Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
315 CALHOUN STREET NO 107
 
Room/suite
City or town, state or country, and ZIP + 4
CHARLESTON, SC29401
D Employer identification number

57-1067254
E Telephone number

G Gross receipts $ 174,533,704
F Name and address of principal officer:
DAVID L DUNLAP
315 CALHOUN STREET NO 107
CHARLESTON,SC29401
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.ROPERSAINTFRANCIS.COM
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1998
M State of legal domicile: SC
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: OPERATION OF NONPROFIT HOSPITAL FACILITY IN CHARLESTON, SC
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 7
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 1,040
6 Total number of volunteers (estimate if necessary) .... 6 343
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,119
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 703,581 45,775
9 Program service revenue (Part VIII, line 2g) ......... 187,937,259 171,436,330
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -82,239 584,778
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,348,225 1,623,373
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 189,906,826 173,690,256
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 3,008 147,167
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) 55,886,675 68,379,071
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 97,800,399 69,471,371
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 153,690,082 137,997,609
19 Revenue less expenses. Subtract line 18 from line 12...... 36,216,744 35,692,647
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 295,148,647 344,403,930
21 Total liabilities (Part X, line 26)............ 10,567,237 24,745,626
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 284,581,410 319,658,304
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: HEALING ALL PEOPLE WITH COMPASSION, FAITH, AND EXCELLENCE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 117,859,593 including grants of $ 147,167 ) (Revenue $ 171,436,330 )
ACTIVELY DEMONSTRATING ROPER ST. FRANCIS HEALTHCARE'S COMMITMENT TO HEAL ALL PEOPLE WITH FAITH, COMPASSION AND EXCELLENCE, BON SECOURS ST. FRANCIS HOSPITAL CONTRIBUTED $12,412,000 MILLION IN COMMUNITY BENEFIT IN 2010. THIS BENEFIT INCLUDED $9,102,000 IN CHARITY CARE, $336,000 IN UNREIMBURSED MEDICAID, AND $2,974,000 IN NUMEROUS SPONSORSHIPS AND COMMUNITY OUTREACH PROGRAMS (SEE SCHEDULE H FOR ADDITIONAL DETAILS). HIGHLIGHTS OF BON SECOURS ST. FRANCIS HOSPITAL'S ACTIVE YEAR INCLUDE: NEARLY 29,000 VOLUNTEER STAFF HOURS FOR ACTIVITIES SUCH AS HEALTH FAIRS, CAREER DAYS AND PUBLIC PROGRAMS THAT BENEFITED 51,000 INDIVIDUALS IN THE COMMUNITY; OFFERED FREE SKIN CANCER SCREENINGS, HOSTED THE STUDENTS CAN REALLY USE BEDSIDE SKILLS ("SCRUBS") PROGRAM, WHICH GIVES STUDENTS AN OPPORTUNITY TO LEARN ABOUT HEALTH CAREERS FROM EXPERTS IN THE FIELD WHO LOVE THEIR WORK; THE ARK ORGANIZATION, WHICH OFFERS ADULT RESPITE-CARE PROGRAMS TO PEOPLE WITH ALZHEIMERS AND OTHER MEMORY-RELATED DISEASES; DOWN SYNDROME ASSOCIATION OF THE LOWCOUNTRY; AMERICAN CANCER SOCIETY; AND THE AMERICAN CANCER SOCIETY RELAY FOR LIFE, TO NAME A FEW.IN ADDITION TO BON SECOURS ST. FRANCIS HOSPITAL'S COMMITMENT TO BETTERING AND SUPPORTING THE HEALTH OF THE COMMUNITY, THE ORGANIZATION ALSO SUPPORTED MANY CHARITABLE ORGANIZATIONS THAT WORK TO FULFILL OTHER NEEDS SUCH AS: TRIDENT UNITED WAY, YOUTH ENDOWMENT FOR THE ARTS, AND OLD SANTEE CANAL PARK.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
PLEASE SEE A DETAILED DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS IN SCHEDULE O. PLEASE VISIT OUR WEBSITE FOR A DETAILED COMMUNITY BENEFIT REPORT AT:HTTP://WWW.ROPERSAINTFRANCIS.COM/ABOUT_US/MISSION_AND_COMMUNITY_ACTIVITIES/ANNUALREPORT.ASPX.
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 117,859,593
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
No
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
 
No
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
1,040
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
13
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
7
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
SC
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
THE FINANCE DEPARTMENT
315 CALHOUN STREET 107
CHARLESTON,SC29401
(843) 789-1704
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) JOHN M JORDAN
CHAIR
 1.00 X           0 289,925 51,575
(2) W BLOUNT ELLISON
VICE CHAIR
 1.00 X           0 0 0
(3) SIS PATRICIA A ECK CBS
BOARD MEMBER (UNTIL JUNE 2010)
 1.00 X           0 0 0
(4) RICHARD STATUTO
BOARD MEMBER
 1.00 X           0 0 0
(5) MICHAEL C TARWATER
BOARD MEMBER
 1.00 X           0 0 0
(6) G FREDERICK WORSHAM MD
BOARD MEMBER
 1.00 X           0 0 0
(7) PERRY KEITH WARING
BOARD MEMBER
 1.00 X           0 0 0
(8) BRANTLEY D THOMAS PHD
BOARD MEMBER
 1.00 X           0 0 0
(9) SISTER ANNE LUTZ
BOARD MEMBER
 1.00 X           0 0 0
(10) DAVID M ELLISON MD
BOARD MEMBER (SEE SCH O)
 1.00 X           0 23,813 0
(11) KATHERINE DUFFY PHD
BOARD MEMBER
 1.00 X           0 0 0
(12) JULIUS R IVESTER MD
BOARD MEMBER
 1.00 X           0 0 0
(13) ALISON E DILLON MD
BOARD MEMBER (SEE SCH O)
 1.00 X           12,000 0 0
(14) ANGRESS WALKER
BOARD MEMBER
 1.00 X           0 0 0
(15) DAVID DUNLAP
PRESIDENT & CEO OF CAHS
 1.00     X       0 1,439,245 319,287
(16) MATTHEW J SEVERANCE
SVP OPERATIONS / SECRETARY
 1.00     X       0 627,104 213,613
(17) BRET JOHNSON
CFO & SVP / TREASURER
 1.00     X       0 563,160 200,812
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) STEVEN D SHAPIRO
CMO & VP MED AFFAIRS
 1.00     X       0 526,921 142,758
(19) ALLEN CARROLL
CEO
 50.00     X       525,356 0 178,850
(20) JOHN SULLIVAN
VP OPERATIONS
 1.00     X       0 398,274 143,132
(21) DOUGLAS W BOWLING
CSO & VP
 1.00     X       0 443,797 136,438
(22) MICHAEL TAYLOR
CIO & VP
 1.00     X       0 372,551 100,965
(23) H DOUGLAS HARRISON
VP HUMAN RESOURCES
 1.00     X       0 398,399 97,367
(24) GREGORY T EDWARDS
VP & GENERAL COUNSEL
 1.00     X       0 333,952 113,262
(25) ELLEN BROWN
VP MGD CARE & BUS RELATION
 1.00     X       0 284,893 94,411
(26) LISA IRVIN
VP NURSING/SR NURSE EXECUT
 1.00     X       0 279,465 83,939
(27) FATHER TERENCE K FLEMING
VP MISSION
 1.00     X       0 258,280 74,997
(28) PENNIE L PERALTA
VP NURSING/SR NURSE EXECUT
 50.00     X       236,699 0 75,265
(29) DIANA TOPJIAN
VP NURSING/SR NURSE EXEC MPH
 1.00     X       0 88,026 15,037
(30) ROBERT OLSON
CHAIR/ST. FRANCIS
 1.00     X       0 0 0
(31) NANCY GLYNN
BOARD PRESIDENT/ ST. FRANCIS
 1.00     X       0 0 0
(32) BROTHER PETER CAMPBELL
PRESIDENT/ST. FRANCIS
 1.00     X       0 0 0
(33) FRANCIS WYCKOFF JR
DIR OF PHARMACY
 12.10       X     48,247 151,120 38,175
(34) WANDA J BROCKMEYER
DIR OF EMERGENCY SVCS
 12.20       X     40,108 123,595 18,923
(35) MICHAEL RICCIARDONE
DIR OF IMAGING SERVICES
 25.60       X     83,495 79,582 18,984
(36) JOHN D STEICHEN MD
DOCTOR
 .60         X   12,926 1,064,194 51,978
(37) GEORGE H KHOURY MD
DOCTOR
 .90         X   17,909 977,027 54,978
(38) STEPHEN E RAWE MD
DOCTOR
 1.00         X   18,830 922,645 44,740
(39) BRIAN G CUDDY MD
DOCTOR
 .90         X   13,936 805,821 51,978
(40) ROBERT LOWERY MD
DOCTOR
 .80         X   11,929 783,283 51,999
(41) PETER DINICOLA
DIR OF PLANT ENG. (FORMER KEY EMPLOYEE)
 1.00           X 0 206,746 15,525
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,021,435 11,441,818 2,388,988
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet22
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
Yes
 
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
NURSE ANESTHESIA OF SC LLC
PO BOX 6633
HIGH POINT,NC27262 		ANESTHESIA SERVICES 1,602,060
ROBINS AND MORTON GROUP
400 SHADES CREEK PKWY 200
BIRMINGHAM,AL35209 		CONSTRUCTION 1,386,214
MCKESSON INFORMATION SOLUTIONS
PO BOX 98347
CHICAGO,IL60693 		INFO SERVICES 651,742
ANGELICA TEXTILE SERVICES
P O BOX 535122
ATLANTA,GA303535122 		LINEN RENTAL 641,828
CHARLESTON EMERGENCY SERVICES
2053 SHELL RING CIRCLE
MT PLEASANT,SC29466 		ER PHYSICIANS SERVICES 509,492
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet21
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 45,775
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 45,775
Program Service Revenue Business Code
2a NET PATIENT SERVICE 621,400 171,436,330 171,436,330    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 171,436,330
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 60,943     60,943
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 1,358,992  
b Less: rental expenses 843,448  
c Rental income or (loss) 515,544  
d Net rental income or (loss).......MediumBullet 515,544     515,544
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 523,835  
b Less: cost or other basis and sales expenses    
c Gain or (loss) 523,835  
d Net gain or (loss)..........MediumBullet 523,835     523,835
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a CAFETERIA REVENUE 722,210 923,486     923,486
b MISCELLANEOUS REVENUE 900,099 184,343   1,119 183,224
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 1,107,829
12 Total revenue. See Instructions....MediumBullet 173,690,256 171,436,330 1,119 2,207,032
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 147,167 147,167
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 945,905 12,000 933,905  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 75,842 75,842    
7 Other salaries and wages 54,645,663 42,804,311 11,841,352  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 2,266,289 523,513 1,742,776  
9 Other employee benefits ....... 6,731,515 6,433,844 297,671  
10 Payroll taxes ........... 3,713,857 2,533,705 1,180,152  
11 Fees for services (non-employees):        
a Management ...... 1,895,293 1,895,293    
b Legal ......... 388,200   388,200  
c Accounting ........... 83,576   83,576  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 9,869,896 8,931,936 937,960  
12 Advertising and promotion .... 803,842 642,652 161,190  
13 Office expenses ....... 8,143,667 6,480,346 1,663,321  
14 Information technology ...... 116,558   116,558  
15 Royalties ..        
16 Occupancy ........... 2,730,324 2,670,431 59,893  
17 Travel ............ 39,825   39,825  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 278,978   278,978  
20 Interest ........... 136,745 136,745    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 7,580,924 7,580,924    
23 Insurance .............. 503,216 389,118 114,098  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a MEDICAL SUPPLIES 24,282,256 24,282,256    
b BAD DEBT EXPENSE 8,328,812 8,328,812    
c MEDICAL DSH TAX 3,806,404 3,806,404    
d OTHER EXPENSES 482,855 184,294 298,561  
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 137,997,609 117,859,593 20,138,016 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 24,600 1 25,199
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 21,532,147 4 24,974,183
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 670,989 7  
8 Inventories for sale or use .............. 2,261,341 8 2,685,262
9 Prepaid expenses and deferred charges ............   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 178,341,988
b Less: accumulated depreciation. ..... 10b 54,422,259 111,593,809 10c 123,919,729
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 .. 155,630,348 13 189,542,037
14 Intangible assets .........   14 379,129
15 Other assets. See Part IV, line 11 ........... 3,435,413 15 2,878,391
16 Total assets. Add lines 1 through 15 (must equal line 34)... 295,148,647 16 344,403,930
Liabilities 17 Accounts payable and accrued expenses . 793,283 17 722,317
18 Grants payable ..........   18  
19 Deferred revenue .......... 2,305,851 19 2,302,295
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24 11,699
25 Other liabilities. Complete Part X of Schedule D..... 7,468,103 25 21,709,315
26 Total liabilities. Add lines 17 through 25..... 10,567,237 26 24,745,626
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 284,581,410 27 319,658,304
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 284,581,410 33 319,658,304
34 Total liabilities and net assets/fund balances ..... 295,148,647 34 344,403,930
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
173,690,256
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
137,997,609
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
35,692,647
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
284,581,410
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-615,753
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
319,658,304
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


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

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
 
Employer identification number

57-1067254
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 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 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 fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 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) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (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) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
 
Employer identification number

57-1067254
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not 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 in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
  		Employer identification number

57-1067254
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
  		Employer identification number

57-1067254
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
  		Employer identification number

57-1067254
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
 
Employer identification number

57-1067254
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, 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" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, 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 XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, 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)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   13,580,943 13,580,943
b Buildings ................   116,029,981 23,621,506 92,408,475
c Leasehold improvements ............   4,628,554 2,179,077 2,449,477
d Equipment ................   43,934,029 28,621,676 15,312,353
e Other .................   168,481   168,481
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 123,919,729
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. 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    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) INVESTMENT IN WEST ASHLEY CANCER CENTER 464,387 F
(2) INTERCOMPANY RECEIVABLES 189,077,650 C







Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet 189,542,037
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
OTHER LIABILITIE 487,526
THIRD PARTY RESERVES 3,835,746
WACC LEASE OBLIGATION 17,386,043






Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 21,709,315
2. Fin 48 (ASC 740) Footnote. In Part XIV, 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 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
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 on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 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 XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
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 XIV): ............ 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 XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to 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; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: CAREALLIANCE, ROPER HOSPITAL, ST.FRANCIS, MOUNT PLEASANT, THE FOUNDATION, AND PHYSICIAN PARTNERS ARE NOT-FOR-PROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501C3 OF THE INTERNAL REVENUE CODE AND ARE GENERALLY EXEMPT FROM FEDERAL AND STATE INCOME TAXES. THE SURGERY CENTER AND NEUROSCIENCES MRI ARE LIMITED LIABILITY COMPANIES. UNDER CURRENT LAWS, INCOME OR LOSS OF LIMITED LIABILITY COMPANIES IS INCLUDED IN THE INCOME TAX RETURNS OF THE MEMBERS. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS MADE IN THE CONSOLIDATED FINANCIAL STATEMENTS. ALTHOUGH CAREALLIANCE IS GENERALLY EXEMPT FROM FEDERAL AND STATE INCOME TAXES, IT EVALUATES WHETHER THERE ARE ANY UNCERTAIN TAX POSITIONS THAT FAIL TO MEET THE MORE-LIKELY-THAN-NOT THRESHOLD FOR RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNCERTAIN TAX POSITIONS MAY INCLUDE THE CHARACTERISTICS OF INCOME, SUCH AS A CHARACTERIZATION OF INCOME AS PASSIVE, A DECISION TO EXCLUDE REPORTING TAXABLE INCOME IN A TAX RETURN, OR A DECISION TO CLASSIFY A TRANSACTION, ENTITY, OR OTHER POSITION IN A TAX RETURN AS TAX EXEMPT. THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION IS RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON TECHNICAL MERITS. CAREALLIANCE HAD NO UNRECOGNIZED TAX POSITIONS AS OF DECEMBER 31, 2010 AND 2009, AND DOES NOT EXPECT THAT UNRECOGNIZED TAX BENEFITS WILL MATERIALLY INCREASE WITHIN THE NEXT TWELVE MONTHS. TAX YEARS FROM 2007 THROUGH 2009 ARE SUBJECT TO EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES, RESPECTIVELY. THERE ARE NO INCOME TAX EXAMINATIONS CURRENTLY IN PROCESS. INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IF ANY, WOULD BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AS INCOME TAX EXPENSE.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
 
Employer identification number

57-1067254
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    13,254,371 4,152,866 9,101,505 7.020 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    13,554,597 13,218,810 335,787 0.260 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		    26,808,968 17,371,676 9,437,292 7.280 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    1,489,488 3,119 1,486,369 1.150 %
f Health professions education
(from Worksheet 5) .. 		    1,196,751 124,456 1,072,295 0.830 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)     58,136   58,136 0.040 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    362,991 41,940 321,051 0.250 %
jTotal Other Benefits ...     3,107,366 169,515 2,937,851 2.270 %
kTotal. Add lines 7d and 7j. ..     29,916,334 17,541,191 12,375,143 9.550 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building     36,509   36,509 0.030 %
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     36,509   36,509 0.030 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense (at cost).....
2
1,454,792
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
581,917
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
39,094,284
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
42,968,279
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-3,873,995
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
11 RSFH WEST ASHLEY CANCER CENTER LLC
  		CANCER TREATMENT 22.200 % 13.000 % 64.800 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 BON SECOURS ST FRANCIS HOSPITAL INC
2095 HENRY TECKLENBURG BLVD
CHARLESTON,SC29414 		X X         X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NA FOR 2010
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?7
Name and address Type of Facility (Describe)
1 STFRANCIS HOSPITAL PAIN MANAGEMENT
2093 HENRY TECKLENBURG DRIVE
150
CHARLESTON,SC29414 		PAIN MANAGEMENT FOR SPINE
2 STFRANCIS HOSPITAL PAIN MANAGEMENT
2093 HENRY TECKLENBURG DRIVE
150
CHARLESTON,SC29414 		PAIN MANAGEMENT FOR SPINE
3 STFRANCIS HOSPITAL PAIN MANAGEMENT
2093 HENRY TECKLENBURG DRIVE
150
CHARLESTON,SC29414 		PAIN MANAGEMENT FOR SPINE
4 STFRANCIS HOSPITAL PAIN MANAGEMENT
2093 HENRY TECKLENBURG DRIVE
150
CHARLESTON,SC29414 		PAIN MANAGEMENT FOR SPINE
5 STFRANCIS HOSPITAL PAIN MANAGEMENT
2093 HENRY TECKLENBURG DRIVE
150
CHARLESTON,SC29414 		PAIN MANAGEMENT FOR SPINE
6 STFRANCIS HOSPITAL PAIN MANAGEMENT
2093 HENRY TECKLENBURG DRIVE
150
CHARLESTON,SC29414 		PAIN MANAGEMENT FOR SPINE
7 STFRANCIS HOSPITAL PAIN MANAGEMENT
2093 HENRY TECKLENBURG DRIVE
150
CHARLESTON,SC29414 		PAIN MANAGEMENT FOR SPINE
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 3C: IN ADDITION TO USING THE FPG TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE, THE SYSTEM OFFERS A 35% DISCOUNT FOR PATIENTS WHO ARE UNINSURED. A 10% PROMPT PAYMENT DISCOUNT IS OFFERED TO ALL SELF-PAY OR SELF-PAY-AFTER-INSURANCE PATIENTS WHO PAY THE BALANCE AT ONE TIME. MEDICAL INDIGENCY ADJUSTMENTS ARE AVAILABLE TO THOSE THAT MEET THE ESTABLISHED GUIDELINES.
    PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS MADE AVAILABLE THROUGH ITS CORPORATE PARENT, CAREALLIANCE HEALTH SERVICES D/B/A ROPER ST. FRANCIS HEALTHCARE.
    PART I, LINE 7: WORKSHEET 2 OF THE 2010 SCHEDULE H INSTRUCTIONS WAS USED TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE CHARITY CARE AND UNREIMBURSED MEDICAID AT COST.
    PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 8328812.
    PART II: IN 2010, ROPER ST. FRANCIS HEALTHCARE PROVIDED APPROXIMATELY 78,300 HOURS OF STAFF TIME IN SUPPORT OF COMMUNITY AND HEALTH RELATED INITIATIVES. DURING THIS TIME, THE HEALTHCARE SYSTEM SERVED MORE THAN 264,000 COMMUNITY RESIDENTS, SPONSORED 36 HEALTH FAIRS, AND PARTICIPATED IN 80 COMMUNITY SCREENINGS. RSFH FURTHER SUPPORTED THE COMMUNITY BY PROVIDING $479,905 IN SPONSORSHIPS TO SEVERAL LOCAL ORGANIZATIONS.PART I, LINE 7(E): DETAIL OF COMMUNITY HEALTH SERVICES (NET): ADVANTAGE PROGRAMS - $ 1,288 COMMUNITY CALENDARS & NEWSLETTERS - 2,219 DIABETES SUPPORT GROUP - 39 ENROLLMENT ASSISTANCE IN PUBLIC PROGRAMS - 1,115,417 HEALTH EDUCATION AND LECTURES BY STAFF - 1,879 HEALTH FAIRS & CAREER DAYS - 10,623 HOUSE CALLS MAGAZINE - 86,530 WELLNESS HOUSE - 242,902 OVERSIGHT OF COMMUNITY BENEFIT PROGRAMS - 25,472 TOTAL TO LINE 7(E), COL(E) - 1,486,369
    PART III, LINE 4: TO CALCULATE BAD DEBT EXPENSE AT COST, THE ORGANIZATION TOOK BAD DEBT EXPENSE FROM THE FINANCIAL STATEMENTS LESS BAD DEBT AMOUNTS THAT RELATE TO MEDICARE OR MEDICAID AS THOSE AMOUNTS ARE INCLUDED IN UNREIMBURSED MEDICAID AND THE MEDICARE SHORTFALL. THE ORGANIZATION THEN USED THE COST TO CHARGE RATIO METHODOLOGY, RATIO OF PATIENT CARE COST-TO-CHARGES.RECEIVABLES ARE REPORTED AT THE NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. CAREALLIANCE PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICIES WITHOUT CHARGE OR AT AMOUNT LESS THAN ITS ESTABLISHED RATES. BECAUSE CAREALLIANCE DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. DURING 2010, CAREALLIANCE ENHANCED ITS EFFORTS TO QUALIFY PATIENTS FOR CHARITY CARE THROUGH THE USE OF AN ELECTRONIC CREDIT SCORING TECHNIQUE, WHICH RESULTED IN SUBSTANTIALLY MORE CHARITY CARE AND SUBSTANTIALLY LESS BAD DEBT EXPENSE RECOGNIZED IN 2010.RSFH USES THE ADVISORY BOARD'S SELF PAY COMPASS PROGRAM TO AUTOMATICALLY QUALIFY PATIENTS FOR CHARITY CARE THROUGH THE USE OF AN ELECTRONIC SCORING TECHNIQUE. THE DATA RECEIVED THROUGH THIS SOFTWARE IS BELIEVED TO ERR ON THE SIDE OF DENYING CHARITY. THE ESTIMATE OF BAD DEBT THAT COULD HAVE BEEN CHARITY IS BASED ON THE SYSTEM ERROR RATE. PLEASE NOTE THAT PATIENTS WHO COMPLETE A FULL CHARITY CARE APPLICATION AND QUALIFY FOR CHARITY UNDER OUR POLICY ARE GRANTED CHARITY REGARDLESS OF THE SCORE IN THE SELF-PAY COMPASS SYSTEM.
    PART III, LINE 8: THE ENTIRE AMOUNT OF MEDICARE SHORTFALL QUALIFIES AS COMMUNITY BENEFIT. OUR TREATMENT OF MEDICARE PATIENTS, AS DESCRIBED IN IRS REV. RUL. 69-545, INDICATES THAT ST. FRANCIS HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. BY TAKING MEDICARE PATIENTS, THE HOSPITAL PROMOTES ACCESS TO HEALTHCARE SERVICES, WHICH IS A COMMUNITY BENEFIT. THE ORGANIZATION USES THE MEDICARE COST REPORT TO DETERMINE THE COSTS REPORTED ON PART III, LINE 5 AND 6.MEDICARE SHORTFALL IS REPORTED BASED ON THE HOSPITAL'S COST REPORT. HAD WE INCLUDED REVENUES AND COSTS FROM ALL MEDICARE PROGRAMS INCLUDING MEDICARE PART C AND PHYSICIANS PRACTICES THIS WOULD HAVE RESULTED IN AN ADDITIONAL SHORTFALL OF $535,914.
    PART III, LINE 9B: THE HOSPITAL USES THE HEALTH CARE ADVISORY BOARD'S SELF PAY COMPASS PROGRAM TO IDENTIFY A PATIENT'S PROPENSITY TO PAY. ACCOUNTS WITH AN FPL OF 399% AND BELOW WILL BE IDENTIFIED ONCE THE SELF PAY AR BILLING PROCESS HAS BEEN COMPLETED AND PRIOR TO THE ACCOUNT BEING REFERRED TO BAD DEBT. ACCOUNTS WITH FPL OF 399% AND BELOW WILL BE GIVEN A CHARITY ADJUSTMENT ONCE AN ACCOUNT HAS BEEN REFERRED TO BAD DEBT, RSFH WILL MAKE EVERY EFFORT TO INSURE THAT ALL SELF PAY COLLECTORS DEMONSTRATE CONSISTENT, COMPASSIONATE, AND PROFESSIONAL SERVICE WHILE CONDUCTING BUSINESS ON BEHALF OF THE HEALTH SYSTEM. THIS WILL INCLUDE, BUT IS NOT LIMITED TO: GUARANTOR NOTIFICATION AND CONTACT/COLLECTION ATTEMPTS, DISCOUNT OPPORTUNITIES, PAYMENT PLAN ARRANGEMENTS, ACCOUNT BALANCE NOTIFICATIONS, FACE TO FACE MEETINGS, AND DETAIL BILL GENERATION. AN OUTSOURCED SELF PAY BILLING AGENCY WILL CONTACT THE GUARANTOR TO COLLECT PAYMENT OR TO SET UP MONTHLY PAYMENT ARRANGEMENTS. FINANCIAL ASSISTANCE DISCOUNTS ARE OFFERED TO GUARANTORS WHO MEET THE CHARITY GUIDELINES.IF THE PATIENT DOES NOT MEET THE CHARITY GUIDELINES, OR NEGLECTS TO COMPLETE THE REQUIRED CHARITY CARE DOCUMENTATION, THE PATIENT WILL RECEIVE A 35% DISCOUNT OFF OF TOTAL CHARGES. PATIENTS ARE ELIGIBLE FOR A 10% PROMPT PAYMENT DISCOUNT IF THEY PAY THE BALANCE DURING THE DISCUSSION. DISCOUNTS MAY BE COMBINED IF ALL REQUIREMENTS ARE MET. IN PURSUIT OF COLLECTIONS, RSFH AND ITS AGENTS, WILL NOT: ATTACH LIENS ON PROPERTY, GARNISH WAGES, PURSUE LEGAL ACTIONS, UNLESS RECOMMENDED BY THE SELF PAY BILLING ENTITIES, SELL ACCOUNTS, OR SEND BANKRUPT GUARANTORS TO COLLECTION AGENCIES.
    PART VI, LINE 2: THE HOSPITAL PARTICIPATES IN PERIODIC NEEDS ASSESSMENT PROJECTS TO ACCESS THE HEALTHCARE NEEDS OF THE COMMUNITY. THE MOST RECENT NEEDS ASSESSMENT TITLED "HEALTH SYSTEM PROFILE FOR THE TRICOUNTY AREA OF BERKELEY, CHARLESTON, & DORCHESTER COUNTIES" WAS PERFORMED IN 2010. THIS REPORT WAS A COLLABORATION BETWEEN THE SOUTH CAROLINA HOSPITAL ASSOCIATION AND THE SOUTH CAROLINA RURAL HEALTH RESEARCH CENTER IN THE ARNOLD SCHOOL OF PUBLIC HEALTH, UNIVERSITY OF SOUTH CAROLINA. A NUMBER OF DATA SETS WERE EXAMINED IN PARTNERSHIP WITH THE OFFICE OF RESEARCH AND STATISTICS AT THE SOUTH CAROLINA BUDGET AND CONTROL BOARD. THE MAJORITY OF THE INFORMATION DELINEATED IN THIS REPORT WAS DRAWN FROM A SERIES OF INTERVIEWS AND FOCUS GROUPS WITH HEALTHCARE PROFESSIONALS, COMMUNITY LEADERS, AND UNINSURED RESIDENTS. THE PURPOSE OF THIS REPORT WAS TO ASSESS LOCAL HEALTHCARE INFRASTRUCTURE INCLUDING LOCATION, SERVICE AVAILABILITY, BUSINESS RULES, AND WORKFORCE ISSUES AS WELL AS TO DESCRIBE HEALTH SERVICE UTILIZATION ISSUES SUCH AS THE TYPES OF CARE UNINSURED PEOPLE ARE SEEKING, THE DEGREE OF UNMET HEALTHCARE NEEDS, AND PERCEIVED REASONS FOR NEEDS GOING UNMET. DATA SUGGESTS THAT RESOURCES AVAILABLE TO UNINSURED IN THE TRICOUNTY AREA ARE MODERATELY EFFECTIVE IN PREVENTING POTENTIALLY AVOIDABLE EMERGENCY ROOM VISITS BUT LACKS IMPACT ON THE SAME TYPE OF INPATIENT HOSPITALIZATIONS. DIABETES, BACTERIAL PNEUMONIA, CONGESTIVE HEART FAILURE, KIDNEY/URINARY TRACT INFECTIONS, AND DENTAL CONDITIONS ARE AMONG THE MOST PREVALENT REASONS FOR AN AVOIDABLE HOSPITAL VISIT. DENTAL CARE REMAINS A SIGNIFICANT UNMET HEALTHCARE NEED AMONG THE UNINSURED. ACCESS TO SPECIALTY CARE FOR THE UNINSURED IS UNANIMOUSLY THE BIGGEST OBSTACLE FOR THE TRICOUNTY KEY STAKEHOLDERS. THE PARTICIPANTS IN THE NEEDS ASSESSMENT WILL ENGAGE IN STRATEGIC PLANNING AND IMPLEMENTATION OF ACTIVITIES THAT WILL IMPROVE ACCESS TO CARE FOR THE UNINSURED. A PROJECT DATABASE WILL INFORM THE GROUP'S PROGRESS. THE UNIVERSITY OF SOUTH CAROLINA TEAM WILL CONTINUE TO MONITOR PROGRESS AS A PROJECT EVALUATOR.
    PART VI, LINE 3: THE HOSPITAL SHALL SEND ANYONE WHO REQUESTS INFORMATION ON THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM A LETTER OUTLINING REQUIRED INFORMATION AND A FINANCIAL ASSISTANCE APPLICATION FORM. REQUESTS FOR FINANCIAL ASSISTANCE MAY BE PROPOSED BY SOURCES OTHER THAN THE PATIENT, SUCH AS THE PATIENT'S PHYSICIAN, FAMILY MEMBERS, SOCIAL SERVICE ORGANIZATIONS, COMMUNITY OR RELIGIOUS GROUPS, OR HOSPITAL PERSONNEL. STATEMENTS TO PATIENTS FROM THE HOSPITAL OUTLINE OUR CHARITY CARE POLICY AND OUR CHARITY CARE POLICY IS POSTED ON OUR WEBSITE. IF PATIENTS INDICATE THEY ARE NOT ABLE TO PAY THEIR BILL, WE WILL SEND THEM A CHARITY CARE APPLICATION. PATIENTS CAN ALSO MEET WITH A MEMBER OF OUR FINANCIAL COUNSELING DEPARTMENT TO LEARN ABOUT THEIR FINANCIAL ASSISTANCE OPTIONS. BROCHURES ARE PRINTED IN ENGLISH AND SPANISH TELLING PATIENTS TO CONTACT THE FINANCIAL COUNSELING DEPARTMENT. WE WANT OUR PATIENTS FOCUS TO BE ON HEALTH AND RECOVERY AND NOT FINANCIAL WORRY. THERE IS ABSOLUTELY NO ADDITIONAL COST FOR OUR FINANCIAL COUNSELING ASSISTANCE. ADDITIONALLY, PATIENTS CAN MEET WITH STAFF OF THE MEDICAID NAVIGATOR PROGRAM. THE PROGRAM STAFF WILL MEET WITH PATIENTS INDIVIDUALLY TO HELP THEM APPLY FOR PUBLICLY SUPPORTED PROGRAMS SUCH AS MEDICAID, MEDICARE, AND DISABILITY. WE MEET WITH PATIENTS AT A NUMBER OF LOCAL OUTREACH CENTERS, SCHOOLS, AND CHURCHES. THE STAFF CAN ALSO HELP IDENTIFY RESOURCES TO HELP PAY FOR MEDICATION. ALL OF THIS INFORMATION IS POSTED ON OUR WEBSITE WITH THE APPROPRIATE CONTACT INFORMATION.
    PART VI, LINE 4: THE SYSTEM'S PRIMARY SERVICE AREA CONSISTS OF CHARLESTON, BERKELEY, AND DORCHESTER COUNTIES, AND INCLUDES THE MAJOR MUNICIPALITIES OF CHARLESTON, NORTH CHARLESTON, MOUNT PLEASANT, AND SUMMERVILLE. APPROXIMATELY 665,000 RESIDENTS LIVE WITHIN THE PRIMARY SERVICE AREA. POPULATION IN THE PRIMARY SERVICE AREA IS PROJECTED TO GROW 9.1% BETWEEN 2009 AND 2014 COMPARED TO PROJECTED NATIONAL POPULATION GROWTH OF 5.1% OVER THE SAME PERIOD. IN 2009, INCOME LEVELS IN THE PRIMARY SERVICE AREA WERE ESTIMATED AS FOLLOWS: INCOME LESS THAN $ 15,000 - 13.4% BETWEEN $ 15,000 AND $ 25,000 - 10.4% BETWEEN $ 25,000 AND $ 50,000 - 26.9% BETWEEN $ 50,000 AND $ 75,000 - 20.4% BETWEEN $ 75,000 AND $100,000 - 12.2% INCOME ABOVE $100,000 - 16.8%COMPARED TO THE NATIONAL AVERAGES OF 12.4%, 10.4%, 26.0%, 19.6%, 12.3%, AND 19.3%, RESPECTIVELY (MOST RECENT DATA AVAILABLE).WITHIN THE PRIMARY SERVICE AREA, POVERTY CONTINUES TO BE AN ISSUE. AN ESTIMATED 148,511 TRICOUNTY RESIDENTS LACK HEALTH INSURANCE. THERE IS A VAST OVER-REPRESENTATION OF THE UNINSURED LIVING AT OR BELOW THE FEDERAL POVERTY LEVEL. THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES DESIGNATED SIX MEDICALLY UNDERSERVED AREAS AND ONE MEDICALLY UNDERSERVED POPULATION WITHIN OUR PRIMARY SERVICE AREA. FROM APRIL 2010 TO APRIL 2011, THE UNEMPLOYMENT RATE IN THE PRIMARY SERVICE AREA DECREASED FROM 8.7% TO 8.0%. THIS IS A LOWER UNEMPLOYMENT RATE THAN THE NATIONAL AVERAGE, WHICH WAS 9.8% IN APRIL 2010 DECLINING TO 9.0% IN APRIL 2011. THE SECONDARY SERVICE AREA INCLUDES COLLETON, ORANGEBURG, GEORGETOWN, HAMPTON, BEAUFORT, WILLIAMSBURG, AND HORRY COUNTIES. IN ADDITION TO THE SYSTEM'S FACILITIES, THERE ARE THREE OTHER NON-MILITARY HOSPITALS IN THE PRIMARY SERVICE AREA.
    PART VI, LINE 6: WE ARE THE LOWCOUNTRY'S ONLY NON-GOVERNMENTAL, NOT-FOR-PROFIT HEALTHCARE SYSTEM. WITH THIS DISTINCTION, WE BELIEVE IT IS OUR RESPONSIBILITY TO ADVOCATE FOR AND RESPOND TO OUR NEIGHBORS NEEDS THROUGH COMMUNITY BENEFIT. IN KEEPING WITH OUR MISSION OF HEALING ALL PEOPLE WITH COMPASSION, FAITH, AND EXCELLENCE, ROPER ST. FRANCIS HEALTHCARE (RSFH) STRIVES TO ENRICH THE HEALTH OF OUR COMMUNITY. WE DO THIS BY OFFERING CHARITY CARE TO THOSE IN NEED, REACHING OUT TO OUR NEIGHBORS WITH HEALTH FAIRS AND EDUCATIONAL MATERIALS, SPONSORING ORGANIZATIONS AND EVENTS THAT PROMOTE WELLNESS AND COMMUNITY WELL-BEING, AND MARSHALLING OUR RESOURCES TO ADVANCE THE HEALTH AND DIGNITY OF EACH PERSON WITH WHOM WE COME IN CONTACT.THE ORGANIZATION IS COMMITTED TO THE ENRICHMENT OF HEALTHCARE IN OUR COMMUNITY AS EVIDENCED BY THE COMPOSITION OF OUR BOARD OF DIRECTORS AND OPEN MEDICAL STAFF. OUR GOVERNING BODY IS COMPRISED OF A 13-MEMBER BOARD OF DIRECTORS. AT LEAST NINE DIRECTORS MUST HAVE THEIR PRIMARY RESIDENCE IN A COMMUNITY SERVED BY THE SYSTEM. FIVE DIRECTORS MUST BE PHYSICIANS ACTIVELY ENGAGED IN THE FULL TIME PRACTICE OF MEDICINE. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE AREA FOR MOST OF OUR DEPARTMENTS.SURPLUS FUNDS ARE RETURNED TO OUR COMMUNITY THROUGH THE DEVELOPMENT OF NEW FACILITIES TO SERVE POPULATION GROWTH, THE EXPANSION OF EXISTING FACILITIES, SUBSIDIZING CARE FOR THOSE WHO ARE UNABLE TO PAY, SPONSORSHIP OF HEALTHCARE RELATED ACTIVITIES INCLUDING OUTREACH CLINICS AND PROGRAMS FOR THE UNINSURED, AND INVESTING IN TECHNOLOGY TO IMPROVE THE QUALITY OF PATIENT CARE.
    PART VI, LINE 7: CAREALLIANCE HEALTH SERVICES (D/B/A ROPER ST. FRANCIS HEALTHCARE (RSFH)) IS A CHARITABLE HEALTH CARE DELIVERY SYSTEM BASED IN CHARLESTON, SOUTH CAROLINA. THE 657-BED HEALTH SYSTEM PROVIDES SERVICES AT 90 FACILITIES AND DOCTORS OFFICES CONVENIENTLY LOCATED THROUGHOUT OUR REGION. ONE OF THESE FACILITIES IS BON SECOURS - ST. FRANCIS XAVIER HOSPITAL, INC, AN ACUTE CARE HOSPITAL WITH 204 LICENSED BEDS. CAREALLIANCE WAS FORMED EFFECTIVE AUGUST 1, 1998, THROUGH THE EXECUTION OF AN AFFILIATION AGREEMENT BETWEEN THE FOLLOWING FOUNDING MEMBERS: - THE MEDICAL SOCIETY OF SOUTH CAROLINA, - BON-SECOURS HEALTH SYSTEM, INC., AND - CAROLINAS HEALTHCARE SYSTEM. CAREALLIANCE IS THE SOLE CORPORATE MEMBER AND, THROUGH ITS BY-LAWS, HAS THE POWER TO CONTROL THE FINANCIAL AND BUSINESS AFFAIRS OF BON SECOURS ST. FRANCIS XAVIER HOSPITAL.
REPORTS FILED WITH STATES PART VI, LINE 7 SC
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
 
Employer identification number
57-1067254
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance






















2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
 
3
Enter total number of other organizations ................................ . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
OTHER INFORMATION: PART IV: THE MAJORITY OF THE GRANTS EXPENSE SHOWN ON PAGE 10 OF THE 990 IS AN ALLOCATION FROM THE PARENT COMPANY, CAREALLIANCE HEALTH SERVICES. ALL GRANTS MEETING DISCLOSURE REQUIREMENTS FOR 2010 HAVE BEEN LISTED ON CAREALLIANCE HEALTH SERVICE'S FORM 990.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
 
Employer identification number

57-1067254
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
Yes
 
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in 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) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) JOHN M JORDAN (i)
(ii)		 0
254,925 		0
35,000 		0
0 		0
34,564 		0
17,011 		0
341,500 		0
0
(2) DAVID DUNLAP (i)
(ii)		 0
474,480 		0
357,193 		0
607,572 		0
291,001 		0
28,286 		0
1,758,532 		0
468,825
(3) MATTHEW J SEVERANCE (i)
(ii)		 0
376,867 		0
248,672 		0
1,565 		0
184,639 		0
28,974 		0
840,717 		0
0
(4) BRET JOHNSON (i)
(ii)		 0
271,352 		0
181,925 		0
109,883 		0
167,390 		0
33,422 		0
763,972 		0
65,987
(5) STEVEN D SHAPIRO (i)
(ii)		 0
335,914 		0
189,233 		0
1,774 		0
133,607 		0
9,151 		0
669,679 		0
0
(6) ALLEN CARROLL (i)
(ii)		 313,887
0 		210,964
0 		505
0 		156,185
0 		22,665
0 		704,206
0 		0
0
(7) JOHN SULLIVAN (i)
(ii)		 0
221,513 		0
147,737 		0
29,024 		0
122,170 		0
20,962 		0
541,406 		0
0
(8) DOUGLAS W BOWLING (i)
(ii)		 0
287,909 		0
155,073 		0
815 		0
119,220 		0
17,218 		0
580,235 		0
0
(9) MICHAEL TAYLOR (i)
(ii)		 0
237,177 		0
121,008 		0
14,366 		0
86,356 		0
14,609 		0
473,516 		0
0
(10) H DOUGLAS HARRISON (i)
(ii)		 0
225,524 		0
130,506 		0
42,369 		0
86,586 		0
10,781 		0
495,766 		0
36,246
(11) GREGORY T EDWARDS (i)
(ii)		 0
253,678 		0
79,591 		0
683 		0
89,837 		0
23,425 		0
447,214 		0
0
(12) ELLEN BROWN (i)
(ii)		 0
180,746 		0
98,512 		0
5,635 		0
70,119 		0
24,292 		0
379,304 		0
0
(13) LISA IRVIN (i)
(ii)		 0
182,524 		0
91,804 		0
5,137 		0
75,527 		0
8,412 		0
363,404 		0
0
(14) FATHER TERENCE K FLEMING (i)
(ii)		 0
163,353 		0
77,130 		0
17,797 		0
68,580 		0
6,417 		0
333,277 		0
10,290
(15) PENNIE L PERALTA (i)
(ii)		 153,036
0 		83,028
0 		635
0 		55,770
0 		19,495
0 		311,964
0 		0
0
(16) FRANCIS WYCKOFF JR (i)
(ii)		 40,707
127,503 		6,962
21,806 		578
1,811 		6,912
21,648 		2,327
7,288 		57,486
180,056 		0
0
(17) WANDA J BROCKMEYER (i)
(ii)		 33,348
102,765 		4,812
14,828 		1,948
6,002 		2,343
7,221 		2,293
7,066 		44,744
137,882 		0
0
(18) MICHAEL RICCIARDONE (i)
(ii)		 65,598
62,524 		11,643
11,097 		6,254
5,961 		4,886
4,656 		4,834
4,608 		93,215
88,846 		0
0
(19) JOHN D STEICHEN MD (i)
(ii)		 12,869
1,059,539 		48
3,952 		9
703 		349
28,715 		275
22,639 		13,550
1,115,548 		0
0
(20) GEORGE H KHOURY MD (i)
(ii)		 17,806
971,423 		8
442 		95
5,162 		523
28,541 		466
25,448 		18,898
1,031,016 		0
0
(21) STEPHEN E RAWE MD (i)
(ii)		 18,074
885,606 		610
29,908 		146
7,131 		581
28,482 		314
15,363 		19,725
966,490 		0
0
(22) BRIAN G CUDDY MD (i)
(ii)		 13,883
802,743 		0
0 		53
3,078 		494
28,570 		390
22,524 		14,820
856,915 		0
0
(23) ROBERT LOWERY MD (i)
(ii)		 11,758
772,076 		30
1,970 		141
9,237 		436
28,628 		344
22,591 		12,709
834,502 		0
0
(24) PETER DINICOLA (i)
(ii)		 0
176,189 		0
29,922 		0
635 		0
10,464 		0
5,061 		0
222,271 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 1A THE ORGANIZATION PROVIDED TAX GROSS UP PAYMENTS FOR EMPLOYEE PERSONAL USE OF CELL PHONES FOR THE FOLLOWING INDIVIDUALS: ALLEN CARROLL BRIAN CUDDY GEORGE KHOURY PENNIE PERALTA STEPHEN RAWE MICHAEL RICCIARDONE JOHN STEICHEN FRANCIS WYCKOFF WANDA BROCKMEYER
  PART I, LINE 4B THE FOLLOWING PARTICIPANTS RECEIVED COMPENSATION THROUGH A 457(F) PLAN: ALLEN CARROLL - $ 22,285 PENNIE PERALTA - 9,600 TERENCE FLEMING - 10,290 (FROM A RELATED ORGANIZATION) LISA IRVIN - 11,100 (FROM A RELATED ORGANIZATION) ELLEN BROWN - 11,400 (FROM A RELATED ORGANIZATION) DOUGLAS BOWLING - 19,710 (FROM A RELATED ORGANIZATION) MATTHEW SEVERANCE - 29,237 (FROM A RELATED ORGANIZATION) H. DOUGLAS HARRISON - 50,046 (FROM A RELATED ORGANIZATION) GREGORY EDWARDS - 16,362 (FROM A RELATED ORGANIZATION) STEVEN SHAPIRO - 24,087 (FROM A RELATED ORGANIZATION) MICHAEL TAYLOR - 14,400 (FROM A RELATED ORGANIZATION)
  PART I, LINE 6 GOALS ARE DEVELOPED EACH YEAR TO SUPPORT THE ORGANIZATION'S STRATEGIC INITIATIVES FOR PEOPLE, QUALITY, FINANCIAL, GROWTH AND SERVICE. THE AD HOC COMPENSATION COMMITTEE APPROVES THE SYSTEM GOALS ANNUALLY AND REPORTS TO THE FULL BOARD OF DIRECTORS. PROGRESS ON EACH METRIC IS REPORTED TO THE BOARD EACH MONTH ON THE CORPORATE SCORECARD. AT YEAR END, THE AD HOC COMPENSATION COMMITTEE APPROVES THE FINAL SCORECARD NUMBER AND REPORTS RESULTS TO THE FULL BOARD. ANNUAL INCENTIVES FOR THE EXECUTIVES ARE BASED ON 60% ON THE CORPORATE SCORECARD AND 40% ON INDIVIDUAL PERFORMANCE. EXECUTIVES MAINTAIN AN INDIVIDUAL SCORECARD ON THE LEADER EVALUATION MANAGER AND DISCUSS RESULTS MONTHLY WITH THE PRESIDENT/CEO. THE PRESIDENT/CEO APPROVES THE INDIVIDUAL EXECUTIVE SCORECARD. SYSTEM VICE PRESIDENTS AND THE SYSTEM CEO ARE ELIGIBLE TO PARTICIPATE IN A LONG TERM INCENTIVE PLAN (LTIP). AN LTIP PLAN TYPICALLY TAKES PLACE OVER A THREE YEAR PERIOD AND DOES NOT VEST UNTIL THE END OF THE THIRD YEAR. TO RECEIVE PAYMENT, EXECUTIVES MUST STILL BE EMPLOYED BY THE SYSTEM AT THE END OF THE PLAN PERIOD. EACH LTIP PLAN HAS A FINANCIAL AND CLINICAL OBJECTIVE THAT IS ALIGNED WITH THE ORGANIZATIONS STRATEGIC GOALS. THRESHOLD, TARGET, AND MAXIMUM PERFORMANCE RANGES ARE ESTABLISHED FOR THESE OBJECTIVES AND ARE MEASURED BASED ON PERFORMANCE AGAINST SIMILAR ORGANIZATIONS OR COMPARED TO AN INTERNAL METRIC SUCH AS AN IMPROVEMENT OVER PRIOR PERFORMANCE. THESE TARGETS AND OBJECTIVES ARE APPROVED BY THE AD HOC COMPENSATION COMMITTEE. THE INCENTIVE IS EARNED BASED ON THE SATISFACTION OF THE THRESHOLD, TARGET, OR MAXIMUM PERFORMANCE RANGES. THE AD HOC COMPENSATION COMMITTEE ALSO APPROVES THE FINAL LTIP PERFORMANCE SCORE AND THE AMOUNT PAID TO EXECUTIVES UNDER THE PLAN. RESULTS ARE REPORTED TO THE FULL BOARD ANNUALLY.
  PART I, LINE 7 SEE THE RESPONSE TO LINE 6 ABOVE.
SUPPLEMENTAL INFORMATION PART III PART II, LINE 1: COMPENSATION FROM UNRELATED ORGANIZATIONS CAROLINAS HEALTHCARE SYSTEM PROVIDES THE COMPENSATION OF DAVID L. DUNLAP, CEO, CAREALLIANCE HEALTH SERVICES; BRET D. JOHNSON, CFO, CAREALLIANCE HEALTH SERVICES; AND JOHN SULLIVAN, CEO, ROPER ST. FRANCIS MT. PLEASANT HOSPITAL. MR. DUNLAP AND MR. JOHNSON ARE EMPLOYEES OF CAROLINAS HEALTHCARE SYSTEM AND THEIR COMPENSATION IS PAID BY CAREALLIANCE HEALTHCARE SERVICES, A RELATED ORGANIZATION, THROUGH A MANAGEMENT FEE TO CAROLINAS HEALTHCARE SYSTEM. MR. SULLIVAN IS ALSO AN EMPLOYEE OF CAROLINAS HEALTHCARE SYSTEM, AND HIS COMPENSATION IS PAID BY ROPER ST. FRANCIS MT. PLEASANT HOSPITAL, A RELATED ORGANIZATION, THROUGH A MANAGEMENT FEE TO CAROLINAS HEALTHCARE SYSTEM. OF THE FULL BONUS AMOUNT RECEIVED BY JOHN SULLIVAN ($147,737), $71,456 RELATES TO SERVICES PROVIDED UNDER CAROLINAS HEALTHCARE SYSTEM PRIOR TO HIS SERVICE WITH ROPER ST. FRANCIS HOSPITAL. ADDITIONAL INFORMATION: CAREALLIANCE HEALTH SERVICES HAS BOARD REPRESENTATIONS FROM THE 3 FOUNDING ORGANIZATIONS: THE MEDICAL SOCIETY OF SC (6 BOARD MEMBERS), BON-SECOURS HEALTH SYSTEM, INC. (6 BOARD MEMBERS), AND CAROLINAS HEALTHCARE SYSTEM (1 BOARD MEMBER). NONE OF THE 13 APPOINTED BOARD MEMBERS RECEIVE COMPENSATION FOR THEIR MEMBERSHIP. ADDITIONALLY, 4 OF THE 6 BOARD MEMBERS APPOINTED BY THE MEDICAL SOCIETY OF SOUTH CAROLINA ALSO SERVE ON THE BOARD OF THE MEDICAL SOCIETY. NONE RECEIVE COMPENSATION FOR THEIR SERVICES AS A BOARD MEMBER. IT IS THE FOUNDING MEMBERS' INTENT THAT THE MEMBERS OF THE BOARD OF DIRECTORS ARE APPOINTED TO SUCH POSITIONS BECAUSE THEY HAVE A WILLINGNESS TO SERVE THE NEEDS OF THE SYSTEM AS A WHOLE AND NOT THE NEEDS OF ANY INDIVIDUAL FOUNDING MEMBER.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
 
Employer identification number

57-1067254
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) JESSICA PERALTA FAMILY RELATIONSHIP TO OFFICER PENNIE PERALTA 53,932 COMPENSATION FOR EMPLOYMENT   No
(2) KIMBERLY TAYLOR FAMILY RELATIONSHIP TO OFFICER MICHAEL TAYLOR 21,910 COMPENSATION FOR EMPLOYMENT   No
(3) CHARLESTON PATHOLOGY PA
  		OWNED IN PART BY BOARD MEMBER G. FREDERICK WORSHAM, MD 244,929 PROVIDED PATHOLOGY SERVICES THROUGHOUT THE YEAR TO THE ORGANIZATION   No
(4) WEST ASHLEY CANCER CENTER LLC
  		OWNED IN PART BY BOARD MEMBER DAVID ELLISON 103,015 LEASE PAYMENTS TO WEST ASHLEY CANCER CENTER   No
(5) WEST ASHLEY CANCER CENTER LLC
  		OWNED IN PART BY BOARD MEMBER DAVID ELLISON 464,387 INVESTMENT IN JOINT VENTURE   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
 
Employer identification number

57-1067254
Identifier Return Reference Explanation
PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4B AT ROPER ST. FRANCIS HEALTHCARE EVERY NUMBER IS A HUMAN STORY COST OF CHARITY CARE: $33,516,340 COMMUNITY OUTREACH PROGRAMS: $8,539,229 UNREIMBURSED COST OF MEDICAID: $4,777,286 SPONSORSHIPS: $479,905 THE TOTAL AMOUNT OF COMMUNITY BENEFIT WE GAVE BACK INCLUDING CHARITY CARE, UNREIMBURSED COST OF MEDICAID, SPONSORSHIPS AND COMMUNITY OUTREACH PROGRAMS: $47,312,760 PATIENTS WHO RECEIVED FINANCIAL ASSISTANCE FOR THEIR HEALTHCARE: 40,200 SPONSORSHIP DOLLARS GIVEN TO LOCAL ORGANIZATIONS WHO SUPPORT THE OVERALL HEALTH OF OUR NEIGHBORS: $479,905 DONATED TO THE TRIDENT UNITED WAY BY ROPER ST. FRANCIS EMPLOYEES SHATTERING THE RECORD AMOUNT GIVEN BY EMPLOYEES FROM A LOWCOUNTRY COMPANY: $506,497.84 HOURS OF ROPER ST. FRANCIS EMPLOYEE TIME DEVOTED TO SUPPORTING OUTSIDE COMMUNITY HEALTH INITIATIVES: 78,312 FREE COMMUNITY HEALTHFAIRS OFFERING VITAL HEALTH SCREENINGS AND INFORMATION: 36 EVENTS THAT ROPER ST. FRANCIS ATTENDED AND PROVIDED PREVENTIVE SCREENINGS AND SUPPORT: 80+ MEALS PROVIDED BY THE LOWCOUNTRY FOOD BANK FROM ROPER ST. FRANCIS FOOD DRIVES AND FINANCIAL SUPPORT: 14,198 HEALTHY BABIES BROUGHT INTO THE WORLD THANKS TO THE GREAT PRENATAL CARE THEIR MOMS RECEIVED AT THE ROPER ST. FRANCIS SUPPORTED OUR LADY OF MERCY COMMUNITY OUTREACH CENTER: 69 RAISED BY ROPER ST. FRANCIS EMPLOYEES FOR THE AMERICAN HEART ASSOCIATION: $56,400 VOLUNTEERS SERVED 88,000 HOURS IN 2010 EQUALING THE WORK OF 42 FULL TIME EMPLOYEES: 860 MEALS CREATED IN ROPER ST. FRANCIS KITCHENS AND DISTRIBUTED TO OUR COMMUNITY THROUGH MEALS ON WHEELS: 16,652 PEOPLE WHO RECEIVED THEIR PRESCRIPTION DRUGS FROM EAST COOPER COMMUNITY OUTREACH: 523 PATIENT VISITS TO THE BARRIER ISLAND FREE CLINIC: 4,497 REDUCTION IN WATER BORNE ILLNESSES IN CHILDREN SINCE THE EMPLOYEE FUNDED WATER TREATMENT SYSTEM WE SENT TO KENYA WAS PUT IN PLACE: 80% PEOPLE ASSISTED WITH NAVIGATING THEIR HEALTHCARE OPTIONS BY OUR MEDICAID NAVIGATOR PROGRAM: 872 LAB TESTS FOR THE HOMELESS WHO STAY AT THE CRISIS MINISTRIES CLINIC: 110 GRANTS RECEIVED BY THE ROPER ST. FRANCIS FOUNDATION TO BENEFIT THE COMMUNITY: $2,830,108 HIV-POSITIVE RESIDENTS BROUGHT INTO CARE THROUGH FEDERAL AND FOUNDATION GRANTS TO THE ROPER ST. FRANCIS FOUNDATION: 469 COMMUNITY PARTNERS BROUGHT TOGETHER TO PROVIDE ACCESS TO QUALITY HEALTHCARE FOR THE TRI-COUNTYS 149,000 UNINSURED THROUGH A GRANT TO THE ROPER ST. FRANCIS FOUNDATION FROM THE DUKE ENDOWMENT: 25 IN COMMUNITY SUPPORT FROM INDIVIDUALS, BUSINESSES AND CORPORATIONS TO THE ROPER ST. FRANCIS FOUNDATION: $3,060,411 HARD-WORKING, SUPPORTIVE MEMBERS MADE UP OUR 2010 BOARD OF DIRECTORS: 13 JOHN JORDAN, CHAIRPERSON BLOUNT ELLISON, MD, VICE CHAIRPERSON ALISON DILLON, MD KATHERINE DUFFY, PHD DAVID ELLISON, MD JULIUS IVESTER, JR, MD SISTER ANNE LUTZ RICHARD STATUTO MICHAEL TARWATER BRANTLEY THOMAS, PHD ANGRESS WALKER PERRY WARING FREDERICK WORSHAM, MD DEAR FRIENDS, WHEN YOU READ THAT ROPER ST. FRANCIS GAVE OVER $47 MILLION* IN COMMUNITY BENEFIT IN 2010, IT CAN BE HARD TO UNDERSTAND WHAT THAT REALLY MEANS. IN OUR CASE, EACH DOLLAR WE GIVE BACK OR EACH VOLUNTEER HOUR THAT IS SPENT DIRECTLY IMPACTS A LIFE. IN THIS YEARS REPORT TO THE COMMUNITY WE HAVE BROKEN DOWN SOME OF THESE BIG NUMBERS TO REVEAL THEIR IMPORTANCE TO THE PEOPLE WE SERVE. WARM REGARDS, DAVID L. DUNLAP, FACHE PRESIDENT AND CHIEF EXECUTIVE OFFICER * ROPER ST. FRANCIS USES THE VOLUNTARY HOSPITAL ASSOCIATION /CATHOLIC HEALTH ASSOCIATIONS STANDARDIZED COMMUNITY BENEFIT VALUATION METHODOLOGY.
FORM 990, PART VI, SECTION A, LINE 3   CAROLINAS HEALTHCARE SYSTEM (CHS), AN UNRELATED ORGANIZATION, PROVIDES THE COMPENSATION OF MR. DAVID L. DUNLAP, CEO, CAREALLIANCE HEALTH SERVICES; MR. BRET D. JOHNSON, CFO, CAREALLIANCE HEALTH SERVICES; AND MR. JOHN SULLIVAN, CEO, ROPER ST. FRANCIS MT. PLEASANT HOSPITAL. MR. DUNLAP AND MR. JOHNSON ARE EMPLOYEES OF CHS AND THEIR COMPENSATION IS PAID BY CAREALLIANCE HEALTH SERVICES, A RELATED ORGANIZATION, THROUGH A MANAGEMENT FEE TO CHS. MR. SULLIVAN IS ALSO AN EMPLOYEE OF CHS, AND HIS COMPENSATION IS PAID THROUGH A MANAGEMENT FEE BY ROPER ST. FRANCIS MT. PLEASANT HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 6   THE SOLE MEMBER OF THE CORPORATION IS CAREALLIANCE HEALTH SERVICES, A SOUTH CAROLINA NONPROFIT, NONSTOCK CORPORATION, D/B/A ROPER ST. FRANCIS HEALTHCARE. CAREALLIANCE HEALTH SERVICES IS IN TURN GOVERNED BY A BOARD OF DIRECTORS APPOINTED BY THE "FOUNDING MEMBERS". PLEASE SEE THE RESPONSE TO LINE 7A BELOW. THE BYLAWS OF THE ORGANIZATION SPECIFY CERTAIN QUALIFICATIONS OF THE THIRTEEN MEMBER BOARD OF DIRECTORS. AT LEAST NINE DIRECTORS MUST HAVE THEIR PRIMARY RESIDENCE IN A COMMUNITY SERVED BY THE SYSTEM. FIVE DIRECTORS MUST BE PHYSICIANS ACTIVELY ENGAGED IN THE FULL TIME PRACTICE OF MEDICINE. FIVE OF THE DIRECTORS ARE APPOINTED TO THE BOARD OF DIRECTORS BY VIRTUE OF POSITIONS HELD WITHIN MSSC, BSHSI AND CHS (EX-OFFICIO DIRECTORS). EACH OF THE FIVE EX-OFFICIO DIRECTORS SERVES AS A DIRECTOR OF THE ORGANIZATION FOR SO LONG AS SUCH PERSON HOLDS HIS OR HER RESPECTIVE ELECTED OR APPOINTED OFFICE IN HIS OR HER RESPECTIVE FOUNDING MEMBER ORGANIZATION. DIRECTORS SERVE THREE-YEAR TERMS AND ARE LIMITED TO THREE CONSECUTIVE TERMS. AFTER AN ABSENCE OF AT LEAST ONE YEAR, DIRECTORS ARE AGAIN ELIGIBLE FOR APPOINTMENT TO THE BOARD OF DIRECTORS FOR TWO CONSECUTIVE COMPLETE TERMS.
FORM 990, PART VI, SECTION A, LINE 7A   THE ORGANIZATION IS GOVERNED BY A THIRTEEN MEMBER BOARD OF DIRECTORS APPOINTED BY THE FOUNDING MEMBERS. SUBJECT TO CERTAIN NOMINATING AND GOVERNANCE COMMITTEE APPROVALS, SIX DIRECTORS ARE APPOINTED BY THE MEDICAL SOCIETY OF SOUTH CAROLINA (MSSC), BON SECOURS HEALTH SYSTEMS, INC. (BSHSI) AND ONE DIRECTOR IS APPOINTED BY CAROLINAS HEALTHCARE SYSTEMS (CHS). IT IS THE FOUNDING MEMBERS' INTENT THAT THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS ARE APPOINTED TO SUCH POSITIONS BECAUSE THEY HAVE A WILLINGNESS TO SERVE THE NEEDS OF THE SYSTEM AS A WHOLE AND NOT THE NEEDS OF ANY INDIVIDUAL FOUNDING MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B   THE FOLLOWING ACTIONS SHALL REQUIRE THE UNANIMOUS AFFIRMATIVE APPROVAL OF ALL OF THE FOUNDING MEMBERS: (A) TO AMEND THE ARTICLES OF INCORPORATION OR THE BY-LAWS, INCLUDING WITHOUT LIMITATION, ANY CHANGE IN THE CORPORATION'S PURPOSES; PROVIDED, HOWEVER, THAT, SUBJECT TO THE PROCEDURES AND VOTING REQUIREMENTS WITH RESPECT TO THE ADMISSION OF NON-FOUNDING MEMBERS, SCHEDULE 3.1 MAY BE AMENDED WITH THE APPROVAL OF TWO (2) OF THE FOUNDING MEMBERS TO REFLECT THE ADMISSION OF A NON-FOUNDING MEMBER; (B) TO DISSOLVE OR LIQUIDATE THE CORPORATION AND TO DETERMINE THE DISTRIBUTION OF ASSETS UPON DISSOLUTION; (C) TO MERGE OR CONSOLIDATE THE CORPORATION OR TO SELL, CONVEY, TRANSFER, LEASE, OR OTHERWISE DISPOSE OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS; (D) TO APPOINT THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION IN A MANNER OTHER THAN THAT ESTABLISHED BY THE BY-LAWS; (E) TO ALTER OR AMEND THE CORPORATION'S ETHICAL PERFORMANCE STANDARDS (DEFINED BELOW); OR (F) TO ENTER INTO ANY MATERIAL AGREEMENT WHEREBY A THIRD PARTY WILL: (I) BECOME AN EQUITY OWNER IN ANY JOINT VENTURE WITH THE CORPORATION OR ANY SYSTEM PARTICIPANT AND WILL NOT BE LEGALLY OBLIGATED TO SUPPORT THE CORPORATION'S ETHICAL PERFORMANCE STANDARDS; OR (II) MANAGE A SUBSTANTIAL PART OF THE FACILITIES, ASSETS, OR OPERATIONS OF THE SYSTEM AND WILL NOT BE LEGALLY OBLIGATED TO COMPLY WITH AND SUPPORT THE CORPORATION'S ETHICAL PERFORMANCE STANDARDS.
FORM 990, PART VI, SECTION B, LINE 11   THE 2010 FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. REVIEWS WERE THEN CONDUCTED BY THE ASSISTANT CONTROLLER, DIRECTOR OF FINANCE, AND CHIEF FINANCIAL OFFICER OF CAREALLIANCE HEALTH SERVICES, THE SOLE MEMBER, BEFORE PRESENTATION AND REVIEW WITH THE ORGANIZATION'S GOVERNING BODY. HIGHLIGHTS OF THE 2010 FORM 990 WERE PRESENTED TO THE ORGANIZATION'S BOARD OF DIRECTORS ON OCTOBER 15, 2011. IN ADDITION TO THE ORGANIZATION'S EXECUTIVE MANAGEMENT, REPRESENTATIVES OF DIXON HUGHES GOODMAN, LLP PARTICIPATED IN THIS REVIEW WITH BOARD MEMBERS. THE OCTOBER 15 BOARD MEETING WAS HELD PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE. A FINAL VERSION OF THE FORM 990 WAS SENT TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING.
  FORM 990, PART VI, SECTION B, LINE 12C THE DIRECTORS SHALL COMPLETE AND RETURN TO THE SECRETARY AN ANNUAL STATEMENT THAT EACH OF THEM: (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) AGREES TO COMPLY WITH THIS POLICY; (D) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES; AND (E) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES.
  FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT COMPANY, TOWERS PERRIN, PROVIDES RESEARCH, ADVICE AND GUIDANCE TO THE COMPENSATION COMMITTEE AND SENIOR LEADERSHIP TO ENSURE THE ORGANIZATION'S COMPENSATION PROGRAMS FOR EXECUTIVES COVERED BY THE "INTERMEDIATE SANCTIONS LEGISLATION" (IRC SECTION 4958) ARE ALIGNED WITH ITS STATED PHILOSOPHY: BASE SALARIES ARE TARGETED AT THE 50TH PERCENTILE OF THE ESTABLISHED COMPARATOR MARKET; TOTAL CASH COMPENSATION (BASE SALARY PLUS ANNUAL INCENTIVE PAYMENTS) ARE TARGETED AT THE 75TH PERCENTILE OF THE ESTABLISHED COMPARATOR MARKET; TOTAL DIRECT COMPENSATION (TOTAL CASH COMPENSATION PLUS LONG TERM INCENTIVE PAYMENTS) WILL NOT EXCEED THE 90TH PERCENTILE OF THE ESTABLISHED COMPARATOR MARKET; BENEFITS ARE TARGETED AT MARKET MEDIAN; AND IN AGGREGATE, BASE SALARY, TOTAL CASH COMPENSATION, TOTAL DIRECT COMPENSATION AND BENEFITS COMPRISE TOTAL COMPENSATION FOR EXECUTIVES. THE COMPENSATION COMMITTEE ENSURES THAT EXECUTIVE TOTAL COMPENSATION IS REFLECTIVE OF THE ORGANIZATION'S STATED COMPENSATION PHILOSOPHY. THE COMMITTEE, IN THIS PROCESS, AUTHORIZES AND SUPPORTS AN ANNUAL THREE STEP PROCESS UTILIZING TOWERS PERRIN'S RESOURCES: 1) SALARY LEVELS, ANNUAL BONUS TARGETS/PAYMENTS AND LONG TERM INCENTIVE GRANTS ARE COMPARED RIGOROUSLY EACH YEAR WITH MARKET DATA BASED ON COMPARABLE POSITIONS AND ORGANIZATIONS. A. COMPARABLE ORGANIZATIONS ARE TYPICALLY NOT-FOR-PROFIT HEALTHCARE SYSTEMS WITH SIMILAR OPERATING REVENUES. PRIVATE SECTOR EMPLOYER DATA, WHEN AVAILABLE, ARE ALSO INCLUDED IN THE ANALYSIS FOR "TRANSFERABLE SKILLS POSITIONS". B. HISTORICALLY, PERFORMANCE INCENTIVE PAYOUTS GENERALLY TRACK WITH A NORMAL BONUS PAYOUT DISTRIBUTION. INCENTIVE GOALS ARE PRIMARILY BASED ON FORMALLY DEFINED QUANTITATIVE GOALS. 2) ALL RECOMMENDED PAY DECISIONS ARE TESTED AGAINST THESE DATA AND THE ORGANIZATION'S STATED COMPENSATION PHILOSOPHY. 3) A FORMAL OPINION LETTER IS PREPARED BY TOWERS PERRIN, REPRESENTING THAT SENIOR EXECUTIVES ARE COMPENSATED WITHIN THE REASONABLENESS STANDARDS MANDATED BY THE IRS. A SIMILAR PROCESS IS PERFORMED BY WATSON WYATT (COMPENSATION CONSULTING FIRM) FOR THE CEO AND CFO POSITIONS. THIS LETTER PROVIDES A "SAFE HARBOR" FOR THE ORGANIZATION'S "DIRECTORS" RELATIVE TO THE REASONABLENESS OF TOTAL EXECUTIVE COMPENSATION CONSISTENT WITH IRC SECTION 4958.
  FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINSITRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
  FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE PUBLISHED ANNUALLY AND ARE AVAILABLE TO THE PUBLIC AT WWW.DACBOND.COM.
GRANTS FORM 990, PART IX, LINE 1 THE MAJORITY OF THE GRANTS EXPENSE SHOWN ON PAGE 10 OF THE 990 IS AN ALLOCATION FROM THE PARENT COMPANY, CAREALLIANCE HEALTH SERVICES. ALL GRANTS MEETING DISCLOSURE REQUIREMENTS FOR 2010 HAVE BEEN LISTED ON CAREALLIANCE HEALTH SERVICE'S FORM 990.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET SUPPORT FROM FOUNDATION 13,253. INDIGENT CARE SUPPORT 3,141. INTERCOMPANY EQUITY TRANSFER -632,147. TOTAL TO FORM 990, PART XI, LINE 5: -615,753.
  FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
COMPENSATION OF BOARD MEMBERS: FORM 990, PART VII, LINE 1: THE FOLLOWING BOARD MEMBERS WERE COMPENSATED FOR SERVICES PERFORMED FOR THE ORGANIZATION (OR A RELATED ORGANIZATION) NOT IN THE CAPACITY OF THEIR POSITIONS ON THE BOARD. NO BOARD MEMBER IS COMPENSATED FOR HIS SERVICES AS A BOARD MEMBER. JOHN M. JORDAN WAS COMPENSATED BY THE MEDICAL SOCIETY OF SOUTH CAROLINA FOR SERVICES AS CHIEF EXECUTIVE OFFICER. DAVID M. ELLISON WAS COMPENSATED FOR MEDICAL SERVICES RENDERED TO A RELATED ORGANIZATION. ALISON E. DILLON WAS COMPENSATED FOR MEDICAL SERVICES RENDERED TO THE ORGANIZATION.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
BON SECOURS-ST FRANCIS XAVIER HOSPITAL INC
 
Employer identification number

57-1067254
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity







(1) NEUROSCIENCES MRI CENTER LLC
315 CALHOUN STREET 107
CHARLESTON,SC29401
20-3348220 		HEALTHCARE SC     N/A










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 organization
Yes No
(1) CAREALLIANCE HEALTH SERVICES

315 CALHOUN STREET 107

CHARLESTON,SC29401
57-0831165 		HEALTHCARE SC 501(C)(3) LINE 3 N/A
 
No
(2) ROPER HOSPITAL INC

315 CALHOUN STREET 107

CHARLESTON,SC29401
57-0828733 		HEALTHCARE SC 501(C)(3) LINE 3 N/A
 
No
(3) ROPER ST FRANCIS MT PLEASANT HOSPITAL

315 CALHOUN STREET 107

CHARLESTON,SC29401
57-0360499 		HEALTHCARE SC 501(C)(3) LINE 3 N/A
 
No
(4) ROPER ST FRANCIS HOSPITAL - BERKELEY

315 CALHOUN STREET 107

CHARLESTON,SC29401
26-3710229 		HEALTHCARE (FUTURE) SC 501(C)(3) LINE 3 N/A
 
No
(5) ROPER ST FRANCIS PHYSICIANS NETWORK

125 DOUGHTY STREET 760

CHARLESTON,SC29403
26-2946628 		HEALTHCARE SC 501(C)(3) LINE 3 N/A
 
No
(6) ROPER ST FRANCIS FOUNDATION

315 CALHOUN STREET 107

CHARLESTON,SC29401
57-1068509 		SUPPORTING ORG SC 501(C)(3) LINE 11A, I N/A
 
No
(7) THE MEDICAL SOCIETY OF SOUTH CAROLINA

69-B BARRE STREET

CHARLESTON,SC29401
57-0288358 		SUPPORTING ORG/FOUNDING MEMBER SC 501(C)(3) LINE 11C, III-FI N/A
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No












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
(1) CAREALLIANCE MEDICAL SERVICES ORGANIZATION
225 DOUGHTY STREET
CHARLESTON,SC29403
57-1012837 		INACTIVE SC N/A
 C      












Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
Yes
 
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version: