAL FOCUS WAS ON ASSISTING PREGNANT, PARENTING, AND NON-PARENTING WOMEN IN DEVELOPING PERSONAL RESPONSIBILITY AND INDEPENDENCE THROUGH COUNSELING, EDUCATION, AND PRIMARY MEDICAL CARE IN COLLABORATION WITH OTHER PROVIDERS. OVER THE YEARS, HOUSE OF MERCY'S MISSION AND SERVICES HAVE EXPANDED TO ADDRESS THE UNMET HEALTH AND HUMAN SERVICE NEEDS OF THOSE IN THE COMMUNITY. TODAY, MERCYONE HOUSE OF MERCY IS ACTIVE IN ITS MISSION AND VISION TO PROVIDE PERSON-CENTERED, BEHAVIORAL HEALTH-FOCUSED SERVICES FOR PEOPLE WITH SUBSTANCE USE DISORDERS AND MENTAL ILLNESS (REGARDLESS OF GENDER AND PARENTING STATUS). HOUSE OF MERCY STRIVES TO EXCEED CLIENT EXPECTATIONS AND HELP THEM CREATE A HEALTHY LIFESTYLE AND SENSE OF PERSONAL SELF-WORTH AND WELL-BEING. IN KEEPING WITH THIS VISION HOUSE OF MERCY IS COMMITTED TO: * ENSURING THE SAFETY, HEALTH, AND WELL-BEING OF CHILDREN. * BUILDING HEALTHY FAMILIES. * SUPPORTING AT-RISK INDIVIDUALS IN THEIR DEVELOPMENT OF A POSITIVE SELF-REGARD. * ASSISTING CHEMICALLY DEPENDENT MEN AND WOMEN, OF ALL AGES, IN ACHIEVING AND MAINTAINING A LIFE OF QUALITY RECOVERY. * ASSISTING CHEMICALLY DEPENDENT INDIVIDUALS IN BECOMING SELF-SUFFICIENT THROUGH THE ENHANCEMENT OF THEIR EDUCATIONAL STATUS AND DEVELOPMENT OF THE SKILLS NECESSARY TO SEEK AND MAINTAIN MEANINGFUL EMPLOYMENT. * PROMOTING COMMUNITY BEHAVIORAL HEALTH THROUGH THE PROVISION OF QUALITY OUTPATIENT BEHAVIORAL HEALTH SERVICES TO MEN AND WOMEN OF ALL AGES. * PROVIDING WOMEN AND WOMEN WITH CHILDREN WITH SAFE, SECURE, THERAPEUTICALLY SUPPORTIVE HOUSING SERVICES. HOUSE OF MERCY IS INCLUDED IN THE OFFICIAL CATHOLIC DIRECTORY AS A TAX-EXEMPT ENTITY. SERVICES ARE PROVIDED TO THE COMMUNITY ON A NON-DISCRIMINATORY BASIS AND GOVERNED BY A BOARD IN WHICH INDEPENDENT PERSONS, REPRESENTATIVE OF THE COMMUNITY, COMPRISE THE MAJORITY. HOUSE OF MERCY RECEIVES FUNDING FROM GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS LIKE MEDICAID AND THE IOWA PROVIDER NETWORK. IN ADDITION TO BEING STATE LICENSED, TREATMENT SERVICES ARE ACCREDITED BY THE COUNCIL ON ACCREDITATION OF REHABILITATION FACILITIES (CARF) AND CHILDCARE SERVICES ARE ACCREDITED BY THE NATIONAL ASSOCIATION FOR THE EDUCATION OF YOUNG CHILDREN (NAEYC). QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT TREATMENT SERVICES PROJECT TOGETHER OFFERS RESIDENTIAL SUBSTANCE USE DISORDER TREATMENT AT HIGH INTENSITY (3.5), MEDIUM INTENSITY (3.3) AND LOW INTENSITY (3.1) TO HOMELESS/NON-HOMELESS, PREGNANT AND/OR PARENTING WOMEN WHO NEED ASSISTANCE WITH RECOVERY, SELF-SUFFICIENCY, PARENTING, AND LIFE SKILLS. HOUSE OF MERCY SUBSCRIBES TO A PHILOSOPHY OF CARE THAT FOCUSES ON ACCESS, ENGAGEMENT, RETENTION, AND OUTCOMES. ALL PARTICIPATING PERSONS IN RECOVERY HAVE ACCESS TO NOT ONLY SUBSTANCE USE DISORDER TREATMENT SERVICES BUT ALSO CO-OCCURRING TREATMENT ASSISTANCE (SUCH AS PROBLEM GAMBLING, MENTAL HEALTH, AND PHYSICAL HEALTH CONCERNS) THROUGH A RECOVERY-ORIENTED SYSTEM OF CARE. PARTICIPANTS WORK WITH A COUNSELOR TO DEVELOP AND IMPLEMENT AN INDIVIDUALIZED TREATMENT PLAN THAT COLLABORATIVELY ADDRESSES THE ISSUES WHICH BROUGHT THEM TO HOUSE OF MERCY. PROGRAMMING IS HOLISTIC IN SCOPE, RESEARCH/BEST PRACTICES-BASED, GENDER-SPECIFIC, AND UNIQUE IN THAT IT ALLOWS FOR MOTHERS TO PURSUE TREATMENT WHILE STILL RESIDING WITH THEIR CHILDREN. KEEPING MOTHERS AND THEIR CHILDREN TOGETHER OR REUNITING THEM AFTER A PROLONGED ABSENCE IS IMPORTANT TO THE HEALING PROCESS. PARTICIPANTS (AND THEIR CHILDREN) HAVE ACCESS TO: INDIVIDUAL AND GROUP THERAPY; 12-STEP MEETINGS; ASSERTIVENESS/COMMUNICATION EDUCATION; TRAUMA EDUCATION AND COUNSELING; MENTAL HEALTH COUNSELING; LIFE SKILLS EDUCATION; SMOKING EDUCATION AND CESSATION SERVICES; PRIMARY MEDICAL CARE (INCLUDING PRENATAL CARE); PRIMARY PEDIATRIC CARE (INCLUDING IMMUNIZATIONS); CHILD CARE; THERAPEUTIC INTERVENTIONS TO ADDRESS RELATIONSHIP, SEXUAL AND PHYSICAL ABUSE ISSUES; GENDER SPECIFIC SERVICES; URINALYSIS RELATED TO SUBSTANCE ABUSE SERVICES; AND, PARENTING EDUCATION AND SKILL DEVELOPMENT SESSIONS. WHEN PARTICIPANTS HAVE DEMONSTRATED PROGRESS AND STABILITY IN THE AREAS OF RECOVERY AND PARENTING, THEY EXPAND THEIR TREATMENT FOCUS TO INCLUDE SELF-SUFFICIENCY PROGRAMMING. THIS INCLUDES, BUT IS NOT LIMITED TO, HISET CLASSES AND COLLEGE COURSES, JOB SKILL TRAINING SESSIONS, EMPLOYMENT SEARCH INITIATIVES, MONEY MANAGEMENT AND DEBT REPARATION ACTIVITIES, ETC. ALL PROGRAMMING IS RESPECTFUL OF CLIENT ISSUES RELATED TO DIVERSITY INCLUDING LANGUAGE, CULTURE, RELIGION, ETHNICITY, AND DISABILITY. SPECIALIZED EFFORTS ARE DIRECTED TOWARDS PROVIDING SERVICES SENSITIVE TO THE NEEDS OF THOSE SERVED (E.G. INTERPRETER SERVICES, USE OF CULTURALLY SPECIFIC MEDIA, ETC.). DURING THE TIME PERIOD JULY 2021 THROUGH JUNE 2022: 378 WOMEN AND CHILDREN RECEIVED RESIDENTIAL SERVICES RESULTING IN 20,363 BED DAYS OF CARE BEING PROVIDED. HOUSE OF MERCY RECOVERY HOUSING ALLOWS PERSONS IN RECOVERY FROM A SUBSTANCE USE DISORDER WITH HIGH VULNERABILITY MORE TIME TO IMPROVE FUNCTIONING WHILE RESIDING IN AN AFFORDABLE, SAFE, CLEAN, AND SUPPORTIVE ENVIRONMENT. THE PROGRAM IS UNIQUELY DESIGNED TO ASSIST TENANTS IN LIVING AS INDEPENDENTLY AS POSSIBLE, IN A RECOVERY-BASED SETTING. SUPPORTIVE SERVICES THAT PROMOTE RESIDENTIAL STABILITY, INCREASED SKILL LEVEL AND/OR INCOME, AND GREATER SELF-DETERMINATION ARE PROVIDED/COORDINATED BY STAFF IN COLLABORATION WITH COMMUNITY PARTNERS. ALL PROGRAM PARTICIPANTS ARE ENCOURAGED TO: CONTINUE WORKING A POSITIVE RECOVERY PROGRAM INCLUDING SERVING AS A SUPPORT TO OTHER WOMEN IN THE PROGRAM; DEVELOP A SELF-SUFFICIENCY PROGRAM THAT HAS A FULL-TIME FOCUS ON EITHER EDUCATION, EMPLOYMENT OR A COMBINATION OF THE TWO; FURTHER DEVELOP CRITICAL LIFE SKILLS; AND ACHIEVE STABILITY WITH RESPECT TO DECISION MAKING, EMOTIONAL HEALTH CIRCUMSTANCES, AND RELATIONSHIP CHOICES. DURING THE TIME PERIOD JULY 2021 THROUGH JUNE 2022, 20 WOMEN AND CHILDREN PARTICIPATED IN THE PROGRAM. CHILD CARE PROGRAMMING HOUSE OF MERCY/JOHN R. GRUBB CHILD DEVELOPMENT CENTER IS A LICENSED AND NATIONALLY ACCREDITED CHILD-CARE FACILITY THAT SERVES THE CHILDREN OF HOUSE OF MERCY'S CLIENTELE. THE CENTER SERVES CHILDREN SIX WEEKS OLD THROUGH SCHOOL AGE. ON AVERAGE, TWENTY TO THIRTY PERCENT OF THE CHILDREN RESIDING AT HOUSE OF MERCY HAVE BEEN AFFECTED BY THE DRUG USE OF THEIR MOTHERS DURING PREGNANCY AND AS A RESULT HAVE SPECIAL NEEDS. SOME OF THESE CHILDREN ARE DEVELOPMENTALLY DELAYED AND SUFFER FROM FETAL ALCOHOL SYNDROME. ALL CHILDREN AT HOUSE OF MERCY QUALIFY AS AT-RISK CHILDREN. CHILDCARE SERVICES WERE PROVIDED TO 53 CHILDREN AT HOUSE OF MERCY DURING FY 2022. SERVICES PROVIDED BY THE CHILD DEVELOPMENT CENTER ARE AVAILABLE TO ANY CHILD OF A CLIENT PARTICIPATING IN HOUSE OF MERCY'S RESIDENTIAL TREATMENT PROGRAM. A LIMITED NUMBER OF CHILDCARE SLOTS ARE ALSO AVAILABLE TO CLIENTS PARTICIPATING IN OTHER HOUSE OF MERCY SERVICES. TEACHERS PROVIDE A NON-BIASED, MULTICULTURAL, DEVELOPMENTALLY APPROPRIATE CURRICULUM. DEVELOPMENTAL ASSESSMENTS ARE COMPLETED REGULARLY ON ALL OF THE CHILDREN TO SUPPORT THEIR INDIVIDUAL LEARNING PLANS. CHILDREN ARE OFFERED EXPERIENCES DESIGNED TO PROMOTE POSITIVE SELF-CONCEPT, SOCIAL SKILLS, CRITICAL THINKING/PROBLEM SOLVING, LANGUAGE DEVELOPMENT, PHYSICAL DEVELOPMENT, AND CREATIVE EXPRESSION. CHILD DEVELOPMENT CENTER STAFF ALSO WORK WITH THE CLIENTS TO ASSIST THEM IN ENHANCING THEIR EXISTING SKILLS AND DEVELOPING NEW, MORE EFFECTIVE PARENTING APPROACHES. PARENTING EDUCATION IS AGE SPECIFIC AND COMPLEMENTED BY A STRUCTURED DAILY "FAMILY ACTIVITY" THAT FOCUSES ON ASSISTING MOTHERS IN THE DEVELOPMENT OF THE SKILLS THEY REQUIRE TO INTERACT APPROPRIATELY WITH THEIR CHILDREN. (CONTINUED BELOW)
FORM 990, PART III, LINE 4A (CONTINUED):	COMMUNITY SERVICES PROGRAMMING OUTPATIENT COUNSELING SERVICES ARE AVAILABLE TO CHILDREN, ADOLESCENTS, AND ADULTS AND CONSIST OF: LEVEL 0.5, LEVEL I, AND LEVEL II.1 SUBSTANCE USE DISORDER TREATMENT SERVICES: INDIVIDUAL, FAMILY, AND GROUP MENTAL/BEHAVIORAL HEALTH SERVICES AND BEHAVIORAL HEALTH INTERVENTION SERVICES. HOUSE OF MERCY SUBSCRIBES TO A PHILOSOPHY OF CARE THAT FOCUSES ON ACCESS, ENGAGEMENT, RETENTION, AND OUTCOMES. ALL PARTICIPATING PERSONS IN RECOVERY HAVE ACCESS TO NOT ONLY SUBSTANCE ABUSE SERVICES BUT ALSO CO-OCCURRING ISSUES (SUCH AS PROBLEM GAMBLING, MENTAL HEALTH, AND PHYSICAL HEALTH CONCERNS) THROUGH A RECOVERY-ORIENTED SYSTEM OF CARE. SUBSTANCE USE DISORDER TREATMENT SERVICES ARE AVAILABLE TO ANY INDIVIDUAL (REGARDLESS OF AGE OR GENDER) WHO NEEDS SUPPORT TO ESTABLISH AND MAINTAIN A RECOVERY PROGRAM. ALL PARTICIPANTS WORK WITH A CERTIFIED ADDICTIONS COUNSELOR TO DEVELOP AND IMPLEMENT AN INDIVIDUALIZED TREATMENT PLAN. PARTICIPANTS ARE INVOLVED IN RESEARCH BASED/BEST PRACTICES CURRICULUM IN THE AREA OF RECOVERY (E.G. EDUCATION IN RELAPSE PREVENTION, EARLY RECOVERY SKILLS, TRAUMA AND RECOVERY). THEY RECEIVE INDIVIDUAL AND GROUP THERAPY; CASE MANAGEMENT SERVICES; AND, ENCOURAGED TO DEVELOP A SUPPORT SYSTEM WITHIN THE COMMUNITY UTILIZING THE 12-STEP PROGRAM, SMART RECOVERY, ETC. CLIENTS PARTICIPATING IN OUTPATIENT PROGRAMMING HAVE ACCESS TO A FLEXIBLE MENU OF SERVICES INCLUDING: INDIVIDUAL AND GROUP COUNSELING; CHEMICAL DEPENDENCY RELATED EDUCATIONAL OFFERINGS; TRAUMA EDUCATION AND COUNSELING; THERAPEUTIC INTERVENTIONS TO ADDRESS RELATIONSHIP, SEXUAL AND PHYSICAL ABUSE ISSUES; GENDER SPECIFIC SERVICES; URINALYSIS RELATED TO SUBSTANCE ABUSE SERVICES; PARENTING CLASSES, AND SELF-SUFFICIENCY ACTIVITIES (E.G., EDUCATION AND EMPLOYMENT ASSISTANCE). CONTINUING CARE GROUPS ARE OPEN TO ANYONE WHO COULD BENEFIT FROM HAVING ADDITIONAL THERAPEUTIC SUPPORT IN REINFORCING A POSITIVE RECOVERY OUTCOME. THESE GROUPS PROVIDE A GROUP THERAPY FORMAT THAT PARTICIPANTS CAN UTILIZE FOR SUPPORT AS THEY FACE THE DAILY CHALLENGES OF REINFORCING RECOVERY, PARENTING AND OVERALL LIVING SKILLS ON THEIR OWN. GROUP SESSIONS ARE FACILITATED BY STAFF THAT ARE ALSO AVAILABLE TO PROVIDE INDIVIDUAL THERAPY, AS WELL AS, CASE MANAGEMENT SERVICES. PARTICIPANTS ARE ENCOURAGED TO COMMIT TO THEIR CONTINUING CARE GROUP FOR AT LEAST ONE YEAR, SECONDARY TO DISCHARGE YET CAN CONTINUE TO ATTEND INDEFINITELY. DURING FY 2022 THERE WERE 1,502 INDIVIDUALS ASSESSED AND OF THOSE, 549 ADMITTED AND RECEIVED OUTPATIENT OR CONTINUING CARE SUBSTANCE USE DISORDER SERVICES ONE OR MORE TIMES THROUGH THIS PROGRAM. MENTAL AND BEHAVIORAL HEALTH SERVICES ARE PROVIDED BY MASTERS PREPARED, LICENSED THERAPISTS AND ARE AVAILABLE TO ANYONE WITH AN IDENTIFIED/DIAGNOSABLE MENTAL HEALTH OR BEHAVIORAL HEALTH NEED. A BOARD-CERTIFIED PSYCHIATRIST IS AVAILABLE TO PROVIDE TREATMENT OVERSIGHT, EVALUATE MEDICATION NEEDS, AND PROVIDE ADDITIONAL NEEDED MENTAL HEALTH SUPPORT. HOUSE OF MERCY MENTAL HEALTH TREATMENT SERVICES INCLUDE, BUT ARE NOT LIMITED TO, INDIVIDUAL, MARITAL, FAMILY, AND GROUP THERAPY SESSIONS, AS WELL AS PHARMACOLOGICAL INTERVENTIONS. BEHAVIORAL HEALTH INTERVENTION SERVICES (BHIS) ARE AVAILABLE TO CHILDREN AND ADULTS. BHIS ARE INTENDED TO BUILD SKILLS AND HELP REDUCE SYMPTOMS AND BEHAVIORS THAT ARE ASSOCIATED WITH A DIAGNOSED PSYCHOLOGICAL DISORDER. BHIS ARE SPECIFICALLY DESIGNED TO RESTORE MENTAL HEALTH FUNCTIONING THAT THE INDIVIDUAL LOST OR NEVER ACHIEVED BECAUSE OF INTERFERENCE IN THE NORMAL MATURATIONAL AND LEARNING PROCESS DUE TO INDIVIDUAL OR PARENTAL DYSFUNCTION. INDIVIDUALS RECEIVING BHIS BEGIN WITH A BEHAVIORAL HEALTH ASSESSMENT, WHICH WILL DETERMINE A DIAGNOSIS AND RECOMMENDATION FOR SERVICE. A TREATMENT PLAN IS THEN ESTABLISHED, WHERE GOALS AND OBJECTIVES ARE SPECIFICALLY LISTED AND OUTLINED. INDIVIDUAL INTERVENTIONS ARE PROVIDED THROUGH A PREDICTABLE SCHEDULE OF FORMAL SESSIONS THAT ARE DIRECTED AT THE COGNITIVE AND EMOTIONAL DYNAMICS THAT INFLUENCE BEHAVIOR. FAMILY INTERVENTIONS ENHANCE THE FAMILY'S ABILITY TO EFFECTIVELY INTERACT WITH THE CHILD AND SUPPORT THE CHILD'S FUNCTIONING. CRISIS INTERVENTIONS ARE UNSCHEDULED INTENSIVE INTERVENTIONS FOR THE PURPOSE OF RESTORING ADEQUATE CHILD OR FAMILY FUNCTIONING. DURING FY 2022 THERE WERE 655 ADULTS AND CHILDREN WHO RECEIVED OUTPATIENT MENTAL/BEHAVIORAL HEALTH SERVICES ONE OR MORE TIMES THROUGH THIS PROGRAM. STUDENT INTERNSHIPS AND EDUCATIONAL PROGRAMMING ARE PROVIDED BY HOUSE OF MERCY FOR STUDENTS FROM A VARIETY OF DISCIPLINES AS PART OF ITS MISSION AND PURPOSE. STUDENTS ARE PROVIDED DIVERSE "REAL LIFE" EXPERIENCES AS THEY WORK ON THEIR DEGREES, FROM ASSOCIATE OF ARTS TO GRADUATE LEVEL. A VARIETY OF HUMAN SERVICE AND HEALTH CARE RELATED PROFESSIONALS PARTICIPATE IN PROGRAMMING AT HOUSE OF MERCY IN ORDER TO GAIN VALUABLE EXPERIENCE IN REAL LIFE WORK SITUATIONS. HUMAN SERVICES RELATED LEARNING EXPERIENCES ARE AVAILABLE IN SUCH PROFESSIONAL DEGREE AREAS AS COUNSELING, ADDICTIONS, VOCATIONAL REHABILITATION, HUMAN SERVICES, MARRIAGE/FAMILY COUNSELING, CHILDREN AND FAMILY SERVICES, CHILD DEVELOPMENT, ETC. HOUSE OF MERCY PERSONNEL ARE ALSO AVAILABLE TO PROVIDE EDUCATIONAL PROGRAMS ON TOPICS RELATED TO THE VARIOUS PROGRAMS AND SERVICES OFFERED AT HOUSE OF MERCY. STAFF FREQUENTLY GUEST LECTURE AT AREA SCHOOLS, COLLEGES AND UNIVERSITIES AS A PART OF THE FACILITY'S COMMITMENT TO COMMUNITY EDUCATION AND OUTREACH.
FORM 990, PART V, LINE 1C:	PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 ARE ISSUED HOUSE OF MERCY. COMMONSPIRIT HEALTH FILES THE FORMS 1099 AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAME WINNINGS. THE FORMS 1099 ISSUED ON BEHALF OF HOUSE OF MERCY ARE REPORTED TO THE IRS.
FORM 990, PART VI, SECTION A, LINE 6	THE ORGANIZATION'S SOLE CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES - IOWA, CORP. DBA MERCY MEDICAL CENTER - DES MOINES, (CHI-IOWA CORP), AN IOWA NON-PROFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7A	ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY CHI-IOWA CORP, THE SOLE CORPORATE MEMBER. 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.
FORM 990, PART VI, SECTION A, LINE 7B	THE ORGANIZATION'S CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES-IOWA, CORP. DBA MERCY MEDICAL CENTER-DES MOINES ("CHI-IOWA CORP"). PURSUANT TO THE ORGANIZATION'S BYLAWS, BOTH CHI-IOWA CORP AND COMMONSPIRIT HEALTH (CATHOLIC HEALTH INITIATIVES - IOWA, CORP'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-IOWA CORP BOARD: * APPROVE MEMBERS OF THE HOUSE OF MERCY BOARD * AMENDMENT OF THE CORPORATE DOCUMENTS OF THE HOUSE OF MERCY * APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE HOUSE OF MERCY * ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR THE HOUSE OF MERCY 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 THE HOUSE OF MERCY * REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE HOUSE OF MERCY * APPROVAL OF ISSUANCE OF DEBT BY HOUSE OF MERCY * APPROVAL OF PARTICIPATION OF HOUSE OF MERCY IN A JOINT VENTURE * APPROVAL OF FORMATION OF A NEW CORPORATION BY HOUSE OF MERCY * APPROVAL OF A MERGER INVOLVING THE HOUSE OF MERCY * APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE HOUSE OF MERCY * TO REQUIRE THE TRANSFER OF ASSETS BY THE HOUSE OF MERCY TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. PURSUANT TO SECTION V OF THE ORGANIZATION'S BYLAWS, CHI-IOWA CORP 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, SECTION B, LINE 11B	ONCE THE RETURN IS PREPARED, THE CFO OF CATHOLIC HEALTH INITIATIVES-IOWA CORP D/B/A MERCY MEDICAL CENTER-DES MOINES ("MMC") REVIEWS THE RETURN AND ANY NECESSARY REVISIONS ARE INCLUDED IN THE FINAL VERSION WHICH IS APPROVED FOR FILING WITH THE IRS. MMC IS THE SOLE CORPORATE MEMBER. SUBSEQUENT TO REVIEW BY MMC'S CFO, THE RETURN IS FILED WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO.
FORM 990, PART VI, SECTION B, LINE 15	DURING THE TAX YEAR ENDED 6/30/2022, 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, SECTION C, LINE 19	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. THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATION DEPARTMENT, AND ON THE IOWA SECRETARY OF STATE'S WEBSITE. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE.
FORM 990, PART IX, LINE 11G	OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 4,184,641. MANAGEMENT AND GENERAL EXPENSES 93,197. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,277,838. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 164,420. MANAGEMENT AND GENERAL EXPENSES 8,654. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 173,074. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 21,156. MANAGEMENT AND GENERAL EXPENSES 1,113. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,269.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

HOUSE OF MERCY

Employer identification number

42-1323808

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)	LINE 3	ACH		No
(2)ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA,NE68154 47-0757164	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(3)ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA,NE68124 47-0484764	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(4)ALEGENT HEALTH-COMM MEM HOSPITAL OF MO VALLEY IA 631 N 8TH ST MISSOURI VALLEY,IA51555 42-0776568	HOSPITAL	IA	501(C)(3)	LINE 3	CHI NEBRASKA		No
(5)ALEGENT HEALTH-IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA,NE68122 47-0376615	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(6)ALEGENT HEALTH-MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER,NE68661 47-0399853	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(7)ALEGENT HEALTH-MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING,IA50841 42-0782518	HOSPITAL	IA	501(C)(3)	LINE 3	CHI NEBRASKA		No
(8)ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS,MN56345 41-1351177	LTERM CARE	MN	501(C)(3)	LINE 10	CSH		No
(9)APPLETREE COURT 601 OAK ST BRECKENRIDGE,MN56520 41-1850500	SENIOR LIVING	MN	501(C)(3)	LINE 10	SFH		No
(10)ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE,CA93420 20-3256066	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(11)BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD,CA93301 95-1802779	HOSPITAL	CA	501(C)(3)	LINE 3	DCC		No
(12)BARROW NEUROLOGICAL FOUNDATION 350 WEST THOMAS ROAD PHOENIX,AZ85013 86-0174371	FUNDRAISING FOUNDATION	AZ	501(C)(3)	LINE 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)	LINE 12A, I	SLHS		No
(14)BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0458535	PHYSICIANS	TX	501(C)(3)	LINE 3	BSLHV		No
(15)BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 23-2187242	INACTIVE	PA	501(C)(3)	LINE 12A, I	CSH		No
(16)BRAZOSPORT HEALTH FOUNDATION INC 100 MEDICAL DRIVE LAKE JACKSON,TX77566 76-0080110	FUNDRAISING FOUNDATION	TX	501(C)(3)	LINE 12A, I	TCHB		No
(17)BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON,TX77566 80-0240261	PHYSICIANS	TX	501(C)(3)	LINE 3	TCHB		No
(18)BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2759890	HOSPITAL	TX	501(C)(3)	LINE 3	SLH-CO		No
(19)BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2913931	REHABILITATION	TX	501(C)(3)	LINE 10	SJSC		No
(20)CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION 1401 SOUTH GRAND AVENUE LOS ANGELES,CA90015 95-4000909	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DCC		No
(21)CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON,ND58421 45-0227311	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(22)CATHOLIC HEALTH INITIATIVES - COLORADO 9100 EAST MINERAL CIRCLE CENTENNIAL,CO80112 84-0405257	HOSPITAL	CO	501(C)(3)	LINE 3	CSH		No
(23)CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES,IA50314 42-0680448	HOSPITAL	IA	501(C)(3)	LINE 3	CSH		No
(24)CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 9100 EAST MINERAL AVE CENTENNIAL,CO80112 84-0902211	FUNDRAISING FOUNDATION	CO	501(C)(3)	LINE 7	CHIC		No
(25)CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 1150 KELLY JOHNSON BLVD 204 COLORADO SPRINGS,CO80920 27-0930004	FUNDRAISING FOUNDATION	CO	501(C)(3)	LINE 12A, I	CSH		No
(26)CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-0992796	TELEHEALTH	CO	501(C)(3)	LINE 12A, I	CHI NS		No
(27)CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG,OR97471 26-3946191	SURGERY CENTER	OR	501(C)(3)	LINE 10	MMC - ROSEBURG		No
(28)CENTRAL CALIFORNIA HEALTH CENTERS 300 OLD RIVER ROAD STE 200 BAKERSFIELD,CA93311 84-4171789	CLINIC	CA	501(C)(3)	LINE 3	DCC		No
(29)CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND,KS67530 48-0543724	INACTIVE	KS	501(C)(3)	LINE 3	CSH		No
(30)CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO,ND58104 27-1966847	SENIOR LIVING	MN	501(C)(3)	LINE 10	CSH		No
(31)CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA,NE68154 47-0648586	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 7	ACH		No
(32)CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER,KY41018 20-2741651	INVESTMENTS	KY	501(C)(3)	LINE 12A, I	CSH		No
(33)CHI LIVING COMMUNITIES 930 S WYNN ROAD OREGON,OH43616 34-1892096	SENIOR LIVING	OH	501(C)(3)	LINE 12A, I	SFH-OH		No
(34)CHI MEMORIAL HOSPITAL - GEORGIA 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE,GA30742 82-2748395	HOSPITAL	GA	501(C)(3)	LINE 3	MHCS		No
(35)CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 45-1261716	HOME HEALTH	CO	501(C)(3)	LINE 10	CHI NS		No
(36)CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 45-2532084	HOLDING CO	CO	501(C)(3)	LINE 12A, I	CSH		No
(37)CHI NEBRASKA 12809 WEST DODGE ROAD OMAHA,NE68510 36-3233121	HOLDING CO	NE	501(C)(3)	LINE 12A, I	CSH		No
(38)CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER,PA17602 23-2342997	HEALTHCARE	PA	501(C)(3)	LINE 12A, I	CSH		No
(39)CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE,NM87102 71-0897107	COMMUNITY	NM	501(C)(3)	LINE 12A, I	CSH		No
(40)CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS,AR71913 71-0236913	HOSPITAL	AR	501(C)(3)	LINE 3	CHI-SVHS		No
(41)CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS,AR71913 26-1125064	HOLDING CO	AR	501(C)(3)	LINE 12A, I	SVIMC		No
(42)CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 300 WERNER ST HOT SPRINGS,AR71913 26-1125131	PHYSICIANS	AR	501(C)(3)	LINE 3	CHI-SVHS		No
(43)COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 47-0617373	HEALTHCARE	CO	501(C)(3)	LINE 12A, I	N/A		No
(44)COMMONSPIRIT HEALTH FOUNDATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 85-3374038	FUNDRAISING FOUNDATION	CO	501(C)(3)	LINE 7	CSH		No
(45)COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL LLC 185 BERRY STREET STE 200 SAN FRANCISCO,CA94107 85-0919176	OPERATING INVESTMENTS	DE	501(C)(3)	LINE 12A, I	CSH		No
(46)COMMONSPIRIT HEALTH RESEARCH INSTITUTE 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 27-1050565	RESEARCH	CO	501(C)(3)	LINE 12A, I	CSH		No
(47)COMMUNITY HOSPITAL OF SAN BERNARDINO 1805 MEDICAL CENTER DRIVE SAN BERNARDINO,CA92411 95-1643373	HOSPITAL	CA	501(C)(3)	LINE 3	DCC		No
(48)COMMUNITY LIMITED CARE DIALYSIS CENTER 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI,OH45202 23-7419853	HOLDING CO	OH	501(C)(2)		GSH		No
(49)COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION 631 N 8TH ST MISSOURI VALLEY,IA51555 42-1294399	FUNDRAISING FOUNDATION	IA	501(C)(3)	LINE 12A, I	AH-CMHMV		No
(50)CONTINUING CARE HOSPITAL ONE SAINT JOSEPH DRIVE LEXINGTON,KY40504 61-1400619	HOSPITAL	KY	501(C)(3)	LINE 3	SJHS		No
(51)DIGNITY COMMUNITY CARE 185 BERRY STREET STE 200 SAN FRANCISCO,CA94107 81-5009488	HOSPITAL	CO	501(C)(3)	LINE 3	CSH		No
(52)DIGNITY HEALTH 185 BERRY STREET STE 200 SAN FRANCISCO,CA94107 94-1196203	HOSPITAL	CA	501(C)(3)	LINE 3	CSH		No
(53)DIGNITY HEALTH CONNECTED LIVING 200 MERCY OAKS DRIVE REDDING,CA96003 23-7115371	SENIOR CENTER SERVICES	CA	501(C)(3)	LINE 7	DH		No
(54)DIGNITY HEALTH FOUNDATION 185 BERRY STREET STE 200 SAN FRANCISCO,CA94107 46-2037641	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(55)DIGNITY HEALTH FOUNDATION - INLAND EMPIRE 2101 N WATERMAN AVENUE SAN BERNARDINO,CA92404 23-7440086	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(56)DIGNITY HEALTH FOUNDATION EAST VALLEY 475 SOUTH DOBSON ROAD CHANDLER,AZ85224 74-2418514	FUNDRAISING FOUNDATION	AZ	501(C)(3)	LINE 12A, I	DH		No
(57)DIGNITY HEALTH MEDICAL FOUNDATION 3400 DATA DRIVE RANCHO CORDOVA,CA95670 68-0220314	MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC	CA	501(C)(3)	LINE 12A, I	DCC		No
(58)DOMINICAN HEALTH SERVICES 1555 SOQUEL DRIVE SANTA CRUZ,CA95065 77-0056778	COMMUNITY HEALTH SYSTEM	CA	501(C)(3)	LINE 12A, I	DH		No
(59)DOMINICAN HOSPITAL FOUNDATION 1555 SOQUEL DRIVE SANTA CRUZ,CA95065 94-2450442	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(60)DOMINICAN OAKS CORPORATION 1555 SOQUEL DRIVE SANTA CRUZ,CA95065 77-0127719	OPERATION AND MANAGEMENT OF HOUSING COMPLEX TO ELDERLY PERSONS	CA	501(C)(3)	LINE 10	DHS		No
(61)EAST TEXAS CLINICAL SERVICES 101 VISION PARK SUITE 100 SHENANDOAH,TX77384 45-4736213	HEALTHCARE	TX	501(C)(3)	LINE 12A, I	SLHS		No
(62)ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1455 BATTERSBY AVE ENUMCLAW,WA98022 91-0715805	HOSPITAL	WA	501(C)(3)	LINE 3	FHS		No
(63)FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN,KY40004 61-1345363	HOSPITAL	KY	501(C)(3)	LINE 3	KOH		No
(64)FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN,KY40004 56-2351341	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 12A, I	FH		No
(65)FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO,OH43623 34-1931806	HEALTHCARE	OH	501(C)(3)	LINE 10	CHILC		No
(66)FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA,WA98405 91-1145592	FUNDRAISING FOUNDATION	WA	501(C)(3)	LINE 10	FHS		No
(67)FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA,WA98405 91-0564491	HOSPITAL	WA	501(C)(3)	LINE 3	CSH		No
(68)FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA,WA98402 91-1939739	PHYSICIANS	WA	501(C)(3)	LINE 10	FHS		No
(69)FRENCH HOSPITAL MEDICAL CENTER FOUNDATION 1911 JOHNSON AVENUE SAN LUIS OBISPO,CA93401 20-3256125	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DCC		No
(70)GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON,ND58540 45-0227752	HOSPITAL	ND	501(C)(3)	LINE 3	SAMC		No
(71)GLENDALE MEMORIAL HEALTH FOUNDATION 1420 SOUTH CENTRAL AVENUE GLENDALE,CA91204 95-3625651	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DCC		No
(72)GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 20-1536108	INACTIVE	CO	501(C)(3)	LINE 12A, I	CSH		No
(73)GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI,OH45202 31-1778403	EDUCATION	OH	501(C)(3)	LINE 2	GSH		No
(74)GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY,NE68848 47-0379755	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(75)GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY,NE68847 47-0659443	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 7	GSH-KN		No
(76)GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI,OH45202 31-1206047	FUNDRAISING FOUNDATION	OH	501(C)(3)	LINE 12A, I	GSH		No
(77)HARRISON MEDICAL CENTER 2520 CHERRY AVE BREMERTON,WA98310 91-0565546	HOSPITAL	WA	501(C)(3)	LINE 3	FHS		No
(78)HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 76-0761782	FUNDRAISING FOUNDATION	MN	501(C)(3)	LINE 12A, I	SFMC-MN		No
(79)HOUSE OF MERCY 1111 6TH AVE DES MOINES,IA50314 42-1323808	ASSISTED LIVING	IA	501(C)(3)	LINE 7	CHI-IA CORP		No
(80)JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC ONE SAINT JOSEPH DRIVE LEXINGTON,KY40504 61-1029768	HOSPITAL	KY	501(C)(3)	LINE 3	KOH		No
(81)KENTUCKYONE HEALTH MEDICAL GROUP INC 100 E LIBERTY ST STE 800 LOUISVILLE,KY40202 61-1352729	PHYSICIANS	KY	501(C)(3)	LINE 10	JHSMH		No
(82)KENTUCKYONE HEALTH INC ONE SAINT JOSEPH DRIVE LEXINGTON,KY40504 61-1029769	HEALTHCARE	KY	501(C)(3)	LINE 12A, I	CSH		No
(83)LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE,MN56623 41-0758434	HOSPITAL	MN	501(C)(3)	LINE 3	CSH		No
(84)LAKEWOOD REGIONAL HEALTHCARE FOUNDATION 600 MAIN AVE S BAUDETTE,MN56623 41-1893795	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 7	LHC		No
(85)LEGACY FOUNDATION OF KENTUCKIANA INC 1451 HARRODSBURG RD STE D-308 LEXINGTON,KY40504 83-2170324	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 12A, I	KOH		No
(86)LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON,ND58054 82-0558836	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(87)LUFKIN VISION ACQUISITIONS PO BOX 1447 LUFKIN,TX75901 82-0563768	PROPERTY MGMT	TX	501(C)(3)	LINE 12A, I	MHSET		No
(88)MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2761145	HOSPITAL	TX	501(C)(3)	LINE 3	SLH-CO		No
(89)MADONNA MANOR INC 2344 AMSTERDAM ROAD VILLA HILLS,KY51017 61-0654635	ASSISTED LIVING	KY	501(C)(3)	LINE 10	CHILC		No
(90)MARIAN REGIONAL MEDICAL CENTER FOUNDATION 1400 E CHURCH STREET SANTA MARIA,CA93454 95-3818027	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(91)MARK TWAIN MEDICAL CENTER 768 MOUNTAIN RANCH ROAD SAN ANDREAS,CA95249 68-0127677	HOSPITAL	CA	501(C)(3)	LINE 3	DCC		No
(92)MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC 2525 DE SALES AVE CHATTANOOGA,TN37404 62-1839548	FUNDRAISING FOUNDATION	TN	501(C)(3)	LINE 7	MHCS		No
(93)MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVE CHATTANOOGA,TN37404 62-0532345	HOSPITAL	TN	501(C)(3)	LINE 3	CSH		No
(94)MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD RD STE 500 CHATTANOOGA,TN37411 03-0417049	HEALTHCARE	TN	501(C)(3)	LINE 10	MHCS		No
(95)MEMORIAL HEALTH SYSTEM OF EAST TEXAS PO BOX 1447 LUFKIN,TX75902 75-0755367	HOSPITAL	TX	501(C)(3)	LINE 3	SLH-CO		No
(96)MEMORIAL MEDICAL CENTER-LIVINGSTON PO BOX 1447 LUFKIN,TX75902 76-0436439	HOSPITAL	TX	501(C)(3)	LINE 3	SLH-CO		No
(97)MEMORIAL MEDICAL CENTER-SAN AUGUSTINE PO BOX 1447 LUFKIN,TX75902 75-2663904	HOSPITAL	TX	501(C)(3)	LINE 3	SLH-CO		No
(98)MEMORIAL MULTISPECIALTY ASSOCIATES 1201 FRANK AVE LUFKIN,TX75904 75-2721155	PHYSICIANS	TX	501(C)(3)	LINE 12A, I	MHSET		No
(99)MEMORIAL SPECIALTY HOSPITAL PO BOX 1447 LUFKIN,TX75902 75-2492741	INACTIVE	TX	501(C)(3)	LINE 3	MHSET		No
(100)MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVE DES MOINES,IA50314 42-6076069	AUXILIARY	IA	501(C)(3)	LINE 12A, I	MF-DM IA		No
(101)MERCY CLINICS INC 1111 6TH AVE DES MOINES,IA50314 42-1193699	PHYSICIANS	IA	501(C)(3)	LINE 10	CHI-IA CORP		No
(102)MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVE DES MOINES,IA50314 42-1511682	EDUCATION	IA	501(C)(3)	LINE 2	CHI-IA CORP		No
(103)MERCY FOUNDATION BAKERSFIELD PO BOX 119 BAKERSFIELD,CA93302 77-0201321	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(104)MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVE DES MOINES,IA50314 23-7358794	FUNDRAISING FOUNDATION	IA	501(C)(3)	LINE 7	CHI-IA CORP		No
(105)MERCY FOUNDATION INC 2700 STEWART PKWY ROSEBURG,OR97471 93-6088946	FUNDRAISING FOUNDATION	OR	501(C)(3)	LINE 7	MMC - ROSEBURG		No
(106)MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING,IA50841 42-1461064	FUNDRAISING FOUNDATION	IA	501(C)(3)	LINE 12A, I	AHMH-CORNING		No
(107)MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BLVD VALLEY CITY,ND58072 45-0435338	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 12A, I	MHVC		No
(108)MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DR COUNCIL BLUFFS,IA51503 42-1178204	FUNDRAISING FOUNDATION	IA	501(C)(3)	LINE 12A, I	AHBMHS		No
(109)MERCY HOSPITAL OF DEVILS LAKE 1031 7TH ST NE DEVILS LAKE,ND58301 45-0227012	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(110)MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 7TH ST NE DEVILS LAKE,ND58301 35-2367360	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 7	MHDL		No
(111)MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BLVD VALLEY CITY,ND58072 45-0226553	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(112)MERCY MCMAHON TERRACE 3865 J STREET SACRAMENTO,CA95816 68-0117340	SENIOR CITIZEN'S HOUSING/RETIREMENT COMMUNITIES	CA	501(C)(3)	LINE 10	DH		No
(113)MERCY MEDICAL CENTER 1301 15TH AVE WEST WILLISTON,ND58801 45-0231183	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(114)MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE,IA52544 42-0680308	HOSPITAL	IA	501(C)(3)	LINE 3	CHI-IA CORP		No
(115)MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON,IA50314 42-1470935	HOSPITAL	IA	501(C)(3)	LINE 3	CHI-IA CORP		No
(116)MERCY MEDICAL CENTER MERCED FOUNDATION 301 E 13TH STREET MERCED,CA95340 77-0035928	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(117)MERCY MEDICAL CENTER INC 2700 STEWART PKWY ROSEBURG,OR97471 93-0386868	HOSPITAL	OR	501(C)(3)	LINE 3	CSH		No
(118)MERCY MEDICAL FOUNDATION 1301 15TH AVE WEST WILLISTON,ND58801 45-0381803	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 12A, I	MMC WILLISTON		No
(119)NEBRASKA HEART HOSPITAL 7500 S 91ST ST LINCOLN,NE68526 39-2031968	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(120)NORTHLAND HEALTHCARE ALLIANCE 2223 EAST ROSSER AVENUE BISMARCK,ND58501 91-1845296	MANAGEMENT	ND	501(C)(3)	LINE 7	SAMC		No
(121)NORTHRIDGE HOSPITAL FOUNDATION 18300 ROSCOE BLVD NORTHRIDGE,CA91328 23-7444901	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DCC		No
(122)OAKES COMMUNITY HOSPITAL 1200 N 7TH ST OAKES,ND58474 45-0231675	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(123)OAKES COMMUNITY HOSPITAL FOUNDATION 1200 N 7TH ST OAKES,ND58474 71-0966606	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 12A, I	OCH		No
(124)PACIFIC CENTRAL COAST HEALTH CENTERS 1400 E CHURCH STREET SANTA MARIA,CA93454 77-0447575	CLINIC	CA	501(C)(3)	LINE 3	DCC		No
(125)PINEYWOODS MEDICAL DEVELOPMENT CORP PO BOX 1447 LUFKIN,TX75902 75-2493116	PROPERTY MGMT	TX	501(C)(3)	LINE 12A, I	MHSET		No
(126)PORT CITY OPERATING COMPANY LLC 3400 DATA DRIVE RANCHO CORDOVA,CA95670 46-5322209	HOSPITAL	CA	501(C)(3)	LINE 3	DH		No
(127)PROVIDENCE CARE CENTER 2025 HAYES AVENUE SANDUSKY,OH44870 34-1658625	LTERM CARE	OH	501(C)(3)	LINE 10	CHILC		No
(128)PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION 5055 PROVIDENCE DRIVE SANDUSKY,OH44870 34-1896807	LIVING COMM	OH	501(C)(3)	LINE 10	CHILC		No
(129)SAINT CLARE'S COMMUNITY CARE INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 22-2876836	INACTIVE	NJ	501(C)(3)	LINE 12B, II	SCHS		No
(130)SAINT CLARE'S HEALTH SERVICES INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 22-3639733	INACTIVE	NJ	501(C)(3)	LINE 10	CSH		No
(131)SAINT CLARE'S HOSPITAL INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 22-3319886	INACTIVE	NJ	501(C)(3)	LINE 3	SCHS		No
(132)SAINT ELIZABETH FOUNDATION 555 S 70TH ST LINCOLN,NE68510 47-0625523	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 7	SERMC		No
(133)SAINT ELIZABETH HEALTH SERVICES 555 S 70TH ST LINCOLN,NE68510 36-3233120	INACTIVE	NE	501(C)(3)	LINE 3	SERMC		No
(134)SAINT ELIZABETH REGIONAL MEDICAL CENTER 555 S 70TH ST LINCOLN,NE68510 47-0379836	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(135)SAINT FRANCIS MEDICAL CENTER 2620 W FAIDLEY GRAND ISLAND,NE68803 47-0376601	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(136)SAINT FRANCIS MEDICAL CENTER FOUNDATION PO BOX 9804 GRAND ISLAND,NE68802 47-0630267	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 7	SFMC-NE		No
(137)SAINT FRANCIS MEMORIAL HOSPITAL 900 HYDE STREET SAN FRANCISCO,CA94109 94-1156295	HOSPITAL	CA	501(C)(3)	LINE 3	DCC		No
(138)SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC 305 ESTILL ST BEREA,KY40403 26-0152877	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 7	SJHS		No
(139)SAINT JOSEPH HEALTH SYSTEM INC ONE ST JOSEPHS DRIVE LEXINGTON,KY40504 61-1334601	HOSPITAL	KY	501(C)(3)	LINE 3	KOH		No
(140)SAINT JOSEPH HOSPITAL FOUNDATION INC 701 BOB OLINK DR 200 LEXINGTON,KY40504 61-1159649	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 12A, I	SJHS		No
(141)SAINT JOSEPH LONDON FOUNDATION INC 1001 SAINT JOSEPH LANE LONDON,KY40741 26-0438748	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 7	SJHS		No
(142)SAINT JOSEPH MOUNT STERLING FOUNDATION INC 225 FALCON DR MOUNT STERLING,KY40353 27-2884584	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 7	SJHS		No
(143)SAINT JOSEPH'S HOSPITAL FOUNDATION 2500 FAIRWAY STREET DICKINSON,ND58601 36-3418207	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 12A, I	SJHHC		No
(144)SAN GABRIEL VALLEY MEDICAL CENTER FOUNDATION 438 WEST LAS TUNAS DRIVE SAN GABRIEL,CA91776 95-3430341	INACTIVE	CA	501(C)(3)	LINE 12A, I	DH		No
(145)SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC 104 W 17TH ST SCHUYLER,NE68661 36-3630014	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 12A, I	AHMHS		No
(146)SIERRA NEVADA MEMORIAL-MINERS HOSPITAL 155 GLASSON WAY GRASS VALLEY,CA95945 94-1439787	HOSPITAL	CA	501(C)(3)	LINE 3	DCC		No
(147)SJRMC JOPLIN MISSOURI 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 44-0545809	INACTIVE	MO	501(C)(3)	LINE 3	CSH		No
(148)ST FRANCIS FOUNDATION OF SANTA BARBARA 2323 DE LA VINA ST SUITE 104 SANTA BARBARA,CA93105 23-7137119	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(149)ST FRANCIS HOSPITAL SUPPORT CORPORATION 601 E MICHELTORENA STREET SANTA BARBARA,CA93103 77-0022302	INACTIVE	CA	501(C)(3)	LINE 12A, I	DH		No
(150)ST JOHNS HEALTHCARE FOUNDATION 1600 NORTH ROSE AVENUE OXNARD,CA93030 20-2865781	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(151)ST JOSEPHS FOUNDATION (PHOENIX) 350 WEST THOMAS ROAD PHOENIX,AZ85013 94-2941245	FUNDRAISING FOUNDATION	AZ	501(C)(3)	LINE 12A, I	DH		No
(152)ST JOSEPHS FOUNDATION OF SAN JOAQUIN 1800 N CALIFORNIA STREET STOCKTON,CA95204 51-0432777	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(153)ST MARY MEDICAL CENTER FOUNDATION 1050 LINDEN AVENUE LONG BEACH,CA90813 23-7153876	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(154)ST MARY PROFESSIONAL BUILDING INC 1050 LINDEN AVENUE LONG BEACH,CA90813 23-7373088	INACTIVE	CA	501(C)(3)	LINE 12A, I	DH		No
(155)ST MARYS MEDICAL CENTER FOUNDATION 450 STANYAN STREET SAN FRANCISCO,CA94117 94-3336143	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DH		No
(156)ST ROSE DOMINICAN HEALTH FOUNDATION 3001 ST ROSE PARKWAY HENDERSON,NV89052 88-0349432	FUNDRAISING FOUNDATION	NV	501(C)(3)	LINE 12A, I	DH		No
(157)ST ALEXIUS MEDICAL CENTER 900 EAST BROADWAY AVENUE BISMARCK,ND58501 45-0226711	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(158)ST ANNE OC 1145 BROADWAY PLAZA STE 1200 TACOMA,WA98402 86-3590968	INACTIVE	WA	501(C)(3)	LINE 10	FHS		No
(159)ST ANTHONY HOSPITAL 2801 ST ANTHONY WAY PENDLETON,OR97801 93-0391614	HOSPITAL	OR	501(C)(3)	LINE 3	CSH		No
(160)ST ANTHONY HOSPITAL FOUNDATION 2801 ST ANTHONY WAY PENDLETON,OR97801 93-0992727	FUNDRAISING FOUNDATION	OR	501(C)(3)	LINE 12A, I	SAH		No
(161)ST ANTHONY'S HOSPITAL ASSOCIATION FOUR HOSPITAL DR MORRILTON,AR72110 71-0245507	HOSPITAL	AR	501(C)(3)	LINE 3	SVIMC		No
(162)ST CATHERINE HOSPITAL 401 EAST SPRUCE ST GARDEN CITY,KS67846 48-0543721	HOSPITAL	KS	501(C)(3)	LINE 3	CSH		No
(163)ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION 401 EAST SPRUCE ST GARDEN CITY,KS67846 20-0598702	FUNDRAISING FOUNDATION	KS	501(C)(3)	LINE 12A, I	SCH		No
(164)ST CLARE COMMONS 12469 FIVE POINT ROAD TOLEDO,OH43551 27-0163752	LIVING COMM	OH	501(C)(3)	LINE 10	CHILC		No
(165)ST DOMINIC OF ONTARIO OREGON 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 93-0433692	INVESTMENTS	OR	501(C)(4)		CSH		No
(166)ST FRANCIS HOME 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 41-0729978	LTERM CARE	MN	501(C)(3)	LINE 10	CSH		No
(167)ST FRANCIS LIFE CARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 22-2536017	INACTIVE	NJ	501(C)(3)	LINE 8	SCHS		No
(168)ST FRANCIS MEDICAL CENTER 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 41-0695598	HOSPITAL	MN	501(C)(3)	LINE 3	CSH		No
(169)ST JOSEPH FOUNDATION OF BRYAN TEXAS 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2351158	FUNDRAISING FOUNDATION	TX	501(C)(3)	LINE 12A, I	SJSC		No
(170)ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2847594	LTERM CARE	TX	501(C)(3)	LINE 10	SJSC		No
(171)ST JOSEPH MEDICAL CENTER INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 52-0591461	INACTIVE	MD	501(C)(3)	LINE 3	CSH		No
(172)ST JOSEPH PHYSICIAN ASSOCIATES 2801 FRANCISCAN DRIVE BRYAN,TX77802 20-3159302	PHYSICIANS	TX	501(C)(3)	LINE 3	SJSC		No
(173)ST JOSEPH PHYSICIAN ENTERPRISE INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 52-1311775	INACTIVE	MD	501(C)(3)	LINE 12A, I	SJMC		No
(174)ST JOSEPH REGIONAL HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-1282696	HOSPITAL	TX	501(C)(3)	LINE 3	SLH-CO		No
(175)ST JOSEPH REGIONAL HEALTH PARTNERS 2801 FRANCISCAN DRIVE BRYAN,TX77802 45-4088170	HOSPITAL	TX	501(C)(3)	LINE 3	SJSC		No
(176)ST JOSEPH REGIONAL HEALTH PARTNERS ACO 2801 FRANCISCAN DRIVE BRYAN,TX77802 46-3265423	HEALTHCARE	TX	501(C)(3)	LINE 10	SJSC		No
(177)ST JOSEPH SERVICES CORPORATION 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2455161	MANAGEMENT	TX	501(C)(3)	LINE 12A, I	SLHS		No
(178)ST JOSEPH'S AREA HEALTH SERVICES 600 PLEASANT AVE PARK RAPIDS,MN56470 41-0695603	HOSPITAL	MN	501(C)(3)	LINE 3	CSH		No
(179)ST JOSEPH'S HOSPITAL AND HEALTH CENTER 2500 FAIRWAY ST DICKINSON,ND58601 45-0226429	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(180)ST LEONARD 8100 CLYO ROAD CENTERVILLE,OH45458 34-1940863	LIVING COMM	OH	501(C)(3)	LINE 10	CHILC		No
(181)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-1947374	HOSPITAL	TX	501(C)(3)	LINE 3	SLH-CO		No
(182)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-0335902	HOSPITAL	TX	501(C)(3)	LINE 3	SLHS		No
(183)ST LUKE'S COMMUNITY HEALTH SERVICES 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0536234	HOSPITAL	TX	501(C)(3)	LINE 3	SLH-CO		No
(184)ST LUKE'S FOUNDATION 1213 HERMANN DRIVE STE 855 HOUSTON,TX77004 45-3811485	FUNDRAISING FOUNDATION	TX	501(C)(3)	LINE 7	SLHS		No
(185)ST LUKE'S HEALTH CLINICAL OPERATIONS 6624 FANNIN ST STE 2505 HOUSTON,TX77030 27-3733278	HOSPITAL	TX	501(C)(3)	LINE 3	SLHS		No
(186)ST LUKE'S HEALTH SYSTEM CORP PO BOX 20269 HOUSTON,TX77225 76-0536232	MANAGEMENT	TX	501(C)(3)	LINE 12A, I	CSH		No
(187)ST LUKE'S HOSPITAL AT THE VINTAGE 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-3734606	HOSPITAL	TX	501(C)(3)	LINE 3	SLH-CO		No
(188)ST LUKE'S PROPERTIES CORPORATION 1213 HERMANN DRIVE STE 855 HOUSTON,TX77004 76-0531716	PROPERTY MGMT	TX	501(C)(3)	LINE 12A, I	SLHS		No
(189)ST LUKE'S SUGAR LAND PROPERTIES CORPORATION 6624 FANNIN ST STE 2505 HOUSTON,TX77030 45-4120549	PROPERTY MGMT	TX	501(C)(3)	LINE 12A, I	SLCDC-SL		No
(190)ST MARY'S COMMUNITY HOSPITAL 1301 GRUNDMAN BOULEVARD NEBRASKA CITY,NE68410 47-0443636	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(191)ST MARY'S HOSPITAL FOUNDATION 1301 GRUNDMAN BLVD NEBRASKA CITY,NE68410 47-0707604	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 7	SMCH		No
(192)ST VINCENT FOUNDATION TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 51-0169537	FUNDRAISING FOUNDATION	AR	501(C)(3)	LINE 12A, I	SVIMC		No
(193)ST VINCENT INFIRMARY MEDICAL CENTER TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0236917	HOSPITAL	AR	501(C)(3)	LINE 3	CSH		No
(194)ST VINCENT MEDICAL GROUP TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0830696	PHYSICIANS	AR	501(C)(3)	LINE 10	SVIMC		No
(195)SYLVANIA FRANCISCAN HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 34-1412964	HOLDING CO	OH	501(C)(3)	LINE 12A, I	CSH		No
(196)SYLVANIA FRANCISCAN HEALTH FOUNDATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 45-5357161	INACTIVE	OH	501(C)(3)	LINE 12A, I	SFH-OH		No
(197)THE COMMONS OF PROVIDENCE 5000 PROVIDENCE DRIVE SANDUSKY,OH44870 34-1826097	ASSISTED LIVING	OH	501(C)(3)	LINE 10	CHILC		No
(198)THE COMMUNITY HOSPITAL OF BRAZOSPORT 100 MEDICAL DRIVE LAKE JACKSON,TX77566 74-1385192	HOSPITAL	TX	501(C)(3)	LINE 3	SLH-CO		No
(199)THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI,OH45202 31-0537486	HOSPITAL	OH	501(C)(3)	LINE 3	CSH		No
(200)THE PHYSICIAN NETWORK 2000 Q ST STE 500 LINCOLN,NE68503 47-0780857	PHYSICIANS	NE	501(C)(3)	LINE 12A, I	CHI NEBRASKA		No
(201)TOTAL HEALTHCARE 9100 E MINERAL CIRCLE CENTENNIAL,CO80112 84-0927232	INACTIVE	CO	501(C)(3)	LINE 3	CHIC		No
(202)TRINITY HEALTH FOUNDATION 380 SUMMIT AVENUE STEUBENVILLE,OH43952 31-1329423	FUNDRAISING FOUNDATION	OH	501(C)(3)	LINE 12A, I	THS		No
(203)TRINITY HEALTH SYSTEM 380 SUMMIT AVENUE STEUBENVILLE,OH43952 34-1818681	HEALTHCARE	OH	501(C)(3)	LINE 12A, I	N/A		No
(204)TRINITY HOSPITAL TWIN CITY 819 NORTH FIRST STREET DENNISON,OH44621 27-5401105	HOSPITAL	OH	501(C)(3)	LINE 3	THS		No
(205)TRI-STATE HEALTH SERVICES INC ONE ROSS PARK BLVD STEUBENVILLE,OH43952 34-1522484	ASSISTED LIVING	OH	501(C)(3)	LINE 7	THS		No
(206)UNITY FAMILY HEALTHCARE 815 SE 2ND ST LITTLE FALLS,MN56345 41-0721642	HOSPITAL	MN	501(C)(3)	LINE 3	CSH		No
(207)VILLA NAZARETH INC 801 PAGE DR FARGO,ND58103 45-0226714	LTERM CARE	ND	501(C)(3)	LINE 10	CSH		No
(208)VISITING NURSE ASSOCIATION OF ST CLARE'S INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 22-1768334	INACTIVE	NJ	501(C)(3)	LINE 10	SCHS		No
(209)YAVAPAI COMMUNITY HOSPITAL ASSOCIATION 1003 WILLOW CREEK ROAD PRESCOTT,AZ86301 86-0098923	HOSPITAL	AZ	501(C)(3)	LINE 3	DCC		No
(210)YAVAPAI REGIONAL MEDICAL CENTER FOUNDATION 1003 WILLOW CREEK ROAD PRESCOTT,AZ86301 86-1038463	FUNDRAISING FOUNDATION	AZ	501(C)(3)	LINE 12A, I	YRMC		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(k) Percentage ownership
(1) AMERICAN MERCY HOME CARE LLC 6281 TRI RIDGE BLVD STE 300 LOVELAND,OH45150 83-0486150	HOME HEALTH	OH	N/A	N/A				No			No
(2) ARIZONA CARE NETWORK - NEXT LLC 4222 E THOMAS RD STE 400 PHOENIX,AZ85018 47-4696671	CARE NETWORK	AZ	N/A	N/A				No			No
(3) ARIZONA CARE NETWORK LLC (ACN LLC) 4222 E THOMAS RD STE 400 PHOENIX,AZ85013 45-4494682	CARE NETWORK	AZ	N/A	N/A				No			No
(4) ARIZONA DIAGNOSTIC RADIOLOGY GROUP LLC 1510 COTNER AVENUE LOS ANGELES,CA90025 85-1067265	DIAGNOSTIC SERVICES	CA	N/A	N/A				No			No
(5) AUDUBON LAND COMPANY LLC 630 SOUTHPOINTE COURT 200 COLORADO SPRINGS,CO80906 84-1513085	REAL ESTATE	CO	N/A	N/A				No			No
(6) BAYLOR CHI ST LUKES HEALTH SERVICES LLC 3100 MAIN STE 566 HOUSTON,TX77002 47-2079184	HEALTHCARE SRVC	TX	N/A	N/A				No			No
(7) BERGAN MERCY SURGERY CENTER LLC 7500 MERCY RD STE 4300 OMAHA,NE68124 20-8671994	AMBUL SURG CTR	NE	N/A	N/A				No			No
(8) BERYWOOD OFFICE PROPERTIES LLC 2501 CITICO AVENUE CHATTANOGA,TN37404 62-1875199	PHYS OFFICE	TN	N/A	N/A				No			No
(9) BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD 709 WING ON PLAZA 62 MODY ROAD TS HONG KONG CH	HEALTH SERVICES	CH	N/A	N/A				No			No
(10) BLUEGRASS REGIONAL IMAGING CENTER 1218 SOUTH BROADWAY STE 310 LEXINGTON,KY40504 61-1386736	DIAGNOSTIC IMAGING	KY	N/A	N/A				No			No
(11) CBCC OUTSMARTING CANCER LLC 6501 TRUXTUN AVENUE BAKERSFIELD,CA93309 46-1602286	RADIATION / ONCOLOGY	CA	N/A	N/A				No			No
(12) CENTRAL NEBRASKA REHABILITATION SVCS LLC 3004 W FAIDLEY AVE GRAND ISLAND,NE68803 81-0653461	PHYSICAL THERAPY	NE	N/A	N/A				No			No
(13) CENTURA SUMMIT ORTHOPEDICS LLC 68 SCHOOL RD FRISCO,CO80443 87-1308304	HEALTHCARE SRVC	CO	N/A	N/A				No			No
(14) CHICAMSURG SURGERY CENTERS LLC 1A BURTON HILLS BLVD NASHVILLE,TN37215 46-5683027	SURGERY CENTER	CO	N/A	N/A				No			No
(15) COLORADO SPRINGS CK LEASING LLC 630 SOUTHPOINTE COURT 200 COLORADO SPRINGS,CO80906 26-2982714	REAL ESTATE	CO	N/A	N/A				No			No
(16) COMMUNITY MERCY HOME CARE OF SPRINGFLD LLC 6281 TRI RIDGE BLVD 300 LOVELAND,OH45150 31-1746556	HOME HEALTH	OH	N/A	N/A				No			No
(17) DE JV LLC 8686 NEW TRAILS DRIVE THE WOODLANDS,TX77381 32-0496548	EMERGENCY CARE	NV	N/A	N/A				No			No
(18) DHHP SURGERY CENTERS LLC 1513 S GRAND AVENUE STE 350 LOS ANGELES,CA90015 83-1847466	SURGERY	DE	N/A	N/A				No			No
(19) DHRT HOLDINGS LLC 185 BERRY STREET SUITE 200 SAN FRANCISCO,CA94107 35-2484591	HOLDING COMPANY	DE	N/A	N/A				No			No
(20) DIGNITY- GOHEALTHURGENT CARE MANAGEMENT LLC 5555 GLENRIDGE CONNECTOR SUITE 700 ATLANTA,GA30342 35-2548698	MANAGEMENT SERVICES	DE	N/A	N/A				No			No
(21) DIGNITY HEALTH AT HOME LLC 6281 TRI RIDGE BLVD STE 300 LOVELAND,OH45150 82-4674115	HEALTHCARE SRVC	DE	N/A	N/A				No			No
(22) DIGNITY HEALTH SPECIALTY PHARMACY LLC 185 BERRY STREET SUITE 200 SAN FRANCISCO,CA94107 32-0589462	SPECIALTY PHARMACY SERVICES	DE	N/A	N/A				No			No
(23) DIGNITY HOME RECOVERY CARE LLC 49 MUSIC SQUARE WEST SUITE 401 NASHVILLE,TN37203 83-2832522	HOME RECOVERY PROGRAM	DE	N/A	N/A				No			No
(24) DIGNITYUSP LAS VEGAS SURGERY CENTERS LLC 14201 DALLAS PARKWAY DALLAS,TX75254 20-2999237	SURGERY	TX	N/A	N/A				No			No
(25) DIGNITYUSP NORCAL SURGERY CENTERS LLC 14201 DALLAS PARKWAY DALLAS,TX75254 20-2468509	SURGERY	TX	N/A	N/A				No			No
(26) DIGNITYUSP PHOENIX SURGERY CENTERS LLC 14201 DALLAS PARKWAY DALLAS,TX75254 13-4248908	SURGERY	TX	N/A	N/A				No			No
(27) DIGNITYUSPJOHN MUIR EAST BAY SURG CTRS LLC 14201 DALLAS PARKWAY DALLAS,TX75254 35-2584991	SURGERY	TX	N/A	N/A				No			No
(28) DIGNITY-ABRAZO HEALTH NETWORK LLC 4222 E THOMAS RD STE 400 PHOENIX,AZ85018 46-5477985	MANAGEMENT SERVICES	AZ	N/A	N/A				No			No
(29) DOMINICAN MAGNETIC RESONANCE IMAGING CENTER 1545 SOQUEL DRIVE SANTA CRUZ,CA94065 77-0095477	IMAGING CENTER	CA	N/A	N/A				No			No
(30) ECCS ACQUISITION COMPANY LLC 2940 NORTH CIRCLE DRIVE COLORADO SPRINGS,CO80909 35-2656413	AMBUL SURG CTR	CO	N/A	N/A				No			No
(31) ENDOSCOPY CENTER OF ARKANSAS 1024 NORTH UNIVERSITY AVE LITTLE ROCK,AR72207 20-1337002	DIAGNOSTIC SERVICES	AR	N/A	N/A				No			No
(32) FOLSOM SIERRA ENDOSCOPY CENTER LP 1671 CREEKSIDE DRIVE SUITE 100 FOLSOM,CA95630 68-0482416	ENDOSCOPY	CA	N/A	N/A				No			No
(33) FRANCISCAN MEDICAL PAVILION BONNEY LAKE LLC 6622 WOLLOCHET DR NW GIG HARBOR,WA98335 46-3494108	REAL ESTATE	WA	N/A	N/A				No			No
(34) FRANCISCAN SPECIALTY CARE LLC 330 SEVEN SPRINGS WAY BRENTWOOD,TN37027 81-3725123	HEALTHCARE SRVC	WA	N/A	N/A				No			No
(35) GOLDEN RIDGE SURGERY CENTER LLC 660 GOLDEN RIDGE RD 100 GOLDEN,CO80401 84-1498087	HEALTHCARE SRVC	CO	N/A	N/A				No			No
(36) GOOD SAMARITAN HOME CARE SVCS OF VINCENNE LLC 6281 TRI RIDGE BLVD 300 LOVELAND,OH45150 20-1792869	HOME HEALTH	OH	N/A	N/A				No			No
(37) HC SL VINTAGE I LLC 1400 N WATER ST STE 500 MILWAUKEE,WI53202 27-0453767	PROPERTY HOLDING	WI	N/A	N/A				No			No
(38) HEALTHCARE SUPPORT SERVICES LLC PO BOX 9804 GRAND ISLAND,NE68802 72-1546196	LAUNDRY	NE	N/A	N/A				No			No
(39) HEARTLAND ONCOLOGY LLC 2337 E CRAWFORD ST SALINA,KS67402 46-4265403	ONCOLOGY	KS	N/A	N/A				No			No
(40) LAKESIDE AMBULATORY SURGICAL CENTER LLC 17030 LAKESIDE HILLS PLAZA STE 110 OMAHA,NE68130 20-4267902	AMBUL SURG CTR	NE	N/A	N/A				No			No
(41) LAKESIDE ENDOSCOPY CENTER LLC 17001 LAKESIDE HILLS PLZ STE 201 OMAHA,NE68130 20-5544496	ENDOSCOPY SRVC	NE	N/A	N/A				No			No
(42) LEXINGTON MBO PARTNERS LTD 5050 SOUTH SYRACUSE ST STE 800 DENVER,CO80237 65-1132855	REAL ESTATE	CO	N/A	N/A				No			No
(43) LINCOLN CK LEASING LLC 555 SOUTH 70TH STREET LINCOLN,NE68510 26-2496856	REAL ESTATE	NE	N/A	N/A				No			No
(44) MEMORIAL MEDICAL PLAZA 3838 SAN DIMAS SUITE B 201 BAKERSFIELD,CA93301 36-4510880	REAL ESTATE	CA	N/A	N/A				No			No
(45) MERCY DAVIS CANCER CENTER MANAGEMENT CO LLC 2740 M STREET MERCED,CA95340 94-3358445	MANAGEMENT OF CANCER CENTER	CA	N/A	N/A				No			No
(46) MERCY REHABILITATION HOSPITAL LLC 330 SEVEN SPRINGS WAY BRENTWOOD,TN37027 81-4437201	HEALTHCARE SRVC	TX	N/A	N/A				No			No
(47) MILITARY ROAD PROPERTIES LLC 18229 TERRACE COURT SW NORMANDY PARK,WA98166 91-2067879	REAL ESTATE	WA	N/A	N/A				No			No
(48) NEBRASKA SPINE HOSPITAL LLC 6901 N 72ND ST STE 20300 OMAHA,NE68122 27-0263191	SPINE HOSPITAL	NE	N/A	N/A				No			No
(49) NICU OPERATING CO OF SANTA CRUZ LLC 1555 SOQUEL DRIVE SANTA CRUZ,CA95065 46-0502935	NEONATAL HEALTHCARE	CA	N/A	N/A				No			No
(50) NORTH RIVER SURGERY CENTER LLC 2209 WILDWOOD AVE SHERWOOD,AR72120 71-0799771	AMBUL SURG CTR	AR	N/A	N/A				No			No
(51) NORTHERN PLAINS LABORATORY LLC 401 N 9 STREET BISMARK,ND58501 84-1641341	DIAGNOSTIC SERVICES	ND	N/A	N/A				No			No
(52) NSC CHANNEL ISLANDS LLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM,AL35209 77-0409291	AMBULATORY SURGICAL CENTER	CA	N/A	N/A				No			No
(53) ORTHOCOLORADO LLC 11650 WEST 2ND PLACE LAKEWOOD,CO80228 37-1577105	ORTHO HOSPITAL	CO	N/A	N/A				No			No
(54) PARK RAPIDS AREA HEALTH CARE 600 PLEASANT AVENUE S PARK RAPIDS,MN56470 20-4926259	HEALTHCARE SRVC	MN	N/A	N/A				No			No
(55) PENINSULA RADIATION ONCOLOGY CENTER LLC 4230 BRIDGEPORT WAY W STE B UNIVERSITY PLACE,WA98466 87-0808610	HEALTHCARE SRVC	WA	N/A	N/A				No			No
(56) PENRAD IMAGING LLC 1390 KELLY JOHNSON BLVD COLORADO SPRINGS,CO80920 84-1072619	MEDICAL IMAGING	CO	N/A	N/A				No			No
(57) PERFORMANCE MED EQUIP & RESPIR SVSC LLC 19625 62ND AVE SOUTH 101 KENT,WA98032 45-2901632	HOLDING COMPANY	WA	N/A	N/A				No			No
(58) PLAZA SURGERY CENTER LP 525 E PLAZA DRIVE SUITE 100 SANTA MARIA,CA93454 77-0573567	SURGERY	CA	N/A	N/A				No			No
(59) PMC HOSPITAL LLC 3100 MAIN ST STE 500 HOUSTON,TX77002 27-3280598	HOSPITAL	TX	N/A	N/A				No			No
(60) PRECISION MEDICINE ALLIANCE LLC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 35-2569159	DIAGNOSTIC SERVICES	CO	N/A	N/A				No			No
(61) RADIATION ONCOLOGY CENTERS OF VENTURA COUNTY 1700 N ROSE AVENUE SUITE 120 OXNARD,CA93030 77-0191706	IMAGING	CA	N/A	N/A				No			No
(62) RBR MANAGEMENT LLC 91 CORPORATE PARK DRIVE SUITE 120 HENDERSON,NV89074 27-1466450	AMBULANCE	NV	N/A	N/A				No			No
(63) REID-ANC HOME CARE SERVICES LLC 6281 TRI RIDGE BLVD STE 300 LOVELAND,OH45150 37-1454747	HOME HEALTH	IN	N/A	N/A				No			No
(64) SAINT JOSEPH - SCA HOLDINGS LLC 1451 HARRODSBURG RD LEXINGTON,KY40503 45-3801157	INACTIVE	DE	N/A	N/A				No			No
(65) SAINT JOSEPH HEALTH ASC LLC ONE SAINT JOSEPH DRIVE LEXINGTON,KY40504 85-2155230	SURGERY	KY	N/A	N/A				No			No
(66) SAINT JOSEPH-ANC HOME CARE SERVICES 6281 TRI RIDGE BLVD STE 300 LOVELAND,OH45150 26-3330545	HOME HEALTH	KY	N/A	N/A				No			No
(67) SANTA CRUZ COMPREHENSIVE IMAGING LLC 1661 SOQUEL DRIVE SUITE G SANTA CRUZ,CA95065 01-0550623	IMAGING	CA	N/A	N/A				No			No
(68) SANTA CRUZ LAND & BUILDING LP 1555 SOQUEL DRIVE SANTA CRUZ,CA95065 77-0285236	REAL ESTATE	CA	N/A	N/A				No			No
(69) SANTA CRUZ SURGERY CENTER LLC 3003 PAUL SWEET ROAD SANTA CRUZ,CA95065 77-0194916	SURGERY	CA	N/A	N/A				No			No
(70) SEVEN OAKS SURGERY CENTER LLC 1801 ORANGE TREE LANE SUITE 200 REDLANDS,CA92374 85-1559544	SURGERY	CA	N/A	N/A				No			No
(71) SOUTHEASTERN HOME CARE LLC 6281 TRI RIDGE BLVD STE 300 LOVELAND,OH45150 27-1219638	HOME HEALTH	OH	N/A	N/A				No			No
(72) ST JOSEPH'S SURGERY CENTER LP 15305 DALLAS PARKWAY SUITE 1600 LB ADDISON,TX75001 20-1019390	SURGERY	TX	N/A	N/A				No			No
(73) ST ELIZABETH HOME CARE SERVICES LLC 6281 TRI RIDGE BLVD STE 300 LOVELAND,OH45150 26-1236191	HOME HEALTH	KY	N/A	N/A				No			No
(74) ST FRANCIS LAND COMPANY 5390 N ACADEMY BLVD STE 300 COLORADO SPRINGS,CO80918 26-3134100	REAL ESTATE	CO	N/A	N/A				No			No
(75) ST LUKE'S DIAGNOSTIC CATH LAB LLP 6624 FANNIN ST STE 800 HOUSTON,TX77030 71-0959365	DIAGNOSTIC SERVICES	TX	N/A	N/A				No			No
(76) ST LUKE'S LAKESIDE HOSPITAL LLC 6624 FANNIN STE 2505 HOUSTON,TX77030 30-0427437	HOSPITAL	TX	N/A	N/A				No			No
(77) ST LUKE'S THE WOODLANDS SLEEP CENTER LLC 6624 FANNIN STE 800 HOUSTON,TX77030 46-2795726	DIAGNOSTIC SERVICES	TX	N/A	N/A				No			No
(78) TEMPLETON SURGERY CENTER LLC 1310 LAS TABLAS ROAD SUITE 104 TEMPLETON,CA94365 20-2246616	SURGERY	CA	N/A	N/A				No			No
(79) THE MEDICAL PAVILION AT ST JOHN'S 1600 ROSE AVENUE OXNARD,CA93030 77-0332349	REAL ESTATE	CA	N/A	N/A				No			No
(80) THREE SPRING IMAGING LLC 1 MERCADO ST STE 200A DURANGO,CO81301 81-3571570	HEALTHCARE SRVC	CO	N/A	N/A				No			No
(81) TIA ARIZONA LLC 3030 N CENTRAL AVENUE SUITE 1402 PHOENIX,AZ85012 86-3158670	CLINIC	AZ	N/A	N/A				No			No
(82) VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC 18330 ROSCOE BLVD NORTHRIDGE,CA91328 80-0864336	SURGERY	CA	N/A	N/A				No			No
(83) WEST LAKES SURGERY CENTER LLC 12499 UNIVERSITY AVE STE 100 CLIVE,IA50325 20-5345295	HEALTHCARE SRVC	IA	N/A	N/A				No			No

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	(h) Percentage ownership	Yes	No
(1) ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SVCS INC 12809 WEST DODGE RD OMAHA,NE68154 47-0802396	MANAGED CARE	NE	N/A	C					No
(2) ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY INC 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2466914	HEALTHCARE	TX	N/A	C					No
(3) ALTERNATIVE INSURANCE MANAGEMENT SERVICE INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 84-1112049	MANAGEMENT SERVICES	CO	N/A	C					No
(4) AMERICAN NURSING CARE INC 1700 EDISON DR MILFORD,OH45150 31-1085414	HOME HEALTH	OH	N/A	C					No
(5) AMERIMED INC 1700 EDISON DR MILFORD,OH45150 31-1158699	HOME HEALTH	OH	N/A	C					No
(6) BC HOLDING COMPANY INC 1850 BLUEGRASS AVE LOUISVILLE,KY40215 31-1542851	INACTIVE	KY	N/A	C					No
(7) BRAZOSPORT HEALTH ALLIANCE 1 WEST WAY COURT LAKE JACKSON,TX77566 76-0518376	HEALTHCARE	TX	N/A	C					No
(8) CADUCEUS MEDICAL ASSOCIATES INC 5600 BRAINERD ROAD STE 500 CHATTANOOGA,TN37411 62-1570736	HEALTHCARE	TN	N/A	C					No
(9) CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 27-2269511	INACTIVE	CO	N/A	C					No
(10) CHI ST LUKE'S HEALTH - MEMORIAL CONDOMINIUM ASSOCIATION INC 1201 W FRANK AVE LUFKIN,TX75904 83-4184717	CONDO ASSOC	TX	N/A	C					No
(11) COASTAL SURGICAL SPECIALISTS INC 921 OAK PARK BLVD SUITE 101 PISMO BEACH,CA93449 74-3000596	AMBULATORY SURGERY CENTER	CA	N/A	S					No
(12) COMCARE SERVICES INC 9100 E MINERAL CIRCLE CENTENNIAL,CO80112 84-0904813	INACTIVE	CO	N/A	C					No
(13) CONSOLIDATED HEALTH SERVICES 1700 EDISON DR MILFORD,OH45150 31-1378212	HOME HEALTH	OH	N/A	C					No
(14) DES MOINES MEDICAL CENTER INC 1111 6TH AVE DES MOINES,IA50314 42-0837382	REAL ESTATE	IA	N/A	C					No
(15) DIGNITY HEALTH HOLDING CORPORATION 185 BERRY STREET SUITE 200 SAN FRANCISCO,CA94107 46-0675371	HOLDING CO	NV	N/A	C					No
(16) DIGNITY HEALTH INSURANCE LTD PO BOX 1051 GRAND CAYMAN ISL GRAND CAYMAN ISL CJ 98-1065338	CAPTIVE INSURANCE	CJ	N/A	C					No
(17) DIGNITY HEALTH PROVIDER RESOURCES INC 185 BERRY STREET SUITE 200 SAN FRANCISCO,CA94107 47-3366764	HEALTH PLAN	CA	N/A	C					No
(18) DIVERSIFIED HEALTH RESOURCES INC 100 MEDICAL DRIVE LAKE JACKSON,TX77566 76-0222679	HEALTHCARE	TX	N/A	C					No
(19) FRANCISCAN CITY URGENT CARE SERVICES PS C/O CPGUSA 1345 AVE OF THE AMERICAS NEW YORK,NY10105 81-2174959	INACTIVE	NY	N/A	C					No
(20) FRANCISCAN SERVICES INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 23-2487967	HOLDING CO	CO	N/A	C					No
(21) GALLERIA PAVILION OWNERS'ASSOCIATION 800 N GIBSON RD HENDERSON,NV89011 82-4275367	REAL ESTATE	NV	N/A	C					No
(22) GOOD SAMARITAN OUTREACH SERVICES PO BOX 1990 KEARNEY,NE68848 47-0659440	MEDICAL CLINIC	NE	N/A	C					No
(23) HARVESTPLAINS HEALTH OF IOWA 32129 WEYERHAEUSER WAY S STE 201 FEDERAL WAY,WA98001 47-3451750	INSURANCE	WA	N/A	C					No
(24) HEALTH SERVICES OF THE PACIFIC CENTRAL COAST INC 1400 E CHURCH STREET SANTA MARIA,CA93454 77-0074057	HEALTH SERVICES	CA	N/A	C					No
(25) HEALTH SYSTEMS ENTERPRISES INC PO BOX 1990 KEARNEY,NE68848 47-0664558	MGMT	NE	N/A	C					No
(26) HEALTHCARE MGMT SERVICES ORGANIZATION INC 1149 MARKET ST TACOMA,WA98402 91-1865474	INACTIVE	WA	N/A	C					No
(27) HEARTLANDPLAINS HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-4368223	INSURANCE	NE	N/A	C					No
(28) HIGHLINE MEDICAL GROUP 1717 S J STREET TACOMA,WA98405 91-1407026	MEDICAL SERVICES	WA	N/A	C					No
(29) INTEGRATED MEDICAL SERVICES 9250 N 3RD STREET SUITE 4010 PHOENIX,AZ85020 86-0783428	MULTI-SPECIALTY PHYSICIANS GROUP	AZ	N/A	C					No
(30) MEDICAL OFFICE BUILDING HORIZONTAL PROPERTY REGIME INC 300 WERNER ST HOT SPRINGS,AR71913 71-0720429	REAL ESTATE	AR	N/A	C					No
(31) MEDQUEST 1301 15TH AVENUE WEST WILLISTON,ND58801 45-0392137	SALE OF DME	ND	N/A	C					No
(32) MEMORIAL CV SERVICE LINE MANAGEMENT COMPANY LLC 1201 W FRANK AVE LUFKIN,TX75904 46-3622849	INACTIVE	TX	N/A	C					No
(33) MERCY PARK APARTMENTS LTD 1111 6TH AVE DES MOINES,IA50314 42-1202422	INACTIVE	IA	N/A	C					No
(34) MERCY SERVICES CORP 2700 STEWART PARKWAY ROSEBURG,OR97471 93-0824308	RETAIL SALES	OR	N/A	C					No
(35) MHI CLINICAL SERVICES 1201 W FRANK AVE LUFKIN,TX75904 46-1967952	HEALTHCARE	TX	N/A	C					No
(36) MILLENNIUM SURGERY CENTER INC 9300 STOCKDALE HWY 200 BAKERSFIELD,CA93311 77-0513445	OUTPAITENT SURGERY SERVICES	CA	N/A	S					No
(37) MOUNTAIN MANAGEMENT SERVICES INC 6028 SHALLOWFORD RD CHATTANOOGA,TN37421 62-1570739	MGMT SVC ORG	TN	N/A	C					No
(38) NORTH CENTRAL HEALTH CARE ALLIANCE PO BOX 5538 BISMARK,ND58506 45-0439894	HEALTHCARE	ND	N/A	C					No
(39) QUALCHOICE ADVANTAGE 32129 WEYERHAEUSER WAY S STE 201 FEDERAL WAY,WA98001 47-3433912	INSURANCE	WA	N/A	C					No
(40) QUALCHOICE HEALTH PLAN SERVICES INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-1224037	ADMIN SERVICES	CO	N/A	C					No
(41) QUALCHOICE HEALTH INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-1222808	HOLDING CO	CO	N/A	C					No
(42) QUALCHOICE HOLDINGS INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 27-4075520	HOLDING CO	AR	N/A	C					No
(43) QUALCHOICE OF NEBRASKA 2401 S 73RD ST OMAHA,NE68124 81-0738827	INACTIVE	NE	N/A	C					No
(44) RIVERLINK HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-4380824	INSURANCE	OH	N/A	C					No
(45) RIVERLINK HEALTH OF KENTUCKY INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-4828332	INSURANCE	KY	N/A	C					No
(46) ROSS PARK PHARMACY INC 380 SUMMIT AVE STEUBENVILLE,OH43952 34-1832654	PHARMACY	OH	N/A	C					No
(47) SAINT CLARE'S PRIMARY CARE INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 22-2441202	INACTIVE	NJ	N/A	C					No
(48) SJH SERVICES CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 23-2307408	INACTIVE	CO	N/A	C					No
(49) SJL PHYSICIAN MANAGEMENT SERVICES INC 424 LEWIS HARGETT CR STE 160 LEXINGTON,KY40503 27-0164198	INACTIVE	KY	N/A	C					No
(50) SOUNDPATH HEALTH INC 32129 WEYERHAEUSER WAY S STE 201 FEDERAL WAY,WA98001 42-1720801	INSURANCE	WA	N/A	C					No
(51) ST MARY HEALTH VENTURES INC 1050 LINDEN AVENUE LONG BEACH,CA90813 95-1912528	RETAIL PHARMACY	CA	N/A	C					No
(52) ST ANTHONY DEVELOPMENT COMPANY 1415 SOUTHGATE PENDLETON,OR97801 93-1216943	ATHLETIC CLUB	OR	N/A	C					No
(53) ST JOSEPH DEVELOPMENT COMPANY INC 1717 SOUTH J ST TACOMA,WA98405 91-1480569	RENTAL	WA	N/A	C					No
(54) ST LUKE'S HEALTH SYSTEM HOLDINGS INC 6624 FANNIN STE 800 HOUSTON,TX77030 76-0637138	HOLDING CO	TX	N/A	C					No
(55) ST VINCENT COMMUNITY HEALTH SERVICES INC TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0710785	HEALTHCARE	AR	N/A	C					No
(56) STE HOLDINGS 12809 WEST DODGE RD OMAHA,NE68154 82-2383629	HOLDING CO	NE	N/A	C					No
(57) SUGAR LAND DOCTOR GROUP 1317 LAKE POINT PARKWAY SUGAR LAND,TX77478 45-4270163	INACTIVE	TX	N/A	C					No
(58) TOWSON MANAGEMENT INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 52-1710750	INACTIVE	MD	N/A	C					No
(59) TRINITY MANAGEMENT SERVICES ORGANIZATION 380 SUMMIT AVE STEUBENVILLE,OH43952 34-1471026	MGMT SERVICES	OH	N/A	C					No

Schedule R (Form 990) 2021

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

Yes

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

Yes

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

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) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	6,018,531	3,715,052
9	Program service revenue (Part VIII, line 2g) .........	2,117,015	1,575,606
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	0	0
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	162,992	148,435
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	8,298,538	5,439,093
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
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)....	6,435,209	6,642,408
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	6,435,209	6,642,408
19	Revenue less expenses. Subtract line 18 from line 12.......	1,863,329	-1,203,315
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	3,800,476	2,708,191
21	Total liabilities (Part X, line 26).............	223,196	334,226
22	Net assets or fund balances. Subtract line 21 from line 20.....	3,577,280	2,373,965

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 6,299,972 including grants of $ 0 ) (Revenue $ 1,575,606 )
	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 expenses6,299,972

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	3,586,868	257,323

(A) Name and business address	(B) Description of services	(C) Compensation
WALDINGER CORP 6200 SCOUT TRAIL DES MOINES,IA50321	MECHNICAL CONTRACTOR	114,031




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 1

1	Briefly describe the organization’s mission or most significant activities: DEDICATED TO ASSISTING PREGNANT, PARENTING AND NON-PARENTING WOMEN IN DEVELOPING RESPONSIBILITY AND INDEPENDENCE THROUGH COUNSELING, EDUCATION AND MEDICAL CARE IN COLLABORATION WITH PROVIDERS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	19
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) BRENNA KAHLER........................................................................ DIRECTOR	1.00 .......................0.00	X	0	0	0
(19) LAUREN PATRICK........................................................................ DIRECTOR	1.00 .......................0.00	X	0	0	0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	2,156,892
e	Government grants (contributions)		1e	1,558,160

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

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

h Total. Add lines 1a-1f.......		3,715,052

		Business Code
2a	PROGRAM SERVICE REVENU	900099	1,575,606	1,575,606	0	0
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,575,606

3 Investment income (including dividends, interest, and othersimilar amounts) ......
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		37,646	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		37,646	6c
d	Net rental income or (loss).......			37,646			37,646
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA		722100	110,789	0	0	110,789
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			110,789
12	Total revenue. See instructions.....			5,439,093	1,575,606	0	148,435

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	4,473,181	4,370,217	102,964
12	Advertising and promotion ....	389	370	19
13	Office expenses .......	606,696	579,395	27,301
14	Information technology ......	294,496	279,771	14,725
15	Royalties ..
16	Occupancy ...........	374,513	327,699	46,814
17	Travel ............	8,817	8,694	123
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	493	263	230
20	Interest ...........
21	Payments to affiliates .......	64,839	64,839
22	Depreciation, depletion, and amortization ..	118,228	118,228
23	Insurance ...
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	RESTRUCTURING / IMPAIRM	299,539	175,102	124,437	0
b	REPAIRS AND MAINTENANCE	237,827	225,936	11,891	0
c	MISCELLANEOUS EXPENSES	115,599	104,058	11,541	0
d	EDUCATION	28,074	26,670	1,404	0
e	All other expenses	19,717	18,730	987
25	Total functional expenses. Add lines 1 through 24e	6,642,408	6,299,972	342,436	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 ........			3,000	1	0
2	Savings and temporary cash investments .........			1,532,153	2	504,884
3	Pledges and grants receivable, net ......				3	0
4	Accounts receivable, net .............			685,838	4	571,920
5	Loans and other receivables from 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 .......
					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) ...
					6	0
7	Notes and loans receivable, net ...........				7	0
8	Inventories for sale or use ............				8	0
9	Prepaid expenses and deferred charges ......				9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	3,898,218
b	Less: accumulated depreciation	10b	2,266,831	1,579,485	10c	1,631,387
11	Investments—publicly traded securities .				11	0
12	Investments—other securities. See Part IV, line 11 .....				12	0
13	Investments—program-related. See Part IV, line 11 ..				13	0
14	Intangible assets ...............				14	0
15	Other assets. See Part IV, line 11 ...........				15	0
16	Total assets. Add lines 1 through 15 (must equal line 33)...			3,800,476	16	2,708,191

17	Accounts payable and accrued expenses .....	13,640	17	16,552
18	Grants payable ...		18	0
19	Deferred revenue .........	134,695	19	286,080
20	Tax-exempt bond liabilities .........		20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D		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 .........
			22	0
23	Secured mortgages and notes payable to unrelated third parties ..		23	0
24	Unsecured notes and loans payable to unrelated third parties ..		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	74,861	25	31,594
26	Total liabilities. Add lines 17 through 25..	223,196	26	334,226

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	3,577,280	27	2,373,965
28	Net assets with donor restrictions ...........		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 ...........	3,577,280	32	2,373,965
33	Total liabilities and net assets/fund balances ........	3,800,476	33	2,708,191