TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Kent Anderson MD Board Chairman	1.00	X			0	0
(2) Joy Rapp Vice Chair	1.00	X			0	0
(3) Sr Esther Polacci Board Secretary	1.00	X			0	0
(4) Sr Kathleen Ann DuRoss Board Member	1.00	X			0	0
(5) Bob Coleman Board Member	1.00	X			0	0
(6) Mike Day Board Member (end 12/10)	0.00	X			0	0
(7) Colin Doyle MD Board Member	1.00	X			0	0
(8) Terry Kolb Board Member	1.00	X			0	0
(9) Sr Anne McMullen Board Member	1.00	X			0	0
(10) Marcy Spilker Board Member	1.00	X			0	0
(11) Mike Thomason Board Member	1.00	X			0	0
(12) Sister Mary Williams Board Member (end 12/10)	0.00	X			0	0
(13) Morgan Wilson MD Board Member	1.00	X			0	0
(14) Howard A Hayes President/CEO (end 1/7/11)	40.00		X		314,488	49,590
(15) Timothy P Sayler President/CEO (beg. 2/14/11)	40.00		X		0	0
(16) Thomas Safley Vice President/CFO	40.00		X		200,712	28,666
(17) Kathleen Connerley VP Patient Care Services	40.00			X	182,142	33,611

(A) Name and business address	(B) Description of services	(C) Compensation
Pathologists Regional Laboratory PO Box 956 Lewiston,ID83501	Laboratory Services	5,094,045
Lewiston ER Physicians c/o Banner Bank PO Box 1628 Lewiston,ID83501	Physician Services	2,556,384
TriMedx LLC PO Box 1627 Indianapolis,IN46278	Professional Services	1,551,757
Valley Anesthesia Associates PO Box 94743 Seattle,WA98124	Professional Services	819,500
Alliance Imaging Inc PO Box 6600 Newport Beach,CA92660	Professional Services	591,180
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 11

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	250,397	250,397
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22	57,828	57,828
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 ....	1,496,597	76,441	1,384,205	35,951
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	45,221,269	38,685,496	6,535,773
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	1,599,286	1,324,529	274,538	219
9	Other employee benefits .......	7,755,026	6,443,147	1,311,586	293
10	Payroll taxes ...........	3,188,509	2,652,329	536,180
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	130,123		130,123
c	Accounting ...........	88,885		88,885
d	Lobbying ...........	18,630	18,393	237
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......
g	Other ..........	5,153,610	5,096,618	56,992
12	Advertising and promotion ....	131,113		131,113
13	Office expenses .......	369,056	146,564	222,492
14	Information technology ......	3,615,470		3,615,470
15	Royalties ..
16	Occupancy ...........	2,842,737	657,306	2,185,431
17	Travel ............	435,241	225,508	209,733
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........	1,042,328		1,042,328
21	Payments to affiliates .......	774,157	774,157
22	Depreciation, depletion, and amortization .....	4,851,272	4,166,922	684,350
23	Insurance ..............	275,654	231,400	44,254
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	Supplies - Med & Other	28,810,546	27,970,355	840,191
b	Bad Debt Expense	4,158,257	4,158,257
c	Other Purchased Service	1,769,801	1,437,566	332,235
d	Provider Tax	1,633,322		1,633,322
e	Physician Recruitment	252,800	252,800
f	All other expenses	7,665,780	6,493,417	904,479	267,884
25	Total functional expenses. Add lines 1 through 24f	123,587,694	101,119,430	22,163,917	304,347
26	Joint costs. Check here 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

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	5,689,294	1	7,274,381
2	Savings and temporary cash investments .......		2
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	16,843,558	4	20,018,833
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5	479
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 .............	386,325	7	277,144
8	Inventories for sale or use ..............	3,676,326	8	3,008,070
9	Prepaid expenses and deferred charges ............	1,557,398	9	441,150
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	80,127,296
b	Less: accumulated depreciation. .....	10b	39,980,874	43,199,462	10c	40,146,422
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 ..		13
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	53,655,999	15	68,436,156
16	Total assets. Add lines 1 through 15 (must equal line 34)...	125,008,362	16	139,602,635
	17	Accounts payable and accrued expenses .	10,316,677	17	8,968,705
18	Grants payable ..........		18
19	Deferred revenue ..........	67,666	19	131,816
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
25	Other liabilities. Complete Part X of Schedule D.....	35,012,270	25	34,138,756
26	Total liabilities. Add lines 17 through 25.....	45,396,613	26	43,239,277
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	79,611,749	27	96,363,358
28	Temporarily restricted net assets .....		28
29	Permanently restricted net assets .....		29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	79,611,749	33	96,363,358
34	Total liabilities and net assets/fund balances .....	125,008,362	34	139,602,635

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

St Joseph Regional Medical Center

Employer identification number

82-0204264

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.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

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

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

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

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

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

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)

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

(i) Name of supported organization	(ii) EIN	(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?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

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

Cat. No. 11285F

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).

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

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

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

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

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

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 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:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below.
SchCMd Bullet

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

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

St Joseph Regional Medical Center

Employer identification number

82-0204264

Part I-A

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

Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2010

Page 2

Part II-A

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

A Check if the filing organization belongs to an affiliated group.
B Check if the filing organization checked box A and "limited control" provisions apply.

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount

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

c	Total lobbying expenditures

d	Grassroots non-taxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2010

Page 3

Part II-B

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

(a)

Yes

(b)

Amount

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

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

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

Yes

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

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

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

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

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

Yes

271

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

Other activities? If "Yes," describe in Part IV ..........................

Yes

18,630

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

18,901

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
Explanation of Other Lobbying Activities:	Part II-B, Line 1i:	Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Additionally, dues are paid to Rural Referral Center/Sole Community Hospital Coalition to lobby on behalf of The Medical Center. St. Joseph Regional Medical Center does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office.

Schedule C (Form 990 or 990EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," 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

St Joseph Regional Medical Center

Employer identification number

82-0204264

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 .......

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

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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. ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

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

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

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

Yes No

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

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

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

Yes No

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.

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.

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

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:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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

Page 2

Part III

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

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

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 ......

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

Permanent endowment: SchDMd Bullet

Term endowment: SchDMd Bullet

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

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

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

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

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	4,861,989		4,861,989
b	Buildings ................	47,226,484	18,259,470	28,967,014
c	Leasehold improvements ............
d	Equipment ................	27,390,813	21,467,142	5,923,671
e	Other .................	648,010	254,262	393,748
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				40,146,422

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther 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.)

Part VIII

InvestmentsProgram 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









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) Other Receivables				291,870
(2) Receivable from Third Party Payors				409,311
(3) Intercompany Receivable				28,411
(4) Deferred Compensation Asset				111,682
(5) Health System Depository Account				61,670,652
(6) Prepaid Pension				4,774,696
(7) Other Miscellaneous Current Assets				1,149,534


Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........				68,436,156

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes
Intercompany Debt to Ascension Health		27,187,478
Payable to Third Party Payors		4,014,331
Deferred Compensation Liability		111,682
Self-Insurance Liability		1,071,508
Asset Retirement Obligation		283,390
Valuation Allowance Liability		1,440,000
Pension Liability		30,367


Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		34,138,756
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

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

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" 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

St Joseph Regional Medical Center

Employer identification number

82-0204264

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

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

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

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:

Yes

100% 150% 200% Other

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: .....

Yes

200% 250% 300% 350% 400% Other 10100.0000000000 %

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.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

Yes

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

Does the organization prepare an annual community benefit report?.............

Yes

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

Yes

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

Charity Care and Certain Other Community Benefits at Cost

	(a) Number of activities or programs (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) ..		2,883,794		2,883,794	2.410 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .		17,340,054	14,751,063	2,588,991	2.170 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....		20,223,848	14,751,063	5,472,785	4.580 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....		273,968		273,968	0.230 %
f Health professions education (from Worksheet 5) ..		322,111		322,111	0.270 %
g Subsidized health services (from Worksheet 6) ..	13	8,022,984	5,083,789	2,939,195	2.460 %
h Research (from Worksheet 7)
i Cash and in-kind contributions to community groups (from Worksheet 8) ..		270,626		270,626	0.230 %
jTotal Other Benefits ...	13	8,889,689	5,083,789	3,805,900	3.190 %
kTotal. Add lines 7d and 7j. ..	13	29,113,537	19,834,852	9,278,685	7.770 %

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	99,301	99,301	0.080 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	191,595	191,595	0.160 %
9	Other
10	Total	290,896	290,896	0.240 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Enter the amount of the organization's bad debt expense (at cost).....

1,815,915

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

154,927

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

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

30,772,766

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

37,470,280

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

-6,697,514

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

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......

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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

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		Other (Describe)
1	St Joseph Regional Medical Center 415 Sixth Street Lewiston,ID83501	X	X	X

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

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

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

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

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?3
Name and address		Type of Facility (Describe)
1	SJRMC Outpatient Mental Health Clinic 428 6th Avenue Lewiston,ID83501	Mental Health Clinic
2	SJRMC Outpatient Mental Health Clinic 428 6th Avenue Lewiston,ID83501	Mental Health Clinic
3	SJRMC Outpatient Mental Health Clinic 428 6th Avenue Lewiston,ID83501	Mental Health Clinic
4
5
6
7
8
9
10

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 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data and is in compliance with the Catholic Health Association ("CHA") guidelines. The best data available was used to calculate the amount reported in the table. For certain categories in the table, this was direct costs from the general ledger, in other categories, a specific cost-to-charge ratio was used.
		Part I, Line 7g: The Medical Center provides in-kind clinical space (value of $33,804) to the Lewis and Clark Health Center, a Federally Qualified Health Clinic serving the primary care needs in our geographic region.
		Part I, L7 Col(f): The amount of bad debt expense reported on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentages in Part I, Line 7, Column (f) is $4,158,257.
		Part III, Line 4: Footnote per the Medical Center's financial statements:The provision for bad debts is based upon management's assessment of historical and expected net collections considering economic conditions, trends in health care benefit coverage and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by payer category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for bad debts to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Medical Center follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Medical Center's policies.The Medical Center's bad debt expense in 2011 was $4,158,257 at charges ($1,815,915 at cost).
		Part III, Line 8: The Medical Center follows the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit.
		Part III, Line 9b: The Medical Center has a written debt collection policy that also includes a provision on the collection of practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity care or financial assistance certain collection practices do not apply.
		Part VI, Line 2: A survey was conducted in fall of 2009 in the Lewis-Clark Valley to determine the community needs regarding issues related to education/youth, emergency services, and health services. A random sample of 430 people completed the needs assessment enabling a 95% confidence interval to be defined around plus or minus five percentage points for each question.The three most important education youth goals were (1) reduce teen drug, tobacco & alcohol use, (2) provide a safe environment for children after school, and (3) reduce the high school dropout rate. The community strongly supported safe after school childcare/daycare, intervention programs for at-risk youth, preschool/kindergarten readiness, tutoring or academic assistance, and mentorship programs. Those familiar with local daycare/childcare services rate the quality, availability, and staff to child ratio as fair. Affordability is rated less favorably and services for special needs children seems wanting. High levels of concern were found for our community's youth with regard to drugs & alcohol, negative home environment/family life, academic achievement, bullying, relationships/teen sex, depression/self harm, and obesity.The three most important emergency services goals were (1) increase services to the number of families with basic needs such as food and shelter, (2) increase job training and educational programs to help individuals increase income, and (3) decrease the number of families and individuals suffering from violence and abuse. Strong community support exists for assistance for low-income persons in the area of food banks/hunger support, domestic violence prevention and treatment, advocates for children in the courts, disaster services/house fires & natural disasters, and shelter for the homeless. The three most important health care goals were (1) increase the number of families able to get regular medical checkups and access preventative medicine, (2) increase the number of families able to access urgent healthcare, and (3) increase the number of people living drug-free. Community members appear to be well aware of the range of health care programs and believe the need is particularly high for family doctors, chemical dependency treatment, emergency care, and public health services. While not rated as high, a very sizable number in the valley believe more respite care, counseling services, dentists, mental health services, and nursing homes are needed. While only 13% report not having medical insurance coverage and only 17% do not have prescription coverage, over a third do not have dental, vision, or mental health insurance. The cost of the insurance is the biggest factor keeping community members from getting health care followed by a lack of insurance itself. People in this community strongly rely on their doctors for information about their health care decisions and they tend to listen to their doctors more than any other sources. The Internet is used as a resource for health decisions twice as much as either the television or newspaper. Community members view health screenings, lack of exercise, poor nutrition, heart problems, and obesity as the most important concerns for their own health and wellness. During FY 2011, additional information was obtained in the initial phase of the strategic planning process entered into by SJRMC which identified other needs, and that information will be utilized in identifying additional services needed as well as collaborative opportunities.
		Part VI, Line 3: St. Joseph Regional Medical Center's financial assistance is available to all patients. The Medical Center's financial assistance notice is posted in all registration areas, emergency department and business services department. Financial assistance applications are available at all registration areas and business services offices. The Medical Center makes every attempt to identify/assist patients who may be eligible for charity or discounted care through the Medical Center's Charity Care Policy. A financial assistance counselor is available to all patients. The Business Office staff is trained on how to qualify patients for Medicaid, County Assistance and other payment programs. The financial assistance counselor discusses with the patient the availability of various government assistance programs and assists the patient with qualification for such programs. As the result of a grant through the state of Washington, a Medicaid eligibility case worker assists Washington applicants in with their application process. Written summary and contact information is also provided in billing communications with patients. For the patient who has limited English proficiency, interpreter services are available at no charge.
		Part VI, Line 4: The Medical Center serves as both a primary care facility and a secondary referral facility for residents of the Medical Center's nine county service area, which includes: Nez Perce, Latah, Idaho, Clearwater and Lewis counties, ID; Asotin, Garfield and Whitman counties, WA; and Wallowa county, OR. The service area has an aggregate population of approximately 174,000 people in north central Idaho, southeast Washington and northeast Oregon. St. Joseph Regional Medical Center is the only full service Medical Center in a region with nine Critical Access Hospitals in the immediate geographic area. St. Joseph Regional Medical Center provides approximately 80% of the inpatient acute care hospital services in its primary care area and 40% of the inpatient services in its regional service area. In FYE June 2011, St. Joseph Regional Medical Center treated 5,791 inpatients and recorded an additional 122,332 outpatient visits. The Medical Center provided a substantial portion of its services to the elderly and poor. In FYE June 2011 approximately 47.1% of services rendered were to elderly patients under the Medicare program, and approximately 14.1% of the services were provided to patients deemed indigent under state, county, or Medical Center guidelines. The Medical Center provided $2,883,794 in unpaid costs of providing traditional charity care, $2,588,992 in unpaid costs of public programs, $157,544 net cost of programs to the poor, and $3,939,249 net expenses for services and community benefit programs provided at a loss to meet community needs. The following comments duplicate the comments for the first bullet point under Part VI, Line 5. At the expense of the Medical Center, the clinic was completely renovated to meet the needs of the Lewis Clark Health Clinic (LCHC).
		Part VI, Line 6: The Medical Center also provided services to meet additional community needs by supporting other health awareness, education and health promotion activities in the community as outlined below: - The Medical Center was an integral member of the Local Access to Care Committee that looked at available options to increase access to Primary Care. Working with the Community Health Association of Spokane, a grant for $1.3 million was secured. Following this, a Federally Qualified Health Clinic opened on July 1, 2009 as the Lewis Clark Health Clinic (LCHC). The LCHC addresses access issues for all patients especially those with Medicare, Medicaid and no insurance. During its first year, the Medical Center provided free clinic space and provided a $10,000 per month operating subsidy. By the end of that year, LCHC had recruited one full time PA and a .75 NP and established a medical home for over 1,700 patients. During its second year of operation, the cash contribution was no longer necessary, but the Medical Center continued to provide space without cost to the clinic. - Due to the rural nature of Idaho and Southeastern Washington, a shortage of mental health professionals exists. The Medical Center has developed strategies to address this issue by working with legislators to fund programs, continuing to develop Mental Health Telemedicine involvement with Idaho's Region II hospitals and educating the region, professionals and non-professionals by sponsoring/facilitating the annual Rural Mental Health Symposium event. The Mental Health Center also has a speaker bureau program where the centers mental health physicians are available to speak on educational and informational topics. This is a free program.- Provided mobile mammography and PACS access to some of the rural hospitals and clinics in the area who are otherwise unable to provide those services.- The Medical Center Foundation offered a series of free "Your Doctor Speaks" programs covering six different healthcare topics presented by local physicians and national speakers. Almost 240 people attended these seminars. - The Medical Center Foundation's "Think First" program, which works with the local school districts, teaches head and spinal cord injury prevention to elementary and junior/ senior high classes. - The Medical Center's Senior Life program for adults over age 60 assisted 269 seniors with Medicare Part D through its pharmacy program. This program is free and open to the public. The coordinator of this program helped seniors sign up for Medicare Part D and select the options that best serve their needs. She also helped them sign up for medication assistance programs that made it possible for them to acquire medications that they could not otherwise afford.- The Outpatient Diabetes Education Center offered free education classes titled "Pre-Diabetes Awareness", "Supermarket Tours and Budget Tips", "Diabetes Boot Camp", and "Diabetes Awareness Fair". These classes are offered at no expense to the participants in an ongoing effort to continue to educate the public on the management of diabetes. - The Medical Center's Community Health Education Resource Center presented "Go Red for Women" day, an event designed to increase awareness of heart disease, the #1 killer of women. This Open House event gave attendees a chance to learn about healthy choices in eating, exercise and risk factor reduction, and other lifestyle options - all in an effort to improve the heart health of the women in our service area.
		Part VI, Line 7: St. Joseph Regional Medical Center continued the training and education of health care professionals to help address the shortage of and expand the availability of trained clinicians. This has been accomplished with a governing body that draws from leaders in the religious community, the physician community and the local community. Idaho has one of the lowest physicians to population ratios in the United States. So, it is very important to emphasize the recruitment and retention of physicians in order to meet the healthcare needs of the community. In FYE June 2010 the Medical Center worked very closely with its Medical Staff to enhance recruitment efforts of new physicians to the community. In addition to working with the Medical Staff, the Medical Center employed an in-house physician recruiter, who developed ongoing relationships with Ascension Health Physician Recruitment Services and Recruitment Firms throughout the country to market the provider opportunities in the community. In FYE June 2010 the Medical Center successfully recruited Oncologists and worked closely with Valley Medical Center to recruit an Obstetrician/ Gynecologist, a Foot and Ankle Surgeon/ Podiatrist and a Family Practice physician. The Medical Center also worked with the local pathology group to recruit a Pathologist. St. Joseph Regional Medical Center welcomed an additional Ophthalmologist and an Oral and Maxillofacial Surgeon to the Medical/Dental staff. Recruitment efforts continue in Neurology, Psychiatry, and Outpatient Family and Internal MedicineIn FYE June 2010 the Medical Center committed to providing a larger space for the St. Joseph Regional Cancer Center. In 2010, the Cancer Center (Medical Oncology Clinic) relocated into the newly remodeled location, tripling the Cancer Center's space from 3,000 square feet to 9,000 square feet. The Medical Center spent $933,000 to complete this remodel which included five additional exam rooms, four additional infusion chairs, plus additional waiting space, physician and staff offices, and separate spaces for pharmacy and social services. The new facility also offers increased privacy for our patients and their families. The Medical Center provides the only cancer care within a 110 mile radius and serves patients from throughout the region. Further actions associated with the development of the Medical Oncology program included successful recruitment of two additional Oncologists in FYE June 2010. During FY 2011, the number of visits recorded at the Cancer Center rose from 8,687 in 2010 to 9,804.The Medical Center is designated by CMS as a Sole Community Hospital and provides many of the same services as a much larger acute care facility. The nearest acute care facility is located more than 110 miles to the north of our service area.
		Part VI, Line 7: St. Joseph Regional Medical Center is a member of Ascension Health. Ascension Health is a Catholic, national health system consisting primarily of not-for-profit corporations that own and operate local health care facilities or Health Ministries, located in 20 of the United States and the District of Columbia. Ascension Health is sponsored by the Northeast, Southeast, East Central and West Central Provinces of the Daughters of Charity of St. Vincent de Paul (DC), the Congregation of St. Joseph (SSJ) and the Sisters of St. Joseph of Carondelet (CSJ).The Medical Center, located in Lewiston, Idaho, is a not-for-profit acute care hospital. The Medical Center provides inpatient, outpatient and emergency care services for the residents in the areas surrounding Lewiston, Idaho and Clarkston, Washington. Admitting physicians are primarily practitioners in the local area. The Medical Center is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services. Ascension Health directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with Ascension Health's mission of service to those who are poor and vulnerable, each Health Ministry accepts patients regardless of their ability to pay. Ascension Health uses four categories to identify the resources utilized for the care of persons who are poor and community benefit programs:1. Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.2. Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the poor.3. Cost of other programs for the poor includes programs intentionally directed at serving the poor and vulnerable of the community including substance abusers, the homeless, victims of child abuse and persons with Acquired Immune Deficiency Syndrome.4. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the poor, including health promotion and education, health clinics and screenings and medical research.St. Joseph Regional Medical Center continues to serve as the only full service acute care hospital in the region. Its goal is to improve the health status of the whole community, by providing essential medical services to all patients, including those unable to pay for their healthcare needs. This continues to be the mission and philosophy of St. Joseph Regional Medical Center. By offering a broad selection of educational offerings and healthcare services, the Medical Center strives to better meet the healthcare needs of the patients and organizations in the service area. The Community Health Resource and Education Center continues to help facilitate classes and training for associates, community members and patients in an effort to better meet the educational and informational needs in the community and surrounding area. St. Joseph Regional Medical Center maintains its position as the regional leader in health education, community-based programs, and providing healthcare services to all its patients.In FYE June 2011 the Medical Center treated 5,789 adult, pediatric, newborn, transitional care and psychiatric inpatients for a total of 27,003 patient days of service. The Medical Center also provided service to 121,042 outpatients, including 2,710 outpatient surgery patients, 30,058 emergency and minor care patient visits, 9,804 Oncology clinic visits and 79,760 other outpatient visits. All Medical Center services are provided without regard to the patient's race, creed, national origin, economic status, or ability to pay. The Medical Center provided $9,569,579 million in un-reimbursed cost of services to the poor and to meet the needs of the community.

Schedule H (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

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
St Joseph Regional Medical Center

Employer identification number
82-0204264

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to 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	(h) Purpose of grant or assistance
(1) Snake River Clinic215 10th Street Lewiston,ID83501	31-1726460	501(c)(3)	36,961	Medical Services
(2) Twin County United Way2207 E Main Street Lewiston,ID83501	82-0261086	501(c)(3)	42,422	Community Support
(3) LCSC Nursing Faculty500 8th Avenue Lewiston,ID83501	82-6000935	501(c)(3)	44,000	Nursing Staff
(4) Valley Vision111 Main Street Lewiston,ID83501	84-1367690	501(c)(6)	10,000	Community Support

Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image

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

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	(d)Amount of non-cash assistance	(f)Description of non-cash assistance
(1) Medical Prescriptions	57,828	Prescriptions for Indigent Patients

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
Procedure for Monitoring Grants in the U.S.:	Part I, Line 2:	Schedule I, Part I, Line 2: Before funds are disbursed, all grants must go through an approval process at the Medical Center. After approval and disbursement of the funds, the funds are monitored by the applicable non-profit's board of directors. Each non-profit organization that receives funds has one or more Medical Center employee(s) that sits on its board of directors to help ensure the funds are spent as directed.

Schedule I (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

Complete if the organization answered "Yes" 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

St Joseph Regional Medical Center

Employer identification number

82-0204264

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

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

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

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

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:

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

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

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

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:

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

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

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

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 ............

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 .............................

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

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

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
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) Howard A Hayes	(i) (ii)	268,787 0	0 0	45,701 0	21,726 0	27,864 0	364,078 0	0 0
(2) Thomas Safley	(i) (ii)	198,572 0	0 0	2,140 0	10,393 0	18,273 0	229,378 0	0 0
(3) Kathleen Connerley	(i) (ii)	181,425 0	0 0	717 0	14,820 0	18,791 0	215,753 0	0 0
(4) Thomas Pfliger	(i) (ii)	174,571 0	0 0	7,297 0	13,908 0	6,628 0	202,404 0	0 0
(5) Sushma Pant	(i) (ii)	553,304 0	0 0	0 0	12,201 0	11,538 0	577,043 0	0 0
(6) Gerardo Midence	(i) (ii)	548,477 0	0 0	0 0	7,788 0	14,571 0	570,836 0	0 0
(7) Katrina A Popham	(i) (ii)	524,606 0	0 0	0 0	12,201 0	6,575 0	543,382 0	0 0
(8) Michael C Minick	(i) (ii)	400,704 0	0 0	0 0	12,201 0	16,723 0	429,628 0	0 0
(9) William C Dir	(i) (ii)	374,759 0	0 0	0 0	7,782 0	20,098 0	402,639 0	0 0

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 paid for temporary housing for the new CFO Timothy Saylor. The amount paid was treated as a taxable benefit to him.

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

St Joseph Regional Medical Center

Employer identification number

82-0204264

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?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

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?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No
(1) Brenda Forge Purchase Computer		X	1,129	479		No	Yes		Yes





Total ............... $				479

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

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Pathologists Regional Laboratory	Board member is a shareholder	5,026,787	Lab Service		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, Part IV	Business Transactions Involving Interested Persons:	All transactions reported on Part IV are reported as arms-length and negotiated for fair market value.

Schedule L (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 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

St Joseph Regional Medical Center

Employer identification number

82-0204264

Identifier	Return Reference	Explanation
Form 990, Part VI, Section A, line 6		St. Joseph Regional Medical Center has a single corporate member, Ascension Health.
Form 990, Part VI, Section A, line 7a		St. Joseph Regional Medical Center has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of St. Joseph Regional Medical Center.
Form 990, Part VI, Section A, line 7b		Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix.
Form 990, Part VI, Section B, line 11		Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, to review and answer any questions. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions.
	Form 990, Part VI, Section B, line 12c	The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
	Form 990, Part VI, Section B, line 15	In determining compensation of the organization's CEO, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Executive Committee of the SJRMC Board and the SJRMC Board reviewed and approved the compensation. In the review of the compensation, the CEO was compared to similarly sized organizations as well as organizations similar in complexity of operations, revenues and job responsibilities across the nation. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Individual was not present when his compensation was decided. In determining compensation of other officers or key employees of the organization, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Executive Committee of the SJRMC Board and the SJRMC Board reviewed and approved the compensation. In the review of the compensations, the other officers or key employees of the organization were compared to similarly sized organizations as well as organizations similar in complexity of operations, revenues and job responsibilities across the nation. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes.
	Form 990, Part VI, Section C, line 19	The organization will provide any document open to public inspection upon request.
Changes in Net Assets or Fund Balances:	Form 990, Part XI, line 5:	Net unrealized gains on investments: 4,502,658. Other Activity 12,895. Transfers to/from Affiliates -2,344,679. Deferred Pension Costs 6,253,597. Total to Form 990, Part XI, Line 5: 8,424,471.
	Form 990, Part III, Line 4:	St. Joseph Regional Medical Center Community Benefit Report For the Period Ended June 30, 2011 This report is designed to provide information regarding the considerable time, financial contributions, and on-going efforts to which St. Joseph Regional Medical Center (the Medical Center) contributes to the positive health status of the communities it serves. As a member of Ascension Health, the nation's largest Catholic healthcare system and largest non-profit health care system, the Medical Center continues to build and strengthen sustainable collaborative services that benefit the health of individuals, families, communities, and society as a whole. The Medical Center strives to facilitate the healing mission of the Church through the delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. The concern for all human life and the dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. The full extent to which the Medical Center provides community benefits and services to the region and to the patients is outlined below: Individuals, Families, and Communities Benefited by the Medical Center: St. Joseph Regional Medical Center, located in Lewiston, Idaho, has 125 acute care beds, a 20 bed inpatient psychiatric unit and a 16-bed sub-acute unit. It is estimated that the Medical Center provides approximately 80% of the inpatient acute care hospital services in its primary care area and 40% of the inpatient services in its regional service area. The Medical Center serves as both a primary care facility and a secondary referral facility for residents of the Medical Center's nine county service area, which includes: Nez Perce, Latah, Idaho, Clearwater and Lewis Counties, ID; Asotin, Garfield and Whitman Counties, WA; and Wallowa County, OR, which has an aggregate population of approximately 168,000 people in north central Idaho, Southeast Washington and Northeast Oregon. The Medical Center is fully accredited by the Joint Commission on the Accreditation of Healthcare Organizations and has a regional cancer program accredited by the American College of Surgeons "With Commendation", which is only awarded to the top 5% of the ACS accredited hospitals in the country. In addition to providing healthcare services to all individuals who require medical attention, the Medical Center seeks to improve the physical, mental, social, and spiritual health status of its surrounding community. Operations and Governance to Providing Community Benefit: In this community, the Medical Center: - Operates an Emergency Room and Minor Care that is open to all persons regardless of the ability to pay; - Provides a comprehensive array of inpatient and outpatient services to all persons without regard to race, color, creed, national origin, economic status, or ability to pay; - Participates in Medicare, Medicaid, County, TriCare, Indian Health Services and/or other government-sponsored health care programs to assure access of patients to services; - Provides a wide range of services and educational offerings to better meet the healthcare needs of patients in the region and improve the health status of the community; - Engages in the training and education of health care professionals to help address the shortage of and expand the availability of trained clinicians required to meet the health care needs of the community and region; and - Has a governing body that draws from leaders in the religious community, the physician community and the local community. Patients Served: In FY2011 the Medical Center treated 5,789 adult, pediatric, newborn, transitional care and psychiatric inpatients for a total of 27,003 patient days of service. The Medical Center also provided service to 122,332 outpatients, including 2,710 outpatient surgery patients, 30,058 emergency and minor care patient visits, 9,804 Oncology clinic visits and 79,760 other outpatient visits. All Medical Center services are provided without regard to the patient's race, creed, national origin, economic status, or ability to pay. Patient Services Provided: St. Joseph Regional Medical Center operates as a regional referral center providing a range of acute care inpatient and outpatient services comparable to much larger hospitals in urban areas. Some services are operated at a loss in order to assure that the service is available to meet community health care needs. BIO-MEDICAL ENGINEERING CARDIOPULMONARY Cardiac Stress Testing - Electrocardiogram (EKG) - Thallium stress testing - Treadmill Neurodiagnostic Laboratory - Electroencephalogram(EEG) - Electromyogram (EMG) - Evoked Potential - Sleep studies Pulmonary Lung Function Testing Remote Cardiac Monitoring - Holter - King-of-Hearts Respiratory Therapy - Inpatient - Outpatient - Home respiratory program DIAGNOSTIC IMAGING (RADIOLOGY) Bone Densitometry Cardiac Catheterization Lab Computerized Tomography (CT) Digital Angiography Echocardiography Magnetic Resonance Imaging (MRI) Digital Mammography Mobile Mammography Mobile PET/CT Scanner Nuclear Medicine Stereotactic Breast Biopsy Ultrasound Diagnostic X-Ray FOOD & NUTRITIONAL SERVICES Inpatient Registered Dietitians Outpatient Registered Dietitians Meals on Wheels PALLIATIVE CARE PASTORAL CARE PATIENT ACCOUNTS REPRESENTATIVE PATIENT CARE AREAS(INPATIENT) Family Beginnings - Neonatal Intensive Care Unit (Level II) - Obstetrics (LDR's) - Pediatrics Intensive/ Cardiac Care Medical Service Oncology Service Palliative Care Unit Progressive Care Surgical Service Transitional Care Unit PATIENT CARE AREAS(OUTPATIENT) Emergency Department - Minor Care - Trauma Center Endoscopy Laboratory Family Hospice (Medicare Certified) IV Services Mental Health - Adult Inpatient & Outpatient Mobile Lithotripsy REGIONAL CANCER CENTER - Oncology/Hematology Clinic - Chemotherapy Radiation Oncology Center - Brachytherapy - IMRT SURGICAL SERVICES Inpatient and outpatient Anesthesiology Ear, nose, throat General surgery Gynecology Neurosurgery Ophthalmology Oral surgery Orthopedic surgery Plastic surgery Thoracic surgery Urology surgery Vascular surgery PHARMACY REGIONAL PATHOLOGY LABORATORY - Blood Bank - Chemistry - Cytology - Hematology - Histology - Pathology REHABILITATION SERVICES Inpatient & Outpatient - Occupational therapy - Physical therapy - Speech therapy - Pediatric o/p rehabilitation SENIORLIFE SOCIAL SERVICE The patients served in this community are done so by a wide range of physician specialities. The Medical Center has cooperated with the medical community to attract well-qualified physicians in a broad array of primary and specialty areas to help insure access to quality health care for patients in the region. Idaho continues to have one of the lowest physicians to population ratios in the United States. Therefore, it is very important to emphasize recruitment and retention of physicians in order to help meet the healthcare needs of the community. In FY2011 the Medical Center worked very closely with its Medical Staff to enhance recruitment efforts of new physicians to the community. In addition to working with the Medical Staff, the Medical Center continues in-house recruiting efforts through Human Resources and developing ongoing relationships with Ascension Health Physician Recruitment Services and Recruitment Firms throughout the country to market the provider opportunities in the community. In FY 2011 the Medical Center successfully recruited an Orthopedic Hospitalist, Psychiatrist, and Neurologist (for locum work.) The Medical Center also worked closely the Valley Medical Center to recruit a Pediatrician and Family Medicine physician, and also with Pathology Regional Lab to recruit a Pathologist. The community and the Medical Center also welcomed an Oral and Maxillofacial Surgeon, Gastroenterologist and Wound Care physician. Recruitment efforts continue in Primary Care, Cardiology, Neurology, and Interventional Radiology.
		The Medical Center performs periodic reviews of medically needed services that are not currently being provided to residents of its service area. This review has led to the introduction of new services over the years: - Medical Oncology, neurosurgery, cardiology, and neurology (1983); - Expanded outpatient surgery, emergency services, and endoscopy laboratory (1985); - Radiation therapy services and magnetic resonance imaging services (1988); - Expanded nuclear medicine capabilities (1990); - Added inpatient and expanded outpatient adult mental health (1992); - Transitional Care Unit (1995); - Expanded outpatient services (ER, Minor care, pain clinic, endoscopy lab (1999); - Picture Archiving Computer (2000); - Radiation Therapy Treatment Planning (2004); - Diagnostic Cardiac Catheterization (2005); - IMRT, New MRI, 64-Slice CT (2006); - Addition of an Inpatient Palliative Care Unit (2008); - Relocation of the Cancer Clinic (2010). In FY2010 and 2011, the Medical Center committed to providing a larger space for the St. Joseph Regional Cancer Center. The Cancer Center relocated into the newly remodeled Idaho Street location. The Medical Center spent $932,528 to complete this remodel which included five additional exam rooms, four additional infusion chairs and tripled the square footage from 3,000 square feet to 9,000 square feet, including additional waiting space, physician and staff offices, and separate spaces for pharmacy and social services. SJRMC provides the only cancer care within a 110 mile radius and serves patients from throughout the region. The relocation of the Cancer Center provided an opportunity to move Outpatient Mental Health to the vacated Cancer Center. This building provides an enhanced layout for Mental Health Services as exam rooms transformed to counseling rooms in November 2011. In FY2011, other major capital improvement projects completed at the Medical Center focused on enhancing patient safety and expanding services available to patients in the regional referral area. These projects included adding a digital fluro room which includes an x-ray fluro. This project was completed to enhance patient services in the area at a cost of $513,000. As patient safety remains a top priority to the Medical Center, at total of $270,000 was spent on new patient beds for the medical/surgical departments. Also aligned with enhancing patient safety, the pharmacy department spent $97,000 installing new Pyxis scanning equipment throughout the Medical Center including the only local OB department. The Medical Center administers the largest surgery department in the region and in FY2011 the Operating Room completed a number of capital projects. These projects included the addition of a C-arm, an orthopedic drill, Stryker TPS/ commend replacement, an updated Endoscopy cart and for the recovery room an improved patient monitoring system, Datascope patient care monitors. These projects totaled $244,000. The total cost of these 4 projects was over $1.125 million, including a variety of other capital projects done in FY 2011, the Medical Center invested over $1.523 million into improving and enhancing the quality of patient services and increasing patient safety. Net Costs of Services Provided to the Elderly and Poor and to meet the Community need: In the spirit of principles adopted by Ascension Health, the Medical Center has taken proactive steps to address those issues that will affect accessibility, the financing and the delivery of health care to all persons, especially the uninsured, underinsured, and the underserved. The Medical Center provides a substantial portion of its services to the elderly and the poor. In FY2011 approximately 47.1% of the cost of services rendered was to elderly patients under the Medicare program, and approximately 14.1% of the services were provided to patients who were deemed indigent under state, county, or Medical Center guidelines. The Medical Center provided $9,569,579 in un-reimbursed cost of services to the poor and to meet the needs of the community as outlined below: - The unpaid cost of providing charity care based on a patient's inability to pay $2,883,794 - The unpaid costs of public programs for individuals $2,588,992 - The net cost of other programs for the poor $157,544 - The net expense of services and community benefit programs $3,939,249 provided at a loss to meet community needs Total cost for care of persons who are poor and community benefit programs $9,569,579 The Medical Center provided hospital inpatient and outpatient services at a net loss in the following departments to maintain services to meet community needs: - Mental Health Inpatient and Outpatient Services - Transitional Care Unit - Occupational Therapy - Inpatient Physical Therapy - Speech Therapy - Special Procedures Unit - Outpatient Education - Palliative Care - Nicotine Intervention Program - Home Respiratory - Hospice - Pastoral Care The Medical Center also provided services to meet community needs to support other Health Awareness, Education and Health Promotion activities in the community as outlined below: - Based on work previously done by the Local Access to Care Committee the Community Health Association of Spokane opened the Lewis Clark Health Center, a Federal Qualified Health Clinic, on July 1, 2009 to help address access issues for Medicare, Medicaid, and uninsured patients. SJRMC provides the clinic with free office space directly across from the Hospital Emergency Room/ Minor Care. - Provided support to the Snake River Medical Clinic, a volunteer-staffed community clinic open two nights per week to treat the uninsured. - Provided funds to purchase initial prescriptions for indigent patients of the Medical Center. - Subsidized faculty expenses at Lewis-Clark State College (LCSC) to enable increased nursing student enrollments to address a local, regional and national shortage of nurses. - Provided Carondelet Scholarships and other scholarships for books and tuition for students enrolled in clinical education programs at local colleges to expand the availability of qualified health care workers in the future. - Provided a 100% match of associate donations to the local United Way, an agency which provides supplemental support to non-profit agencies involved in Health Awareness, Education and Promotion. - Provided support to assist in recruitment of physicians to the community to meet community health care needs. Uninsured patients continue to receive a discount off their initial bills in order to improve the affordability of health care to these patients. All uninsured and insured patients are eligible for financial screening for further adjustment to their bills based on documented income and expense profiles provided by the patient or guarantor; and the resulting ability to pay all of, or part of, the remainder of the bill over a four year period of time. Financial Assistance materials have been included in the Admission packets and are available at all Registration Areas alerting the patient to the availability of Financial Assistance. Information is also included on bills sent to patients so they can contact the Medical Center to request an application for Financial Assistance in the settlement of their bill. The Medical Center will write off 100% of a bill for a patient/family with no insurance which has a documented income profile level that is 100% or less of the Federal Poverty Level. Eligibility for further discounts is based on an ability of the patient to pay after the patient completes a financial application for the Medical Center evaluation. The Medical Center reviews the completed application regarding income, expense, assets, and liabilities to determine the extent of Financial Assistance that can be offered according to the Medical Center policies. The Medical Center has an arrangement with a financing company to enable the patient or guarantor to finance payment of medical bills. The Medical Center has a policy that all alternative sources of financial assistance, including application to various Medicaid, County and other available programs must be applied for, and rejected, before Financial Assistance is provided by the Medical Center. Failure of the patient or guarantor to follow-through on the application of financial assistance that may be available from another source will constitute reason for denial of an application for Financial Assistance from the Medical Center. Trends, Needs, and Issues in the Community and the Medical Center Strategies to Address Them:
		Shortage of Primary Care Physicians There are not enough Primary Care Physicians (Family Practice and Internal Medicine) to meet the needs of the community, and provide timely access to care, especially those without insurance or on Medicaid. The shortage is such that some Medicare patients and patients with insurance are not able to establish a Primary Care relationship. Due to this shortage, the Medical Center is experiencing an increase in volume in our Minor Care and Emergency Department. The Medical Center strategies to address the issue: - Employ local primary care physicians. The Medical Center began employing primary care physicians in February 2011 with the employment of a family practice physician whose practice is on campus. The Medical Center assumed all aspects of running this practice, including the employment of the physician and the staff, billing and collections, compliance and management. The Medical Center has plans to employ more local primary care providers in FY 2012. - Purchased the Lewiston Medical Center Office buildings to ensure that the 20 physicians located there would have a place to continue their practice. - Provide the Community Health Association of Spokane (CHAS Clinic) free rent for two years, FY2010 and FY2011 for establishing a Federally Qualified Health Clinic in the Lewis-Clark Valley with two providers offering services. - Recruitment efforts for Internal Medicine, Family Practice and Neurology include recruitment fees and expenses, relocation assistance and income guarantee with "loan" forgiveness in conjunction with the Medical Staff. - Establish a Primary Care Strategic Directions Committee to develop strategies to address physician shortages. Growing Number of Uninsured North Central Idaho has not seen the growth or economic prosperity that the rest of Idaho has experienced over the past several years. This region still has a natural resource based economy and the loss of jobs in timber and agriculture, that traditionally had insurance benefits, has not rebounded. This is especially true in the outlying communities and counties. The shift in jobs has been to lower paying jobs, many with limited or without health benefits. The Medical Center has also seen a dramatic increase in the amount of deductibles and co-pays, especially patients with individual coverage. The Medical Center strategies to address the issue: - Work with the Idaho Hospital Association to continue to fund ACCESS IDAHO, a private/public program to provide health insurance access to lower paid workers - Continue to advocate for CHIP funding at the State and Federal levels - Participate in Ascension Health Leadership Plan including the 100% Access Campaign - Continued involvement with Cover the Uninsured Week activities - Continue the Medical Center's Patient Advocate/ Representative program - Assist with the establishment of a Federally Qualified Health Clinic in the community. Medical Education: The Medical Center is concerned that a number of educational programs for health care professionals are either not available in the local community, or are not graduating enough students to meet the health care needs of the community. Therefore, the Medical Center has developed an extensive affiliation program with educational institutions. 367 students utilized the Medical Center as a clinical teaching site in FY2011, a 30% increase in utilization from FY2010, in the programs outlined below: Registered Nurse Education: Walla Walla Community College - 133 Lewis - Clark State College - 107 Life Flight - 5 Certified Nurse Assistant: Lewis - Clark State College - 40 Bachelors of Social Work: Lewis - Clark State College - 1 Masters of Social Work: Boise State University - 2 Psychology Students: Fielding Institute - 1 Medical School Rotations: WWAMI Program - 4 Physicians Assistant/Family Nurse Practioners: University of Washington - 2 Gonzaga University - 1 Idaho State University - 1 Washington State University - 1 Physical Therapy: Eastern Washington University - 4 EMT/ Paramedic: Lewis - Clark State College - 30 Moscow Fire Department - 12 Radiology Technicians: Lewis - Clark State College - 16 Wenatchee Community College - 2 Respiratory Therapy: Independence University - 2 PharmD Students: Washington State University - 2 Pharmacy Students: Washington State University - 1 Total - 367 Access to Mental Health Services: With the rural nature of Idaho and Southeastern Washington, Mental Health Services are often only found at the larger population centers. This is due to a shortage of mental health professionals and very inadequate reimbursement for those who provide service. People often don't seek help until their mental health problems have created a crisis. The Medical Center strategies to address this issue: - Continue work with Senator Stegner (District State Senator) to champion additional Regional Mental Health Councils, fund programs, and create additional legislation to better address mental health and drug addiction services. - Continue Mental Health Telemedicine involvement with the Regional Tele-health Board, and Idaho's Region II hospitals. - Maintain presence on Regional Mental Health Board. - Advocate Legislature for a Drug Treatment Center for North Central/Northern Idaho. - Work with the Social Detox Committee, through the United Way and various other locations. - Continue to educate the region, professionals and non-professionals, thru the annual education event the Rural Mental Health Symposium.
		Community organizations collaborating with the hospital to improve community health, expand access to health care, or in other ways benefit the community: - Lewis-Clark State College, Walla Walla Community College and other educational institutions outlined Medical Education utilize the Medical Center as a clinical teaching site for 367 students in 13 specific educational programs and increase the number of clinical service students that would choose employment in the community after graduation. - Coordination with the North-Central Health District on health screening programs to identify developmentally disabled children who can benefit from an improvement in their physical abilities and/or speech functions. - Donations to support of the Snake River Community Clinic for the uninsured population. - Bringing the Hospitalist Program in house to better recruit additional Hospitalist which will allow PCP's to practice solely in the outpatient clinic setting; extend PCP's work life, and better position the community to recruit needed physicians to the area. - Sponsor educational programs on wellness, health education and disease-specific support groups to improve the health status of the community. - Collaborate with Meals on Wheels to produce dietary appropriate, balanced meals to the home-bound. - Provided mobile mammography and PACS access to some of the rural hospitals and clinics in the area who are otherwise unable to provide those services. - Contracted to provide Mental Health professional services in local nursing homes. - Provided contracted Physical, Occupational, and Speech Therapy services to Head Start and school districts that don't have the capability of supporting those services independently. - Expanded / Upgraded IT linkages between the Medical Center and physician offices to transmit test results and radiology, MRI, CT and other images to accelerate diagnosis and treatment. - Assist the community Access to Care group and CHAS Clinic to establish a Federally Qualified Health Clinic (FQHC) in the community. - Provided a Nicotine Intervention Program. - The Medical Center Foundation works with the local school districts. Presenting Think First, a head and spinal cord prevention program to elementary and junior/ senior high classes. - The Medical Center collaborates with the American Cancer Society to sponsor a community resource center at the Medical Center to serve the needs of cancer patients. - The Medical Center Foundation developed a presentation, "Methamphetamine Prevention", on the negative impact methamphetamine has on its users and the community overall that was used as a teaching tool at the local and surrounding high schools. - The Medical Center's Senior Life program for adults over age 60 assisted many seniors with Medicare Part D through its indigent pharmacy program and with ongoing wellness programs and workshops throughout the year for its 1,200 members. - The Medical Center matches employee donations dollar for dollar to the United Way to improve the breadth of services provided by the United Way agencies. - The Medical Center associates are involved with a number of local organizations, including the Northwest Children's Home, Consumer Credit Counseling, Lewiston School District and Regional Health Care Planning Group among others to stay current on issues and challenges faced in the community. - The Social Services and Pastoral Care divisions of the Medical Center provides many support groups, including Cancer, Parkinson's, "Friends Reach Out" (grief support group), and SHARE (for families who have lost babies). - Provided over 781 nights of free housing at the Carondelet House to patients and families from out of town to stay at during treatments or hospital admissions. - The Medical Center made available free Child Birth class scholarships to all expecting parents, Car Seat training and distribution, Parenting for Life classes, and supplies to the Pregnancy Counseling Center. - Worked with the United Way to create and print an updated Community Wide Needs Assessment for the Lewis Clark Valley to included Health, Emergency Services, Education and other social services. - Provided the Federally Quality Health Center, Lewis - Clark Health Clinic, a member of the Community Health Association of Spokane, a rent-free space to see primary care patients.
		Patient and Associate Education: The Medical Center believes that, in order to provide the best health care to the community, its personnel must receive ongoing medical education. Educational resources are provided in-house, and externally, to insure that both clinical and non-clinical personnel maintain up-to-date education related to their area of responsibility. Through the Medical Center's educational tuition reimbursement program available to all employees, incentives are provided to upgrade the staff's knowledge base, encourage continued professional development and training, and offer potential advancement opportunities. In addition to educating its own staff, the Medical Center also facilitates and funds education programs for other health care providers in the region. The Hospital Satellite Network, an educational service subscribed to by the Medical Center, is available throughout the area. Funding is provided for additional faculty at Lewis Clark State College in the nursing and radiographic technology programs to increase the number of students in these fields (where there is current shortages). Carondelet scholarships are provided for books and tuition to local students to assist them in attaining their educational objectives; in return these scholars have agreed to provide service to the Medical Center's patients upon graduation from their respective programs. THE SJRMC Auxiliary awards four $1,500 scholarships each year to students in the Nursing programs at neighboring Lewis-Clark State College and Walla Walla Community College. Both in-house and throughout the community and region, the Medical Center strives to supply educational opportunities at all levels. From students, to employees and area healthcare providers the Medical Center continues to be a strong supporter of medical education. Expanding Awareness, Education and Health Promotion Offerings at the Medical Center: General Areas of Emphasis for all Associates: - Emergency Management - Hand washing - Hazardous Materials/Waste Training - HIPAA Education - Infection Control - Moderate Conscious Deep Sedation - Limited English Proficiency - Loss and Grief In-service - P.I.E.S Customer Service Program - Patient Experience Commitment - 100% - Safety and Environment of Care - Up-to-Date Online Medical Reference Library General Areas of Emphasis for Patient Care Services: - 2009 Rural Mental Health Symposium - Abuse, Neglect, Abandonment & Domestic Violence - Advanced Oral Care - Associate Mentoring Program - Blood Bank Procedures - BLS CPR Provider Training - BLS CPR Instructor Training - Charge Nurse Program - Dennis De Simone - Code 11 Security - Code 4 Practice Sessions - Complicated Bereavement - Crisis Prevention Intervention Training and Updates - Diversity Lunch & Learn - E.A.S.Y. Assessment: Department Specific Education - Cardiac - Endocrine - Fluid & Electrolytes - Neurological - Respiratory - Vascular Miscellaneous Newsletter Resources: - Nurse Advise - ERR Newsletter - Pharmacy & Therapeutics Newsletter Specific Offerings in Ascension Health Corporate Compliance: - Corporate Responsibility Program Annual/Ongoing Compliance Training-via Mandatory Updates - Corporate Responsibility Program Specialized Training - Corporate Responsibility Program Training for New Employees at General Orientation - HIPAA & Confidentiality - Understanding Your Responsibility - National HIPAA Week Education/Train Specific Offerings in the Pediatric/Age Specific Category: - Easy Assessment: Pediatric and Newborn focused education - EFM Collaborative Training - EFM Strip Review/Common Fetal Monitoring - Emergency Nurse Pediatric Course - Genetic Evaluations - Newborn Resuscitation Program (Staff and Physicians) - Noelle Skills Lab - Noelle - Cardiac Arrest - Pediatric Advanced Life Support - Pediatric Advanced Life Support Instructor Training - Providence Sacred Heart Pediatric Grand Rounds - Pediatric Sleep - Sound Beginnings Specific Offerings in Ethics Presents: - Lunch & Learn Diversity - Ethical Issues Affecting the ED - Providing Care and Services - Ethics of Privacy Continuing Medical Education: - Tumor Case Review w/Gritman and Pullman Regional - Providence Sacred Heart Grand Rounds - National Corporate Compliance and Ethics Week Specific Offerings in Critical Care: - Advanced Cardiac Life Support - Advanced Cardiac Life Support Instructor Training - Arrhythmia Course - Code 4 Documentation Reviews - Code 4 Medication Reviews - Code 4 Team Leader Reviews - Course in Advanced Trauma Nurse - Critical Care Class & Skills Fair - ENPC - Rapid Response Team Training - Trauma Nurse Core Course Specific Offerings in Information Management: - Bedside Medication Verification Training - Clinical Documentation Training - Incidence command System Training - Micromedex/Carenotes Training - MSDS Computer System - Office Automation - Online Event Reporting Computer Training - Order Entry - Password/Confidentiality - Patient Care Inquiry Training - Physician and Departmental Specific Offerings in Medical Coding & Documentation: - 10 Hours of Required Ascension Health Coding via EDUCODE - Basic intro ICD-10-CM - Coding Clinic Update - Coding with ICD-10 & ICD-10-PCS - ICD-9-CM Updates for 2009 - Core Components of a solid Charge Master - FY CMS IPPS Update - Joint Replacement Coding - Ms-DRG List: a Clinical Review - RAC Healthport Training - Medicare Consultation Code changes in 2010 Specific Offerings in Management Development: - Patient Experience Commitment - 100% - Brenda McIntosh R.N., M.Ed. Controlling Unemployment Costs through Effective Documentation, Discipline and Discharge. - Deanna O'Toole, IHA, Vice President Human Resources & Employment Issues for Managers; Steve Berenter, Hawley, Troxell, Ennis & Hawley
		Joint Commission Satellite Network Teleconferences: - Infection Control: Reducing Risk, Improving Care - Disruptive Behavior; Impacting Quality and Patient Safety - Being prepared for the H1N1 Pandemic - Overview of 2010 NPSG - Using Performance Improvement Methodologies to Increase Compliance/ Measuring Outcomes - Facing the Challenge of the Joint Commission - Update: Joint Commission and CMS - Patient Records Management - Emergency Preparedness: Standards, Practices and Solutions - Survey Survival: What You Need to Know - Reducing the Risk; preventing Hospital Acquired Infections - Creating a Safe and Functional Environment of Care Equipment In-services: - Anatomy of a Ridge Scope - Aquamantys - Balloon Pump - Banking Bone and Camino Cart - Button Vaporization - Cleaning and Decontaminating Medical Devices - Crano Fix 2 - Elastic Nail & Clavical Plates - ETEX Bone Substitute - Entertan System - Graded compression Stockings - Jet X Bar - KUSA Inservice - Mastergaft Matrix - Natus Algo 5 Hearing Screener - Neoprobe - OBTRYX Sling - Scopes Care and Handling - Stryker Bone Mill - Versacare Bed - VLP Plates and Screws - Woundvac Expanding Awareness, Education and Health Promotion Offerings in the community: Diabetes Education, including Gestational Diabetes Classes: - Asotin School District staff presentation series on Type 1 Diabetes - Burrell Street Station presentation to the residents on Pre-Diabetes and basics of Type 2 Diabetes and prevention - City of Lewiston Health Fair attendance and distribution of free education materials and blood glucose testing - Asotin County School Health Nurse Type 1 Diabetes education - Clarkston Boys and Girls Club and Lewiston Boys and Girls Club presentations of basic diabetic information to bring awareness of World Diabetes Month in November - GO RED booth with diabetes facts, nutrition educational materials and free blood glucose testing - Highlander Apartment Complex presentation on Pre-Diabetes and basics of Type 2 Diabetes and prevention - Ladies Night Out attendance, free educational materials and free blood glucose testing - McSorely Elementary School, St. Stanislaus Tri-Parish School and Parkway Elementary School presentations to the students, teachers and staff on Type 1 Diabetes - Senior Health and Fitness Fair and Sterling Senior Health and Fitness Fair attendance, free educational materials, and blood glucose testing Wound/ Ostomy Education: - Ostomy Basics & Beyond - Choosing the Right Dressing - Skin Defense Team - Defend Skin Prevent Pressure Ulcers Pastoral Care Educational Offerings: - Community Workshops on Advanced Directives - Including participation in National Healthcare Decision Day - Holiday Grief Workshop for the Community - Quarterly Community Memorial Services - Assist community members with completion of advanced directives - Provide Funeral services when requested - Friends Reach Out - Grief Support Group for the Community every 2nd and 4th Monday - Host the Monthly Ministerial Meeting for area clergy - Christmas Brunch for area clergy - S.H.A.R.E. Support Group for parents/families who have lost babies - Hosted National Health Care Decision Day for the Community - Talk with staffs of the Skilled Nursing Facilities and Assisted Living Facilities about POST and Advanced Directives - Provide time to people from the community who walk in and need someone to talk to about grief issues - Send bereavement cards and information about grieving to families who have lost loved ones. - Relay for Life Prayer Service Critical Care Education Course Offerings: - Advanced Cardiac Life Support (ACLS) - Pediatric Advanced Life Support (PALS) - Course in Advanced Trauma Nursing (CATN) - Trauma Nurse Core Course (TNCC) - Emergency Nursing Pediatric Course (ENPC) - Critical Care Class - Arrhythmia Class "Your Doctor Speaks" series - "What To Do When Your Bootstraps Break: Coping with the Effects of Fear" by Mary Moller, DNP, ARNP, BC, CPRP - "Current Cutting-Edge Treatments" by Sandra Lotstein, D.O. - "Human Pappiloma Virus & Vaccine" by Kim Fisher, M.D. - "Partial Knee Replacements" by Bryan Beardsley, M.D. - "Gum Disease & Systemic Health/ Dental Implants" by Brad Morlock, D.D.S & Dan Wilson, D.D.S. - "Diabetes & the Eye" by Mark Eggleston, M.D. - "Sleep Apnea: New Developments, Diagnosis & Treatment" by Luke Pluto, M.D. Family Beginnings Community Education Course Offerings: - Lamaze - Preparation for Childbirth - Lamaze - Childbirth Seminar - Lamaze - Moms on the Go - Private Childbirth Class - Private Tours of Family Beginnings - Pre-Delivery Interview - ABC's of Parenting - Breastfeeding Basics - Natural Family Planning - New Mom's Group - Sibling Class - Safe Sitter Classes - Car Seat Safety Checks
		Community Health Education Resource Center: - American Heart Association Community Training Center - BLS First Aid and CPR Courses - ACLS, PALS & BLS Instructor Course - Community Wellness Education Series Presentations: - "Practical Nutrition - Improving Your Nutrition from the Ground Up" - "Obstructive Sleep Apnea Syndrome - Current Testing and Treatment" - National Healthcare Decision Day Event - National Heart Health Month - GO RED for Women's Health Open House Event - Ladies Night Out - Women's Connection Community Event - WA/Idaho Volunteer Senior Health & Fitness Fair - ATK/CCI - Speer Employee Health Fair - Clearwater Paper Corporation Employee Health Fair - City of Lewiston & Nez Perce County Employee Health Fair - National Breast Cancer Awareness Month - World Diabetes Day Awareness Event - "Tobacco Free You" Nicotine Intervention Program - Senior Life Program
		Summary: St. Joseph Regional Medical Center continues to serve as the only full service acute care hospital in the region. Improving the health status of the whole community, by providing essential medical services to all patients, including those who have an inability to pay for their healthcare needs, continues to be the goal and mission of St. Joseph's. The Community Health Resource and Education Center continues to help facilitate classes and training for associates, community members and patients in an effort to better meet the educational and informational needs in the community and surrounding area. By offering a broad selection of educational offerings and healthcare services, the Medical Center strives to better meet the healthcare needs of the patients and organizations in the service area. St. Joseph Regional Medical Center maintains its position as the regional leader in health education, community based programs, and providing healthcare services to all patients.

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:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

St Joseph Regional Medical Center

Employer identification number

82-0204264

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

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) Ascension Health PO Box 45998 St Louis,MO63145 31-1662309	National Health System	MO	Section 501(c)(3)	Schedule A, Line 11a	N/A		No
(2) St Joseph Regional Medical Center Foundation Inc 415 Sixth Street Lewiston,ID83501 51-0168321	Fundraising	ID	Section 501(c)(3)	Schedule A, Line 11a	St Joseph Regional Medical Center	Yes

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

Cat. No. 50135Y

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	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	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

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

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 . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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

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

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

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) St Joseph Regional Medical Center Foundation Inc	N	116,465	Cost
(2) Ascension Health	Q	3,115,333	Cost
(3)
(4)
(5)
(6)

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 VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

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:

1	Briefly describe the organization’s mission or most significant activities: Provides inpatient, outpatient and emergency care services.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	10
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	1,055
6	Total number of volunteers (estimate if necessary) ....	6	174
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	2,117
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	-55

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	24,683	37,636
9	Program service revenue (Part VIII, line 2g) .........	118,049,835	126,168,209
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,163,754	5,107,635
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	603,291	601,352
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	121,841,563	131,914,832
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	204,350	308,225
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)	55,808,861	59,260,687
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 304,347
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	58,920,602	64,018,782
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	114,933,813	123,587,694
19	Revenue less expenses. Subtract line 18 from line 12......	6,907,750	8,327,138
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	125,008,362	139,602,635
21	Total liabilities (Part X, line 26)............	45,396,613	43,239,277
22	Net assets or fund balances. Subtract line 21 from line 20 .....	79,611,749	96,363,358

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 101,119,430 including grants of $ 308,225 ) (Revenue $ 126,168,209 )
	As a member of Ascension Health, the nation's largest Catholic Healthcare System, SJRMC continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families and society as a whole. The goal of SJRMC is to perpetuate the healing mission of the Church. SJRMC furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community. Our concern for all human life and the dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status or ability to pay. Description continued in attached community benefit report (See Schedule O).

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 101,119,430

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Thomas Pfliger VP Professional Services	40.00	X		181,868	0	20,536
(19) Sushma Pant Physician	40.00		X	553,304	0	23,739
(20) Gerardo Midence Physician	40.00		X	548,477	0	22,359
(21) Katrina A Popham Physician	40.00		X	524,606	0	18,776
(22) Michael C Minick Physician	40.00		X	400,704	0	28,924
(23) William C Dir Physician	40.00		X	374,759	0	27,880

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,281,060	0	254,081

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e		37,636

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.......			37,636
			Business Code
2a	Net Patient Services		621,990	126,168,209	126,168,209
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			126,168,209
3	Investment income (including dividends, interest
	and other similar amounts).....			5,151,099			5,151,099
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents	459,031
b	Less: rental expenses	150,017
c	Rental income or (loss)	309,014
d	Net rental income or (loss).......			309,014			309,014
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		2,550
b	Less: cost or other basis and sales expenses		46,014
c	Gain or (loss)		-43,464
d	Net gain or (loss)..........			-43,464			-43,464
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..
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...
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..
Miscellaneous Revenue			Business Code
11a	Gift Shop		453,220	217,952			217,952
b	Non-Operating Income		621,990	72,269			72,269
c	Catering Revenue		722,320	2,117		2,117
d	All other revenue ....
e	Total. Add lines 11a–11d ......			292,338
12	Total revenue. See Instructions....			131,914,832	126,168,209	2,117	5,706,870


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			5,689,294	1	7,274,381
2	Savings and temporary cash investments .......				2
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			16,843,558	4	20,018,833
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5	479
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 .............			386,325	7	277,144
8	Inventories for sale or use ..............			3,676,326	8	3,008,070
9	Prepaid expenses and deferred charges ............			1,557,398	9	441,150
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	80,127,296
b	Less: accumulated depreciation. .....	10b	39,980,874	43,199,462	10c	40,146,422
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 ..				13
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			53,655,999	15	68,436,156
16	Total assets. Add lines 1 through 15 (must equal line 34)...			125,008,362	16	139,602,635
17	Accounts payable and accrued expenses .			10,316,677	17	8,968,705
18	Grants payable ..........				18
19	Deferred revenue ..........			67,666	19	131,816
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
25	Other liabilities. Complete Part X of Schedule D.....			35,012,270	25	34,138,756
26	Total liabilities. Add lines 17 through 25.....			45,396,613	26	43,239,277
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			79,611,749	27	96,363,358
28	Temporarily restricted net assets .....				28
29	Permanently restricted net assets .....				29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			79,611,749	33	96,363,358
34	Total liabilities and net assets/fund balances .....			125,008,362	34	139,602,635