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)
(1) Doug Blatt Board Chair	1.00	X	X	0	0	0
(2) Jeniffer Dupree Mooney Board Vice Chair	1.00	X	X	0	0	0
(3) Roy Kletcha Treasurer	1.00	X	X	0	0	0
(4) Diane Radloff Sch O Board President	50.00	X	X	0	581,057	25,996
(5) Suzanne Zieske CSJ Secretary	1.00	X	X	0	0	0
(6) Victor Battani Board Member	1.00	X		0	0	0
(7) Sr Xavier Ballance DC Board Member	1.00	X		0	0	0
(8) Edward K Christian Board Member	1.00	X		0	0	0
(9) James Cole Board Member	1.00	X		0	0	0
(10) Albert DePolo Jr DO Board Member	50.00	X		48,378	0	1,209
(11) Paul Falcone Board Member	1.00	X		0	0	0
(12) Michael Glusac Board Member	1.00	X		0	0	0
(13) Bal Gupta MD Board Member	50.00	X		122,688	0	16,430
(14) Richard Kitch Esq Board Member	1.00	X		0	0	0
(15) Patricia Manley Board Member	1.00	X		0	0	0
(16) Steve Minnick MD Sch O Board Member	50.00	X		0	240,820	21,315
(17) David Siegel MD Board Member	1.00	X		0	0	0

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Edward Swanson Board Member	1.00	X				0	0	0
(19) Laydell Wyatt Board Member	1.00	X				0	0	0
(20) Connie O' Malley VP Nursing	50.00		X			175,637	0	27,458
(21) Michael Beaubien VP Clinical Services	50.00		X			348,193	0	51,598
(22) Gary Berg Chief Medical Officer	50.00		X			390,682	0	45,747
(23) Tomasine Marx St. John Hospital - CFO	50.00		X			0	308,925	21,751
(24) Radha Chitturi MD Physician	50.00			X		275,413	0	38,422
(25) Thomas Borland MD Physician	50.00			X		345,379	0	19,815
(26) Gary Szmanski MD Physician	50.00			X		370,186	0	37,334
(27) Michael Kobernick MD Director	50.00			X		410,791	0	52,233
(28) Joseph Tasse Administrator	50.00			X		454,400	0	43,220
(29) Maria Strom Former Vice President	0.00				X	0	291,593	21,718

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
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	1,228,020		1,228,020
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	160,420,371	127,324,884	33,095,487
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	11,143,910	8,017,821	3,126,089
9	Other employee benefits .......	12,500,045	861,582	11,638,463
10	Payroll taxes ...........	9,956,294	9,182,307	773,987
11	Fees for services (non-employees):
a	Management ......	4,141,109	2,832,055	1,309,054
b	Legal .........	63,336		63,336
c	Accounting ...........	9,153		9,153
d	Lobbying ...........
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......
g	Other ..........	8,797,004	8,792,480	4,524
12	Advertising and promotion ....	389,226	389,226
13	Office expenses .......	813,790	226,575	587,215
14	Information technology ......	19,906,866	6,542,506	13,364,360
15	Royalties ..
16	Occupancy ...........	14,143,891	3,696,488	10,447,403
17	Travel ............	101,375	101,375
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	601,491	601,491
20	Interest ...........	4,771,448	4,711,762	59,686
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	14,752,793	9,795,855	4,956,938
23	Insurance ..............	3,374,458	3,374,458
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	Medical Supplies	57,620,854	56,417,549	1,203,305	0
b	Purchased Services	53,409,178	17,625,029	35,784,149	0
c	Bad Debt	34,279,278	34,279,278	0	0
d	Restructuring Costs	2,564,428	0	2,564,428	0
e	Fundraising Allocation	70,051	0	0	70,051
f	All other expenses	3,008,813	1,465,608	1,543,205
25	Total functional expenses. Add lines 1 through 24f	418,067,182	296,238,329	121,758,802	70,051
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 ..........	4,972,060	1	2,435,745
2	Savings and temporary cash investments .......		2
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	43,149,346	4	45,541,840
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	3,959,442	8	4,087,740
9	Prepaid expenses and deferred charges ............	562,063	9	546,512
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	328,774,951
b	Less: accumulated depreciation. .....	10b	248,089,063	88,501,866	10c	80,685,888
11	Investments—publicly traded securities ..........		11
12	Investments—other securities. See Part IV, line 11 ......	50,358,858	12	307,376
13	Investments—program-related. See Part IV, line 11 ..	371,652	13	286,035
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	51,428,143	15	130,957,082
16	Total assets. Add lines 1 through 15 (must equal line 34)...	243,303,430	16	264,848,218
	17	Accounts payable and accrued expenses .	28,670,539	17	26,558,541
18	Grants payable ..........		18
19	Deferred revenue ..........	320,364	19	219,204
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.....	218,904,453	25	238,480,971
26	Total liabilities. Add lines 17 through 25.....	247,895,356	26	265,258,716
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	-4,945,312	27	-717,874
28	Temporarily restricted net assets .....	353,386	28	307,376
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 .....	-4,591,926	33	-410,498
34	Total liabilities and net assets/fund balances .....	243,303,430	34	264,848,218

- 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 John Macomb-Oakland Hospital

Employer identification number

38-3322109

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

OMB No. 1545-0047

2010

Name of organization

St John Macomb-Oakland Hospital

Employer identification number

38-3322109

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

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

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

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization St John Macomb-Oakland Hospital
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization St John Macomb-Oakland Hospital
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
St John Macomb-Oakland Hospital

Employer identification number

38-3322109

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (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 John Macomb-Oakland Hospital

Employer identification number

38-3322109

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)? ....

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? ........

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

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

Yes

20,456

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

20,456

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 associates that are specifically allocable to lobbying. St. John Macomb-Oakland Hospital 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 John Macomb-Oakland Hospital

Employer identification number

38-3322109

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
1a	Beginning of year balance ....	37,087	38,581	36,114
b	Contributions ........	601	300	310
c	Investment earnings or losses ...	1,929	1,928	1,855
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	-350	3,722	-302
f	Administrative expenses ....
g	End of year balance ......	39,967	37,087	38,581

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

Board designated or quasi-endowment: SchDMd Bullet

Permanent endowment: SchDMd Bullet

73.000 %

Term endowment: SchDMd Bullet

27.000 %

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 .................	2,060,865		2,060,865
b	Buildings ................	33,993,777	25,729,982	8,263,795
c	Leasehold improvements ............	362,450	308,017	54,433
d	Equipment ................	128,380,932	110,194,348	18,186,584
e	Other .................	163,976,927	111,856,716	52,120,211
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				80,685,888

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) Malpractice Fund				4,579,642
(2) Other Receivables				96,819
(3) Long-Term HSD Investments				119,387,266
(4) Other Long-Term Receivables				6,158,476
(5) Workers Compensation Fund				734,879




Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........				130,957,082

Part X

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

1.(a) Description of Liability		(b) Amount
Federal Income Taxes
Estimated Third Party Settlements		17,551,351
Self Insurance Liability		7,901,283
Historical Allowances		3,503,129
Other Liabilities		40,000
Other Long-Term Liability		4,004,825
Advances to Affiliates		12,822,434
Intercompany Debt due to Ascension Health		192,657,949


Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		238,480,971
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
Description of Uncertain Tax Positions Under FIN 48:	Part X:	The member health care entities of the System are primarily tax-exempt organizations under Internal Revenue Code Section 501(c)(3) or 501(c)(2), and their related income is exempt from federal income tax under Section 501(a). The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. During the year ended June 30, 2011, the System recognized other revenue of approximately $9,000,000 related to medical resident FICA refunds that had been remitted to the Internal Revenue Service (IRS) during years ended prior to March 2005. Such amounts represent management's estimate of claims submitted to the IRS related to the IRS acceptance of residents' qualification as students for purposes of determining Medicare and social security tax.

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 John Macomb-Oakland Hospital

Employer identification number

38-3322109

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

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?.........

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

	(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) ..	11,111,944		11,111,944	2.900 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .	47,595,516	37,970,349	9,625,167	2.510 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....	58,707,460	37,970,349	20,737,111	5.410 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	217,900	4,000	213,900	0.060 %
f Health professions education (from Worksheet 5) ..	24,247,405	10,977,972	13,269,433	3.460 %
g Subsidized health services (from Worksheet 6) ..
h Research (from Worksheet 7)	2,751		2,751	0 %
i Cash and in-kind contributions to community groups (from Worksheet 8) ..	17,363		17,363	0 %
jTotal Other Benefits ...	24,485,419	10,981,972	13,503,447	3.520 %
kTotal. Add lines 7d and 7j. ..	83,192,879	48,952,321	34,240,558	8.930 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

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).....

11,214,795

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

7,440,268

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).....

193,654,796

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

180,984,311

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

12,670,485

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?2 Name and address		Other (Describe)
1	St John Macomb Hospital 11800 E 12 Mile Rd Warren,MI48093	X	X	X	X
2	St John Oakland Hospital 27351 Dequindre Madison Heights,MI48071	X	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?1
Name and address		Type of Facility (Describe)
1	St John Conner Creek Village 4777 E Outer Drive Detroit,MI48234	Urgent Care Center
2
3
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 3c: The organization provides medically necessary care to all patients, regardless of race, color, creed, ethnic origin, gender, disability or economic status. The organization uses a percentage of Federal Poverty Level (FPL) to determine free and discounted care. At a minimum, patients with income less than or equal to 200% of the FPL, which may be adjusted for cost of living utilizing the local wage index compared to national wage index, will be eligible for 100% charity care write off of charges for services that have been provided to them. Also, at a minimum, patients with incomes above 200% of the FPL but not exceeding 300% of the FPL, subject to adjustments for cost of living utilizing the local wage index compared to national wage index, will receive a discount of 70% on the services provided to them. Additionally, for any Pure Self Pay patient (someone presenting with no insurance regardless of income), there is a 40% Uninsured Discount automatically applied against total charges.
		Part I, Line 6a: The organization is part of a community benefit report which is prepared by St. John Providence Health System on a consolidated basis.
		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 calculated in compliance with Catholic Health Association (CHA) guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured or self pay). The best available data was used to calculate the amounts reported in the table. For certain categories in the table, this was a cost accounting system; in other categories, a specific cost-to-charge ratio was applied.
		Part I, Line 7g: The organization has not included costs attributable to a physician clinic as part of subsidized health services.
		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 $34,279,278.
		Part II: Community Building Activities are critical to the five counties that St. John Providence Health System serves. The May 2010 report of "Michigan's Economic Outlook and Budget Review" from the Senate Fiscal Agency listed health services as the only employment growth area in the state at 23.8% compared to all other employment sectors whose decline ranged between -7.1% and -64.3%. Workforce development in healthcare is vital to the states economic future. "CNN U.S. Economy Tracker" showed Michigan's foreclosure rate as of April 2010 to be nearly double the National foreclosure rate. During April of 2010 Michigan's unemployment rate was 41 percent higher than the national average. The unemployment rate in St. John Providence Health Systems service area was 11.5 percent in 2011. This weakened economy makes for an extremely reduced tax base in both property and income tax. St. John Providence Health System makes a contribution to the community by physically improving the community through beautification efforts which relieves some of the local government's burden."The Michigan Critical Indicators Report" and Healthy People 2010 Targets showed that the "Healthy People Objectives" for reducing the number of adults who binge drink regularly, and adults and adolescence who use tobacco were unmet. Both of these gateway drugs make it necessary for St. John Providence Health System to support advocacy and participate in coalitions aimed at preventing and reducing drug and alcohol use. Brighton Hospital is a behavioral health specialty hospital providing treatment for substance abuse.The latest "Annie E. Casey's Foundation Kids Count" data reported Michigan as having an infant mortality rate higher than 39 states at 7.9 compared to the national rate of 6.8. The city of Detroit, which is the health systems largest service area, has an infant mortality rate of 14.0% during this same time period. The 2009 FBI uniform crime report listed Detroit as having 1,966 violent crimes per 100,000. These statistics compel St. John Providence Health System to use its resources in working toward significantly reducing these negative community health outcomes.A community assessment led St. John Providence Health System, in collaboration with community leaders, to create a separate 501(c)(3) called Healthy Neighborhoods Detroit (HND). Healthy Neighborhoods Detroit's core activities are community building. The assessment illustrated that there was a significant absence or gap in services that addressed the communities' access to healthcare, workforce development and safe and affordable housing. HND works collaboratively with community organizations and community members to co-create interventions to address these problems.Inventories of some of St. John Providence's community building activities include: - Physical Improvements/Housing :The hospital helped to build and improve houses through the local Habitat for Humanity and for low-income families. They also helped to develop a barrier-free environment for individuals with disabilities.- Community Support :The hospital provided medical support for the annual "gold cup" boat races in Detroit.St. John Providence Health System Community Building Activities:- Economic Development: SJPHS Administration is active in various Chambers of Commerce throughout our service area. - Coalition Building:SJPHS Business Development department participated in Coalition Building. Eastwood Clinics also participates on the "Save Our Youth" Coalition whose goal is to prevent substance abuse among youth in Royal Oak. SJPHS Community Health participates on the infant morality task force, state coalition of school-based health centers and youth violence prevention task force.- Workforce Development/Job Creation and Training Programs:SJPHS Work Life Services partners with area schools, universities and technical schools to mentor students and educate them about careers in healthcare. They also provide assistance with resume writing and interviewing techniques. - Community Health Improvement Advocacy:Eastwood Clinics participates on the Behavioral Health Legislative Drug Court Committee which partners with judges and prosecutors from counties throughout Michigan and provides advocacy and support for drug and alcohol treatment for legislative staff.
		Part III, Line 4: The provision for bad debts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care 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 payor 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 System 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 System's policies.
		Part III, Line 8: Ascension Health and related health ministries follow 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 organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply.
		Part VI, Line 2: A community health needs assessment of the St. John Providence Health System service area has occurred every three years since 2001. An assessment was done and published in 2001, 2004, and 2008, and most recently in 2011. The current assessment was led by a steering committee composed of members with diverse health professional backgrounds representing the services provided by St. John Providence Health System. Members included professionals with backgrounds in Finance, Marketing, Nursing, Social Work, Medicine, Pharmacy and Public Health to name a few. The process was based on the 6 steps outlined by the Association for Community Health Improvement (ACHI). Each county in the service area was determined to be the focus of the assessment. Data was collected from a variety of reliable sources including but not limited to CDC, Michigan Department of Public Health, local health departments, and the US Census. Data was collected and organized by county for analysis. The University of Wisconsin State and County Health Rankings of 2011 was also discussed after it was released. The latter was consistent with the data collected. The data collected was discussed and input received from several stakeholder groups including the health system board of directors, advisory committee and other local agencies. The process resulted in a ranking of the health needs by county and then three were selected as priority areas of focus. These three are: 1) Diabetes Prevention and Management 2) Infant Mortality Prevention 3) Access to Primary Care for Underinsured and Uninsured. The risk factors related to these three, when addressed will have a positive impact on the other major community health needs related to heart failure, kidney failure, cancer early identification and treatment, asthma education and treatment, infant mortality, and obesity in children and adults. At this writing, the assessment is being edited for printing and will be put on the web site for accessibility. Also the process for developing a community benefit plan related to the identified priority area is beginning. The identification of the health needs of the community resulting from previous CHNA was used to affirm and/or modify the existing St. John Providence Health System community health programs and partnerships. For example, an identified unmet need of accessible primary care for low-income uninsured adults in the city of Detroit resulted in the establishment of a St. John Providence Health System safety net health center, a partnership with a local Federally Qualified Health Center (FQHC) agency, and creation of a volunteer network of physician specialists to improve access to care for this population who are enrolled in the primary care program. Consequently, the establishment of two new FQHC health centers and recruitment of more than 400 volunteer physicians has increased access and capacity to serve this population in the St. John Providence Health System service area.
		Part VI, Line 3: Financial assistance staff is trained on how to qualify patients for Medicaid, SCHIP and other such programs. During the pre-registration, registration, admissions, and discharge processes, the hospital attempts to identify all self pay patients who may be eligible for government programs or for discounted care through the health system charity care policy. A financial assistance counselor is provided to all patients identified as eligible for charity care and the process and paper work is explained by the counselor. Patients with limited English proficiency are provided with a translator as needed. Those who are deemed eligible for government programs are provided with the needed information, forms and contact information including assistance in filling out forms as needed. The Hospitals charity care policy is posted in the admissions, emergency, and finance department, as well as on the website. A summary of the policy along with financial assistance contact information is provided to patients in the ED and inpatients or upon discharge. Self pay patients are also provided with referrals to partner FQHCs or free primary care clinics in the area as well as locations to obtain low cost pharmaceuticals. A written summary of financial guidelines/charity policy and contact information is also provided in all communications with patients regarding bills and accounts. Non-English speaking patients receive translation assistance as needed.All third parties that work on behalf of the organization to collect fees (such as collection agencies and legal firms) are required to follow the hospitals policies regarding patient notification about the availability of financial assistance including its guidelines for collection of payment.
		Part VI, Line 4: St. John Providence Health System and its seven hospital campuses including one specialty hospital are located in a five-county area of southeastern Michigan. The health system campuses are organized as follows: Providence/Providence Park Hospitals; St. John Macomb-Oakland Hospital; St. John Hospital, St. John River District Hospital; and Brighton Hospital. The community served by the organization includes Wayne, Oakland, Macomb, Livingston and St. Clair counties. The city of Detroit is part of Wayne County. This service area is predominately urban and suburban with pockets of rural in St. Clair and Livingston counties. Also, there is one Medical Underserved Area (MUA) in St. Clair county, two in Macomb county, and one in Oakland county. Almost the entire city of Detroit is either a MUA or Health Professional Shortage Area (HPSA) or both. In the remaining part of Wayne County, there are three areas designated as MUAs. There are no MUA's in Livingston County. There are six other health systems represented in the service area. One is a for-profit entity and the others remain nonprofit. The East Community includes Macomb and St. Clair Counties, and parts of Wayne and Oakland Counties. The West Community includes Livingston county, most of Oakland county and parts of Wayne County. Total population in the West Community (2010 Thompson Reuters) is 1,633,906 with 57.7% White, 34.7% Black, 0.2% American Indian and Alaska native, 0.2% Hispanic, 4.3% Asian/Pacific Islander and 0.7% other. Total estimated population in the East Community is 1,432,398 with 70.7% White, 23.0% Black, 0.3% Hispanic, 2.9% Asian/Pacific Islander, and 0.5% other. Note the following additional information by county. Unless otherwise indicted, the data is from the 2010 U.S. Census.- Wayne excluding Detroit has 12.7% of the population over age 65; median household income is $42,241; 21.4% of household are in poverty with 19.6% of individuals with incomes below 200% of the federal poverty level; 10.3% are uninsured and 23.7% (including Detroit) are enrolled in Medicaid (State of Michigan, June 2010). The city of Detroit has a total population of 713,777 and 11.5% of the population is over age 65; median household income of $28,357; 34.5% of the population in poverty; 48.5% are below 200% of the federal poverty level and 21% uninsured (State of Michigan, June 2010). Wayne County includes 52.3% White, 40.5% Black, 2.5% Asian, and 5.2% Hispanics. The city of Detroits population is 10.6% White, 82.7% Black, 1.1% Asian and 6.8% Hispanic/Latino (By 2010 U.S. Census).- Oakland County has 13.2% of its population over 65 years of age; the median household income is $66,390; 8.7% of the households are in poverty; 14.5% of individuals are below 200% of the federal poverty level; 7.5% are uninsured and 9.5% are Medicaid enrollees. (State of Michigan, June 2010) Population includes 77.3% White, 13.6% Black, 5.6% Asian, and 3.5% Hispanic/Latino (By 2010 U.S. Census).- Macomb County has a total population of 840,978 with 14.3% of the population over the age of 65; median household income is $53,996; 9.8% of households live in poverty; 16.3% of individuals live below 200% of the federal poverty level; 11.2% are uninsured and 13% are Medicaid enrollees. (State of Michigan, June 2010). Population includes 85.4% White, 8.6% Black, 3.0% Asian, and 2.3% Hispanic/Latino (By 2010 U.S. Census).- St. Clair County has a total population of 163,040 with 14.5% of the population over age 65; median household income of $49,120; 12.4% of households in poverty; 21.9% of individuals have incomes below 200% of the federal poverty level; 9.1% uninsured and 16.8% enrolled in Medicaid (State of Michigan, 2010). Population includes 93.9% White, 2.4% Black, and 2.9% Hispanic/Latino (By 2010 U.S. Census).- Livingston County has a total population of 180,967, with 12% of the population over age 65; median household income of $72,129; 6.2% of households live in poverty; 10.4% of individuals live below 200% of the federal poverty level; 9.3% uninsured; and 7.1% enrolled in Medicaid (State of Michigan, June 2010). Population includes 96.7% White, 0.4% Black, 0.8% Asian, and 1.9% Hispanic or Latino (By 2010 U.S. Census).In summary these counties represent the southeastern Michigan region of the state. The total population is approximately 4 million, which represents 46% of the state's population and accounts for 46% of the federal monies received. Twenty-two percent of the service area population is represented by the city of Detroit. Approximately 90% of Detroit consists of minorities, compared to 21% for the state. Thirty-four percent of Detroiters live below the poverty level compared to 14% statewide. The average income for Detroit is $28,357 while the statewide average is almost double that at $48,432. In Detroit, 22% of residents are uninsured compared to a statewide total of 11%. The city is currently experiencing the nation's highest unemployment rate at 29% compared to 14% for the rest of the state and 9.5% for the nation. Historically, auto manufacturing, government and health care are the largest employers. In each of these areas, heart disease followed by cancer is the leading cause of death. Further, congestive heart failure and bacterial pneumonia are the leading causes of preventable hospitalizations (2004). Additionally, Detroit has higher rates of illness and chronic disease than other parts of the state, and a lack of access to primary care and a shortage of health care professionals. Sixty percent of Wayne county residents reside in medically underserved area, compared to 8% for the remaining southwestern Michigan area. St. John Providence Health System provides many community based programs and services. In FY 2010, over 130,000 encounters were provided through its community outreach programs. The distribution of these services include 59% in Detroit; 14% in Macomb County; 13% Oakland County; 8% in Wayne County; 4% St. Clair County and 2% in Livingston County. Services provided include safety net primary care, through ten school-based health centers and two adult primary care centers; HIV/AIDS treatment; health education and screening referral support services and faith community nursing to name a few. Additionally, the hospitals in Detroit, Wayne, Oakland and Macomb serve a disproportionate share of uninsured or Medicaid beneficiaries. Access to primary care for the uninsured and underinsured remains a challenge in most of the service area. Partnership with local FQHCs is improving access and the health system hospitals support their expansion.
		Part VI, Line 6: St. John Providence Health System:The health system provides internship opportunities for administrative, marketing, finance, information technology, and public health and medical billing professionals. St. John Providence Health System administrators and staff have provided leadership and participated on collaborative initiatives with Voices of Detroit Initiative, Greater Detroit Area Health Council, Wayne County Health Department, The City of Detroit Department of Health and Wellness Promotion, Wayne County Health Authority, Tomorrows Child, The Michigan Department of Community Health, Michigan Primary Care association and area Federally Qualified Health Centers, and other community organizations to identify community needs and address community problems.The health system has a model program that serves the vulnerable and poor in our community and is not offered by any other hospitals in this area called Physicians Who Care (PWC). The program is a network of St. John Providence Health System (SJPHS) credentialed specialty physicians who volunteer their time to provide health care services to uninsured adults. It is designed to ensure a continuum of care exists for the working poor in the communities SJPHS serves. Each physician pledges to see a self-defined number of eligible patients per year. Currently, more than 400 physicians are registered in a common database using a web-based specialty referral network, which is maintained by the Physicians Who Care staff. The patient load is spread equally among all physicians that have agreed to participate in the project. The program provides diagnostics and hospitalizations, and prescription drugs. St. John Providence Health System has a demonstrated history and strong foundation built upon its Mission, Vision, and Values. It is this spirit that leads the institution and drives health care services. Often patients, family members, friends, and the like, are pleased with our position on care to heal the body, mind, and spirit, have experienced it first-hand, and wish to show their appreciation by making a gift to support care of others that are vulnerable. The spiritual essence that's woven into the fabric of our daily operations allows members of the community to comfortably and directly impact the lives of others through philanthropy. We work to create an ethical legacy for emphasizing the important value of community and encourage the compassionate generosity of others to make gifts that enhance the exemplary care St. John Providence Health System has become recognized for. - Medical Staff Privileges:St. John Providence Health System extends medical staff privileges to all qualified physicians in its community for some or all of its departments. Physicians who apply for St. John Providence staff membership and privileges go through a credentialing process.- Clinical Research funded by for-profit companies:The majority of clinical research conducted at SJPHS is funded by for-profit organizations such as pharmaceutical and medical device companies that test the efficacy and safety of health products. Examples include research projects funded by Boston Scientific, Eli Lily & Company and Medtronic.- Board Membership:St. John Providence Health System board membership is comprised of persons who reside in the five counties that represent SJPHS's primary service area.
		Part VI, Line 7: St. John Macomb-Oakland Hospital is part of the St. John Providence Health System ("SJPHS"). SJPHS, as a Catholic health ministry, is committed to providing spiritually centered, holistic care which sustains and improves the health of individuals in the communities we serve, with special attention to the poor and vulnerable. SJPHS owns and operates 7 hospital campuses plus more than 125 medical facilities in southeast Michigan. System wide, for the year ended June 30, 2011, SJPHS provided more than $120,873,000 in community health services including health services, professional education, subsidized health care, research, financial contributions, and other community building activities.In addition, SJPHS is part of Ascension Health (AH), a Catholic, national health care system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 20 states and the District of Columbia. For the year ended June 30, 2011, AH provided more than $1,227,000,000 in community health services including health services, professional education, subsidized health care, research, financial contributions, and other community building activities.

Schedule H (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 John Macomb-Oakland Hospital

Employer identification number

38-3322109

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....

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? ....

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? ........

Yes

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

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

Only 501(c)(3) 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) Diane Radloff Sch O	(i) (ii)	0 509,366	0 69,254	0 2,437	0 11,025	0 14,971	0 607,053	0 0
(2) Steve Minnick MD Sch O	(i) (ii)	0 200,548	0 0	0 40,272	0 8,397	0 12,918	0 262,135	0 0
(3) Connie O' Malley	(i) (ii)	160,936 0	14,701 0	0 0	26,248 0	1,210 0	203,095 0	0 0
(4) Michael Beaubien	(i) (ii)	313,636 0	34,557 0	0 0	31,513 0	20,085 0	399,791 0	0 0
(5) Gary Berg	(i) (ii)	253,406 0	137,141 0	135 0	32,981 0	12,766 0	436,429 0	0 0
(6) Tomasine Marx	(i) (ii)	0 282,001	0 26,205	0 719	0 11,025	0 10,726	0 330,676	0 0
(7) Radha Chitturi MD	(i) (ii)	275,413 0	0 0	0 0	24,383 0	14,039 0	313,835 0	0 0
(8) Thomas Borland MD	(i) (ii)	305,901 0	14,292 0	25,186 0	6,125 0	13,690 0	365,194 0	0 0
(9) Gary Szmanski MD	(i) (ii)	333,852 0	36,334 0	0 0	25,296 0	12,038 0	407,520 0	0 0
(10) Michael Kobernick MD	(i) (ii)	359,311 0	0 0	51,480 0	31,796 0	20,437 0	463,024 0	0 0
(11) Joseph Tasse	(i) (ii)	377,180 0	77,018 0	202 0	40,025 0	3,195 0	497,620 0	0 0
(12) Maria Strom	(i) (ii)	0 236,029	0 30,785	0 24,779	0 10,992	0 10,726	0 313,311	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 4b	These executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. - Diane Radloff - $6,129 paid from 457(f) plan - Maria Strom - $24,780 paid from 457(f) plan
Supplemental Information	Part III	Part I, Line 3: St. John Macomb-Oakland Hospital, a related organization of St. John Health, uses the following methods to establish the compensation of the organization's CEO/Executive Director: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee

Schedule J (Form 990) 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 John Macomb-Oakland Hospital

Employer identification number

38-3322109

Identifier	Return Reference	Explanation
Form 990, Part VI, Section A, line 6		St. John Macomb-Oakland Hospital has a single corporate member, St. John Health.
Form 990, Part VI, Section A, line 7a		St. John Macomb-Oakland Hospital has a single corporate member, St. John Health, who has the ability to elect members to the governing body of St. John Macomb-Oakland.
Form 990, Part VI, Section A, line 7b		All decisions that have a material impact to St. John Macomb-Oakland Hospital financial information or corporation as a whole are subject to approval by its sole corporate member, St. John Health.
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, officer, key employee 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 will decide if conflict of interest exist. Each director, officer, key employee 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 audit committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to other hospitals in the area who hold the same title. 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 audit committee reviewed and approved the compensation. In the review of the compensations, the other officers or key employees of the organization were compared to other hospitals' employees in the area who hold the same title. 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 documents open to public inspection upon request.
Changes in Net Assets or Fund Balances:	Form 990, Part XI, line 5:	Net unrealized gains on investments: 7,308,876. Net Assets Released from Restriction -144,032. Contributed Capital 845,049. Equity Change in Unconsolidated Entities -6,627,135. Other Restricted Activity -761,628. Total to Form 990, Part XI, Line 5: 621,130.
	Form 990, Part VII:	The compensation listed is for services provided to this organization or a related organization in an employee capacity, and not for participation in this organization's board.
	Form 990, Part XII, Line 3a:	The financial statements of St. John Macomb-Oakland Hospital were audited on a consolidated basis. An audit committee has been delegated the responsibility to oversee the audited financial statements in accordance with standards contained in government auditing standards, issued by the comptroller general of the united states pursuant to OMB Circular A-133 and the selection of the independent accountants that audited the financial statements.
	Form 990, Part III:	Community Benefit Report St. John Macomb-Oakland Hospital For the fiscal year ended June 30, 2011 This report illustrates the significant degree to which St. John Macomb-Oakland Hospital ("the Hospital") contributes to the positive health status of the communities it serves. As a member of Ascension Health, the nation's largest Catholic healthcare system, St. John Macomb-Oakland Hospital continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of St. John Macomb-Oakland Hospital is to perpetuate the healing mission of the church. The Hospital furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community, and medical research. Our concern for all human life and 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. In order to portray the full breadth of our contribution, our community benefit information is described below: EXPANDING AWARENESS, EDUCATION, AND HEALTH PROMOTION: St. John Macomb-Oakland Hospital believes that it is essential to educate people regarding the types of behavior that improve their chances of living a healthy life. The Hospital has invested significantly in unique, top quality health education and materials to accomplish its goals. - Various classes the System has provided to the community are as follows: Bone density, blood pressure and skin cancer screening, CPR, Risk factors, stress management, weight loss seminar, What every man/woman needs to know about smart eating, baby care basics, breastfeeding preparation, childbirth classes, Nutrition/Weight Loss Management Health fairs cholesterol screening, Heart-saver first aid, Nutrition for women, CD, Implantable defibrillator, ICD, Menopause, Medicare Part D prescription drug coverage, BLS Re-certification, Substance abuse and dependence, Lifestyle changes for diabetes, Courageous conversations, Blood pressure screening, Senior spirit day, Diabetes risk factors, Cardiac and pulmonary support, Prostate cancer screening, Blood drives, Osteoporosis screening & education, osteoporosis & osteoarthritis, Cardiac rehab, Smoking cessation, Parish nurse sites, Coping with various cancers, and support groups for various cancers, Caregivers and other diseases - Other Programs: Kids on the Go, After Care Group, Headaches. Community education & screenings Support Groups: Bereavement/Grief, Diabetes, Nutrition/Weight Management, Headache Support, Aftercare Mental Health, Stress Management Health Screenings, Blood Pressure Screening, Cholesterol Testing, Cancer, Prostate Screening. Fitness/Exercise Immunizations: Adult Immunization Programs, Child Immunization Programs. Family Support Services: Assistance to enroll in Public Medical Programs, Phone calls/mailings to Uninsured to help enroll. Transportation Services: Cab Fares Education Material is provided on the web under www.stjohn.org and www.realmedicine.org ACCESS TO CARE PROGRAMS: St. John Macomb-Oakland Hospital operates many public health clinics. Public clinics range from specialty clinics such as pediatrics to general internal medicine clinics. Our Community Health Centers provide care for all community residents, regardless of their ability to pay. Services include the full range of preventive and primary health and some dental care for adults and children, prenatal care, and management of chronic diseases such as asthma, diabetes and heart disease. COMMUNITY OUTREACH AND SERVICE: The Hospital provides charitable contributions to various communities by volunteering and giving support to health expos, American Red Cross blood drives, churches, schools, Belle Isle Run/Walk, town hall series lectures, career fairs at schools, police officers benefit, community foundation outings, chamber golf outings, college health care scholarships, fall fairs, Girl Scouts, YMCA kids programs and Salvation Army. St. John Macomb-Oakland Hospital partners with many organizations to improve community health, such as American Red Cross and the American Diabetes Association. CHARITY CARE: Nearly 11% of Michigan residents or 1.1 million people lacked health insurance in 2011. In Detroit, 22% of residents are uninsured; this figure remains high due to increased layoffs, fewer companies offering health insurance and a lessened ability to afford coverage in the Metro Detroit area. The uninsured are likely to seek care in hospital emergency rooms. The Hospital had 85,769 Emergency Department (ED) visits in fiscal 2011, approximately the same number of visits from the prior year. Increasingly, patients are experiencing limited abilities to pay for health care services or qualify for state and federally funded programs like Medicaid and Medicare, programs that cover only a portion of the cost of services provided. For many Michigan residents, finding someone to care for them when they are sick is not as easy as making an appointment. Lack of health insurance, transportation issues and language barriers combine to create challenges. St. John Macomb-Oakland Hospital offers various free clinics. St. John Macomb-Oakland Hospital provides a substantial portion of its services to the elderly and poor. During the fiscal year ending June 30, 2011, approximately 59% of the value of services rendered was to elderly patients under the Medicare program, and approximately 15% of the services were provided to patients who were deemed indigent under state, county, or Medical Center Guidelines. We currently offer financial assistance programs through the Voices of Detroit Initiative, a program that assists the uninsured and underinsured in managing their health care. MEDICAL RESEARCH: St. John Macomb-Oakland Hospital furthers its mission by contributing funds and personnel to support research that has helped advance medical care. Research projects include various cardiac and interventional cardiac research projects, oncology, pediatric hematology and oncology, internal medicine, obstetrics and gynecology and infectious disease research. MEDICAL EDUCATION: St. John Macomb-Oakland Hospital believes that, in order to provide the best health care to the community, its clinical personnel must receive ongoing medical education. Numerous seminars and classes are provided to medical residents and staff and are posted on our web site www.sjhs.com/GME residency training. OPERATIONS AND GOVERNANCE: St. John Macomb-Oakland Hospital 1. Operates an emergency room that is open to all persons regardless of ability to pay. 2. Has an open medical staff with privileges available to all qualified physicians in the area. 3. Has a governing body in which independent persons representative of the community comprise a majority. 4. Engages in medical or scientific research programs. 5. Engages in the training and education of health care professionals. 6. Participates in Medicaid, Medicare, CHAMPUS, Triage and/or other government-sponsored health care programs.
		PATIENT SERVICES: St. John Health provides the following inpatient and outpatient medical services to the community: Allergy and immunology, anatomic and clinical pathology, anesthesiology, anesthesiology-pain medicine, cardiology, cardiovascular disease, cardiothoracic surgery, colon and rectal surgery, dentistry, dermatology, diagnostic radiology, emergency medicine, emergency medicine-pediatric emergency medicine, endocrinology diabetes and metabolism, family medicine, family medicine-addiction, family medicine-geriatric medicine, family medicine-sports medicine, gastroenterology, gynecologic oncology, gynecology, hematology and medical oncology, infectious disease, internal medicine, internal medicine-critical care medicine, internal medicine-geriatric medicine, internal medicine-hematology, interventional cardiology, maternal and fetal medicine, neonatal-prenatal medicine, nephrology, nuclear medicine, obstetrics and gynecology, occupational medicine, ophthalmology, oral and maxiofacial surgery, orthopedic surgery, orthopedic surgery-hand surgery, otorhinolaryngology and orofacial plastic surgery, pediatric-endocrinology, pediatric-allergy and immunology, pediatric-cardiology, pediatric-critical care medicine, pediatric-dentistry, pediatric-emergency medicine, pediatric-gastroenterology, pediatric-hematology oncology, pediatric-infectious disease, pediatric-radiology, pediatric-surgery, pediatrics, physical medicine and rehabilitation, plastic and reconstructive surgery, plastic surgery, plastic surgery-surgery of the hand, podiatric surgery, podiatry, pulmonary medicine, radiation oncology, radiology, reproductive endocrinology, rheumatology, sleep medicine, surgery, surgery of the hand, therapeutic radiology, urology, vascular and interventional radiology, and vascular surgery. Some of the services listed above operate at a loss in order to ensure that all services are available to meet community health care needs. During the fiscal year ending June 30, 2011, St. John Macomb-Oakland Hospital treated adults and children from the community for a total of 138,974 patient days of service. The System also provided services to 255,089 outpatients, including 8,754 outpatient surgery patients, 101,086 emergency and minor care visits, and 389 homebound patients. Additional links to additional community benefit information: //www.mha.org FINANCIAL INFORMATION: The financial information presented below was prepared in accordance with the Catholic Health Association's (CHA) community benefit reporting guidelines. These guidelines recommend the following: - Report care of the poor at cost, not charges. - Do not include bad debt, contractual allowances, and quick pay discounts as part of care of the poor expense. - Do not count Medicare shortfall as a community benefit. - Report the net expense for community benefit services, i.e., the total community benefit expense minus any associated revenue from patients, payers, and other external sources. The CHA reporting guidelines reflect a conservative approach to reporting quantifiable community benefit. The goal of the reporting guidelines is to produce community benefit financial reports that reflect true costs and that describe community benefit activities that increase access to health care and improve community health. St. John Macomb-Oakland information for fiscal year ended June 30, 2011: 1) Care of the poor (at cost) = $11,111,944 2) Unpaid cost of public indigent care programs (includes Medicaid, SCHIP, and other safety net programs; does not include Medicare shortfalls) = $9,625,167 3) Community benefit programs (net expense) $14,265,750 Total quantifiable community benefit, as determined in accordance with CHA reporting guidelines = $35,002,861 SUPPLEMENTAL INFORMATION: Bad debt costs attributable to charity = $7,440,268 Medicare Surplus = $12,670,485

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 John Macomb-Oakland Hospital

Employer identification number

38-3322109

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 Services	MO	Section 501(c)(3)	Schedule A, Line 11a	N/A		No
(2) StJohn Health 28000 Dequindre Warren,MI48092 38-2244034	Parent	MI	Section 501(c)(3)	Schedule A, Line 11c	Ascension Health		No
(3) Brighton Hospital 12851 Grand River Brighton,MI48116 38-1576680	Hospital	MI	Section 501(c)(3)	Schedule A, Line 3	St John Health	Yes
(4) Brighton National Addiction Foundation 12851 Grand River Brighton,MI48116 26-0694680	Fundraising	MI	Section 501(c)(3)	Schedule A, Line 7	Brighton Hospital	Yes
(5) Father Murray Nursing Center 8444 Engleman Centerline,MI48015 38-2601348	Medical Care	MI	Section 501(c)(3)	Schedule A, Line 9	St John Health	Yes
(6) Macomb Hospital Center Auxiliary 11800 E Twelve Mile Warren,MI48093 38-6091287	Fundraising	MI	Section 501(c)(3)	Schedule A, Line 11c	St John Macomb-Oakland Hospital Corp		No
(7) Macomb Hospital Foundation 22101 Moross Rd Mack Office Buildin Detroit,MI48236 20-2962353	Fundraising	MI	Section 501(c)(3)	Schedule A, Line 7	St John Health	Yes
(8) Medical Resources Group 43800 Garfield Rd Clinton Township,MI48038 38-3494637	Medical Care	MI	Section 501(c)(3)	Schedule A, Line 9	St John Health	Yes
(9) Providence Health Foundation 22101 Moross No-102 Detroit,MI48236 38-3526629	Fundraising	MI	Section 501(c)(3)	Schedule A, Line 11c	St John Health	Yes
(10) Providence Hospital 16001 West Nine Mile Rd Southfield,MI48037 38-1358212	Hospital	MI	Section 501(c)(3)	Schedule A, Line 3	St John Health	Yes
(11) Seton Health Corp of SE Michigan 16001 W Nine Mile Rd Southfield,MI48037 38-2820107	Medical Care	MI	Section 501(c)(3)	Schedule A, Line 11c	St John Health	Yes
(12) St John Community Health Investment Corp 28000 Dequindre Warren,MI48092 38-2262856	Medical Care	MI	Section 501(c)(3)	Schedule A, Line 3	St John Health	Yes
(13) St John Home Care 37650 Garfield Rd Clinton Township,MI48036 38-3408684	Medical Care	MI	Section 501(c)(3)	Schedule A, Line 7	St John Health	Yes
(14) St John Hospital and Medical Center 28000 Dequindre Rd Warren,MI48092 38-1359063	Hospital	MI	Section 501(c)(3)	Schedule A, Line 3	St John Health	Yes
(15) St John Hospital Foundation 22101 Moross Rd Mack Office Buildin Detroit,MI48236 20-2961579	Fundraising	MI	Section 501(c)(3)	Schedule A, Line 7	St John Health	Yes
(16) St John Hospital Guild 28000 Dequindre Rd Warren,MI48092 38-6091110	Fundraising	MI	Section 501(c)(3)	Schedule A, Line 11c	St John Hospital and Medical Center		No
(17) St John River District Hospital 4100 River Road East China,MI48054 38-3160564	Hospital	MI	Section 501(c)(3)	Schedule A, Line 3	St John Health	Yes
(18) St John Senior Community 18300 E Warren Detroit,MI48224 38-2631907	Medical Care	MI	Section 501(c)(3)	Schedule A, Line 9	St John Health	Yes
(19) Our Lady of Providence League PO Box 2043 South Fields,MI48037 38-6108200	Fundraising	MI	Section 501(c)(3)	Schedule A, Line 11c	Providence Hospital		No
(20) Eastwood Community Clinics 28000 Dequindre Rd Warren,MI48092 38-1958763	Medical Care	MI	Section 501(c)(3)	Schedule A, Line 9	St John Health	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	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code 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
(1) Advent Partners LP 28000 Dequindre Warren,MI48092 38-3494197	Investment	MI	N/A	Investment				No			No
(2) Open MRI of Michigan 28000 Dequindre Warren,MI48092 38-3544539	Medical Services	MI	N/A	Medical Services				No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)
(1) Advent Inc 28000 Dequindre Warren,MI48092 38-2971743	Investment	MI	N/A	C
(2) Affiliated Health Services Inc 28000 Dequindre Warren,MI48092 38-2292922	Medical Supply Sales	MI	N/A	C

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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 John Health	N	191,491,373	Journal Entry
(2) St John Health	P	172,308,082	Journal Entry
(3) St John Health	A	7,275,972	Journal Entry
(4) St John Health Foundation	Q	499,650	Cash Transfer
(5) St John Health Foundation	P	1,211,670	Journal Entry
(6) St John Health Foundation	I	64,727	Journal Entry
(7) St John Hospital Foundation	O	1,228,312	Journal Entry
(8) St John Hospital Foundation	Q	195,914	Cash Transfer
(9) St John Hospital & Medical Center	Q	5,210,383	Cash Transfer
(10) St John Hospital & Medical Center	N	792,987	Journal Entry
(11) St John Hospital & Medical Center	O	3,369,579	Journal Entry
(12) St John Hospital & Medical Center	I	59,410	Journal Entry
(13) Father Murray Nursing Center	R	231,251	Cash Transfer
(14) St John River District Hospital	N	84,319	Journal Entry
(15) St John River District Hospital	P	132,787	Journal Entry
(16) Medical Resources Group	Q	6,841,790	Cash Transfer
(17) Medical Resources Group	H	817,297	Journal Entry
(18) Medical Resources Group	O	12,156,020	Journal Entry
(19) Medical Resources Group	I	128,046	Journal Entry
(20) St John Home Care	R	179,327	Cash Transfer
(21) St John Home Care	P	352,435	Journal Entry
(22) St John Community Health Investment Corporation	R	475,316	Cash Transfer
(23) St John Community Health Investment Corporation	P	296,560	Journal Entry
(24) Eastwood Community Clinics	Q	1,056,898	Cash Transfer
(25) Open MRI of Michigan	R	125,000	Cash Transfer
(26) Affiliated Health Services Inc	R	240,149	Cash Transfer
(27) Affiliated Health Services Inc	P	187,827	Journal Entry
(28) Providence Hospital	Q	93,416	Cash Transfer
(29) Providence Hospital	O	797,526	Journal Entry
(30) Providence Hospital	R	495,190	Cash Transfer
(31) Providence Hospital	N	103,494	Journal Entry

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: Our Catholic Health Ministry is dedicated to spiritually centered, holistic care.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	19
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	15
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	3,831
6	Total number of volunteers (estimate if necessary) ....	6	275
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,124	98,684
9	Program service revenue (Part VIII, line 2g) .........	401,937,263	408,710,401
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	6,655,163	8,825,806
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	9,640,959	3,992,589
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	418,234,509	421,627,480
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	187,539,972	195,248,640
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 70,051
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	212,782,711	222,818,542
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	400,322,683	418,067,182
19	Revenue less expenses. Subtract line 18 from line 12......	17,911,826	3,560,298
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	243,303,430	264,848,218
21	Total liabilities (Part X, line 26)............	247,895,356	265,258,716
22	Net assets or fund balances. Subtract line 21 from line 20 .....	-4,591,926	-410,498

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 $ 296,238,329 including grants of $ ) (Revenue $ 408,710,401 )
	In furtherance of its mission and in an effort to reduce the government's financial burden, St. John Macomb-Oakland Hospital provides essential health care services, such as emergency rooms and other facilities that serve low-income patients as well as community services, which sustains and improves the health of individuals and communities.See Schedule O for community benefit report.

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$ 296,238,329

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,941,747	1,422,395	424,246

(A) Name and business address	(B) Description of services	(C) Compensation





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 7

				(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

f	All other contributions, gifts, grants, and similar amounts not included above1f		98,684
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			98,684
			Business Code
2a	Net Patient Revenue		621,990	408,062,183	408,062,183
b	Medical Education		531,110	648,218	648,218
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			408,710,401
3	Investment income (including dividends, interest
	and other similar amounts).....			8,626,382			8,626,382
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents	3,131,070
b	Less: rental expenses	1,168,149
c	Rental income or (loss)	1,962,921
d	Net rental income or (loss).......			1,962,921			1,962,921
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		222,608
b	Less: cost or other basis and sales expenses		23,184
c	Gain or (loss)		199,424
d	Net gain or (loss)..........			199,424			199,424
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	Cafeteria Revenue		722,210	979,910			979,910
b	Disc Operations Inc.		900,099	555,777			555,777
c	Unconsol Op Income		621,300	76,771			76,771
d	All other revenue ....			417,210			417,210
e	Total. Add lines 11a–11d ......			2,029,668
12	Total revenue. See Instructions....			421,627,480	408,710,401	0	12,818,395


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			4,972,060	1	2,435,745
2	Savings and temporary cash investments .......				2
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			43,149,346	4	45,541,840
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			3,959,442	8	4,087,740
9	Prepaid expenses and deferred charges ............			562,063	9	546,512
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	328,774,951
b	Less: accumulated depreciation. .....	10b	248,089,063	88,501,866	10c	80,685,888
11	Investments—publicly traded securities ..........				11
12	Investments—other securities. See Part IV, line 11 ......			50,358,858	12	307,376
13	Investments—program-related. See Part IV, line 11 ..			371,652	13	286,035
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			51,428,143	15	130,957,082
16	Total assets. Add lines 1 through 15 (must equal line 34)...			243,303,430	16	264,848,218
17	Accounts payable and accrued expenses .			28,670,539	17	26,558,541
18	Grants payable ..........				18
19	Deferred revenue ..........			320,364	19	219,204
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.....			218,904,453	25	238,480,971
26	Total liabilities. Add lines 17 through 25.....			247,895,356	26	265,258,716
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			-4,945,312	27	-717,874
28	Temporarily restricted net assets .....			353,386	28	307,376
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 .....			-4,591,926	33	-410,498
34	Total liabilities and net assets/fund balances .....			243,303,430	34	264,848,218