TY 2011 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) STEPHEN GUIMOND PRESIDENT & CEO THRU 06/29/13	40.0	X	X			421,434		18,586
(2) VICTOR POIRIER CHAIRPERSON	1.0	X				0	0	0
(3) GREG WERTHEIMER VICE CHAIRPERSON	1.0	X				0	0	0
(4) TERRENCE MCCARTHY SECRETARY	1.0	X				0	0	0
(5) RAYMOND ANSTISS JR DIRECTOR	1.0	X				0	0	0
(6) IRWIN BUCHWALD MD DIRECTOR	1.0	X				0	0	0
(7) GARY CAMBELL DIRECTOR	1.0	X				0	0	0
(8) SISTER PAULINE LEBLANC DIRECTOR	1.0	X				0	0	0
(9) SISTER PRESCILLE MALO SCO DIRECTOR	1.0	X				0	0	0
(10) KIMBERLY OBERHAUSER DIRECTOR	1.0	X				0	0	0
(11) JACK D O'CONNOR DIRECTOR	1.0	X				0	0	0
(12) MARK O'NEIL DIRECTOR	1.0	X				0	0	0
(13) ROBERT COCHRANE CFO & TREAS THRU 06/30/12	42.0		X			220,280		17,988
(14) JUDY CASAGRANDE COO-ASS TREAS THRU 06/30/12	45.0		X			301,534		18,075
(15) HELENE THIBODEAU ACTING CNO THRU 06/30/12	50.0			X		190,518		18,680
(16) RICHARD MA PHYSICIAN/HIGHEST PAID	50.0				X	465,859		17,585
(17) SIVASUBRAMANIAN RAMYA PHYSICIAN/HIGHEST PAID	50.0				X	256,128		2,020

(A) Name and business address	(B) Description of services	(C) Compensation
ANESTHESIA ASSOCIATES MA 690 CANTON STREET SUITE 325 WESTWOOD,MA02090	MEDICAL CONSULTING	2,176,265
AFFILIATED PROFESSIONAL SVCS STONEGATE PROF CTR 2527 CRANBERRY H WAREHAM,MA02571	BILLING & COLLECTION	598,097
PROPOCO INC 13028 COLLECTION DRIVE CHICAGO,IL60693	ENGINEERING	1,709,374
MASSACHUSETTS GENERAL HOSPITAL PHYS 55 FRUIT STREET BOSTON,MA02114	MEDICAL CONSULTING	4,570,138
MORRISION MANAGEMENT SERVICES INC 5801 PEACHREE DUNWOODY RD ATLANTA,GA30342	FOOD SERVICE	573,181
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 27

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 United States. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	850,326	142,889	707,437
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	41,623,540	40,086,586	1,536,954
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	0
9	Other employee benefits .......	6,615,574	6,265,996	349,578
10	Payroll taxes ...........	3,095,281	2,931,721	163,560
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	905,889		905,889
c	Accounting ...........	112,500		112,500
d	Lobbying ...........	24,615		24,615
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	0
g	Other ..........	11,593,141	10,795,480	797,661
12	Advertising and promotion ....	63,894		63,894
13	Office expenses .......	551,566	154,324	397,242
14	Information technology ......	718,153	427,971	290,182
15	Royalties ..	0
16	Occupancy ...........	4,855,047	4,314,342	540,705
17	Travel ............	215,708	206,033	9,675
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	2,059,068	1,849,901	209,167
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	4,096,165	3,852,508	243,657
23	Insurance ..............	797,848	698,585	99,263
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	PROGRAM SUPPL & MATERIALS	17,049,325	16,831,415	217,910
b	PROVISION FOR BAD DEBT	6,791,241	6,791,241
c	EQUIP LEASE AND RENTAL	1,435,610	1,065,773	369,837
d	OTHER	1,053,730	333,860	719,870
e
f	All other expenses	726,319	477,933	248,386
25	Total functional expenses. Add lines 1 through 24f	105,234,540	97,226,558	8,007,982	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	0	1	0
2	Savings and temporary cash investments .......	928,205	2	0
3	Pledges and grants receivable, net .........	0	3	0
4	Accounts receivable, net .........	17,690,291	4	0
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	0	5	0
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 ..........	0	6	0
7	Notes and loans receivable, net .............	50,129	7	0
8	Inventories for sale or use ..............	2,355,599	8	0
9	Prepaid expenses and deferred charges ............	874,007	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation. .....	10b		34,937,097	10c
11	Investments—publicly traded securities ..........	0	11	0
12	Investments—other securities. See Part IV, line 11 ......	1,883,444	12	0
13	Investments—program-related. See Part IV, line 11 ..	0	13	0
14	Intangible assets .........	0	14	0
15	Other assets. See Part IV, line 11 ...........	11,745,258	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)...	70,464,030	16	0
	17	Accounts payable and accrued expenses .	22,954,636	17	0
18	Grants payable ..........	0	18	0
19	Deferred revenue ..........	0	19	0
20	Tax-exempt bond liabilities ..........	44,891,086	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	2,958,882	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....	22,278,393	25	0
26	Total liabilities. Add lines 17 through 25.....	93,082,997	26	0
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	-22,656,695	27	0
28	Temporarily restricted net assets .....	37,728	28	0
29	Permanently restricted net assets .....	0	29	0
	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 .....	-22,618,967	33	0
34	Total liabilities and net assets/fund balances .....	70,464,030	34	0

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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

2011

Open to Public
Inspection

Name of the organization

SAINTS MEMORIAL MEDICAL CENTER INC

Employer identification number

04-2104885

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) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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—2011. 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—2010. 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—2011. 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—2010. 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) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. 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—2010. 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) 2011

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) 2011

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

2011

Name of organization

SAINTS MEMORIAL MEDICAL CENTER INC

Employer identification number

04-2104885

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, total 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 total 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 on line H of its
Form 990-EZ or on Part I, 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) (2011)

Page 2

Name of organization SAINTS MEMORIAL MEDICAL CENTER INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED 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) Total 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) Total 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) Total 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) Total 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) Total 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) (2011)

Page 3

Name of organization SAINTS MEMORIAL MEDICAL CENTER INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part II	Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
SAINTS MEMORIAL MEDICAL CENTER INC

Employer identification number

04-2104885

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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

$
Use duplicate copies of Part III if additional space is needed

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

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

2011

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, line 35c (Proxy Tax), then
Round Bullet

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

Name of the organization

SAINTS MEMORIAL MEDICAL CENTER INC

Employer identification number

04-2104885

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 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 function 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) 2011

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 (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) Total

2a	Lobbying non-taxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2011

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)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(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? ..........................

Yes

24,615

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

24,615

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 carry over 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) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.

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

Section 162(e) nondeductible 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, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
PART II-B LINE 1(I), OTHER LOBBYING ACTIVITIES:		A PORTION OF MASSACHUSETTS HOSPITAL ASSOCIATION ANNUAL DUES AS LOBBYING EXPENSES.

Schedule C (Form 990 or 990EZ) 2011

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

2011

Open to Public Inspection

Name of the organization

SAINTS MEMORIAL MEDICAL CENTER INC

Employer identification number

04-2104885

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the

following was the family income limit for eligibility for discounted care: ............

Yes

200% 250% 300% 350% 400% Other

If the organization did 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 used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......

Yes

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

Did the organization prepare a community benefit report during the tax year?...........

Yes

If "Yes," did 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.

Financial Assistance 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 Financial Assistance at cost (from Worksheet 1) ..	3,122,731	1,660,613	1,462,118	1.430 %
b Medicaid (from Worksheet 3, column a) .....	17,556,063	17,194,560	361,503	0.350 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .
dTotal Financial Assistance and Means-Tested Government Programs .....	20,678,794	18,855,173	1,823,621	1.780 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	26,772	70	26,702	0.030 %
f Health professions education (from Worksheet 5) ..	61,864	15,650	46,214	0.050 %
g Subsidized health services (from Worksheet 6) ..
h Research (from Worksheet 7)	231,500		231,500	0.230 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....	17,877		17,877	0.020 %
jTotal Other Benefits ...	338,013	15,720	322,293	0.330 %
kTotal. Add lines 7d and 7j. ..	21,016,807	18,870,893	2,145,914	2.110 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011

Schedule H (Form 990) 2011

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense
1	Physical improvements and housing
2	Economic development
3	Community support	947	947
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	3,701	3,701
8	Workforce development
9	Other
10	Total	4,648	4,648

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

Enter the amount of the organization's bad debt expense........

2,658,785

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

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

30,722,465

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

28,103,606

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

2,618,859

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

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures

(see instructions)

(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) 2011

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	SAINTS MEDICAL CENTER INC ONE HOSPITAL DRIVE LOWELL,MA01852	X

Schedule H (Form 990) 2011

Page

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)

SAINTS MEDICAL CENTER INC

Name of Hospital Facility:

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 2011)
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 the community health 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 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	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a 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 Needs Assessment
	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 and 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	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 200.% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	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	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted 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 (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

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	Yes
	If “No,” indicate why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	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)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	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		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?5
Name and address		Type of Facility (describe)
1	SAINTS MEMORIAL MEDICAL WALK-IN CENTER 1320 BRIDGE STREET LOWELL,MA01850	WALK-IN CLINIC
2	SAINTS MEMORIAL - MEDICAL ONCOLOGY 2 HOSPITAL DRIVE LOWELL,MA01852	OUTPATIENT SERVICES
3	SAINTS WOMEN'S CNTR FOR HEALTH AND WEL 203 TURNPIKE STREET NORTH ANDOVER,MA01845	OUTPATIENT SERVICES
4	SAINTS MEDICAL CENTER MERRIMACK VALLEY 100 MILK SREET METHUEN,MA01844	WALK-IN CLINIC
5	SAINTS MEDICAL CENTER DIALYSIS 847 ROGERS STREET LOWELL,MA01853	DIALYSIS CENTER
6
7
8
9
10

Schedule H (Form 990) 2011

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions 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, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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: DISCOUNTED CARE IS DETERMINED BY THE FREE CARE		Discounted care is determined by the free care guidelines in the medical centers credit and collection policy. Hardship determinations are made on a case by case basis by the patient financial assistance office. Part I, Line 7 Saints Medical Center does not have a cost accounting system and relies on the Medicare cost report, the state 403 cost report and cost to charge ratio calculations to determine cost of community benefit expenses. Part I, Line 7G There are no subsidized health services. Part I, Line 7 Col (F) A cost to charge ratio is used to determine the cost of bad debt expenses of $2,658,785. Part I, Line 7E Community Health Improvement Activities provided to the community to support and improve the health of the community have included numerous class and discussion groups to include the following: -Ten pounds Ten dollars Ten week. Program to help employees gain knowledge of nutrition and exercise through class time and physical activity. -Al anon. Weekly support group of relatives and friends of alcoholics who believe their lives have been affected by someone else's drinking. -Alcoholics anonymous. Weekly support group to help alcoholics learn how to deal and overcome their disease. -Cancer survivors support group. Support group for cancer survivors. -Coping with the Holidays. Monthly meetings of the bereavement support group. -Diabetes support group. Support group for people living with diabetes. -Helping hands. A support group of people that live with chronic health conditions meet monthly to help each other deal with the ups and downs of living with a health condition. -Joint replacement surgery lecture. Joint replacement surgery lecture conducted by a local physician. -Learn to cope. Peer lead support group for parents/caregivers struggling with a member of the family who is addicted to opioids/alcohol or other drugs. -Navigating through loss bereavement. Support group help people deal with a loss. -Oral Cancer Screening. Local event to provide free oral screening. -Overeaters anonymous. Weekly support group to help people deal with eating disorder. -Pulmonary support group. Support group for people living with pulmonary diseases. -Saints celebrates women. Annual event at the hospital to celebrate women and provide education and raise awareness about health matters afflicting women. -Spring blood drive. Annual spring blood drive. Part I, Line 7F Activities provided to the community to support and improve the health of the community have included numerous education and professional development classes for health care providers to include the following: -ACLS New Provider. Advanced cardio life support course open to the public. -ACLS renewal course. Advanced cardio life support renewal certification course open to the public. -Basic 12-lead EKG interpretation. One day course to the public on EKG interpretation. -Basic Dysrhythmia. One day course on understanding Dysrhythmia a medical condition causing irregular heart rate. -Basic life support new provider. Course on teaching and certification on basic life support. -Basic life support recert. Recertification course on basic life support. -Cardiac abnormality. One day course of understanding cardiac abnormalities. -Diabetes workshop. A series of four diabetes workshops at the Lowell adult education center to educate the public about the disease. -Heart saver first aid and rene. One day course on heart saver first aid sponsored by the American Health Association. -Mechanical ventilation. Mechanical ventilation course conducted by two hospital employees. -Parents of murdered children. Monthly support group to help parents deal with the loss of a murdered child. -Pediatric advanced life support. Course for training and certification of pediatric life support skills. -Pediatric Emergency Assessment. Course for training and certification of pediatric emergency assessment. -Trauma Nurse Critical Care. Trauma nurse critical care and new provider course. Part II: Form 990, Schedule H, Part VI, Supplemental Information Part II, Line 3 -Asian community lecture. Lecture at the Cambodian mutual assistance association on the topic of heart disease prevention, diabetes and healthy living. -What's new in plastic surgery? Lecture provided by local healthcare professional on plastic surgery. -DUDE! Where's my soap? Lecture by Dr. Sidebottom. Part II, Line 7 -Chelmsford Health Fair. Participation in the annual Chelmsford health fair. -National cancer survivorship. National event to raise awareness about cancer and coping as a survivor. -Tewksbury Health Fair. Provide staff and information to support the annual Tewksbury town health fair. -Tyngsboro road race. Provide staff to assist event with free health screenings, EKG's, vital signs, cholesterol/blood sugar and pulmonary function tests. Attendees Also provided education material on stroke, nutrition and smoking cessation to name a few. Part III, Line 4: The cost methodology used was derived by applying a total hospital overall cost to charges for a ratio of 39.95%. That percent was then multiplied by the incurred and reported bad debt expense. Part III, Line 9B: It is the policy of Saints Medical Center (The Medical Center) that within the resources of the medical center, care is provided to all that seek it. The medical center assists patients in obtaining financial assistance from public programs and other sources whenever appropriate. To remain viable as it fulfills its mission, the medical center must meet its fiduciary responsibility to appropriately bill and collect for medical services provided to patients. We do not discriminate on the basis of race, color, national origin, citizenship, alienage, religion, creed, sex, sexual preference, age, or disability, in its policies, or in its application of policies, concerning the acquisition and verification of financial information, pre-admission or pretreatment deposits, payment plans, deferred or rejected admissions, or low income patient status as determined by the Massachusetts office of Medicaid, determinations that a patient is low income, or in its billing and collection practices. The medical center derives its revenue primarily from patient care. It is necessary that those receiving care pay for it to the extent that their own resources and/or third party coverage permit. It is therefore essential that complete and accurate information concerning such resources and coverage is obtained prior to admission or treatment or, if this is not feasible, as soon as possible following admission or treatment. Credit and collection procedures relating to patient care are provided as the basis for the extension of credit, the collection of funds, and the write-off of certain patient balances, as either health safety net or as un-collectable accounts. The credit and collection policy was developed to ensure compliance with applicable criteria required under (1) the health safety net eligibility regulation (114.6 CMR 13.00), (2) the centers for Medicare and Medicaid services Medicare bad debt requirements (42 CFR 413.89), and (3) the Medicare provider reimbursement manual (part 1, chapter 3). This credit and collection policy applies to the medical center and any entity that is part of the medical center's license or tax ID number. The medical center does not pursue collection efforts on patients who are on financial assistance. Saints Medical Center: Part V, Section B, Line 9: 1. Eligibility for financial assistance is posted throughout the hospital. 2. Notice of availability of free care is included with all patient statements that are mailed. 3. Inpatient information package provides information on financial assistance. 4. At the time of registration patients are advised on the availability of financial assistance. 5. All patients classified as self-pay who cannot afford to pay will be screened for financial assistance eligibility. Saints Medical Center: Part V, Section B, Line 10: It is the policy of Saints Medical Center (The Medical Center) that within the resources of the medical center, care is provided to all that seek it. The medical center assists patients in obtaining financial assistance from public programs and other sources whenever appropriate. To remain viable as it fulfills its mission, the medical center must meet its fiduciary responsibility to appropriately bill and collect for medical services provided to patients. We do not discriminate on the basis of race, color, national origin, citizenship, alienage, religion, creed, sex, sexual preference, age, or disability, in its policies, or in its application of policies, concerning the acquisition and verification of financial information, pre-admission or pretreatment deposits, payment plans, deferred or rejected admissions, or low income patient status as determined by the Massachusetts office of Medicaid, determination that a patient is low income, or in its billing and collection practices. Part VI, Line 2: Form 990
Part VI, line 2 continued...		Saints partners with the following agencies when focusing on community program planning: Academy of Notre Dame Tyngsboro African Assistance Center Alternative house emergency women's services American Cancer Society American Heart Association - MV American Red Cross (Merrimack Valley) Asian-American Business Association Billerica Senior Center Cambodian Mutual Assistance Associations Career Center of Lowell Catholic Collaborative of Lowell Chelmsford Council on Aging CHNA 10 City Manager's Domestic Violence Task Force City of Lowell Gang Task Force City of Lowell Stroke Task Force City of Lowell Substance Abuse Task Force Community Teamwork Inc. (CTI) Deana's Educational Theatre D'youville senior care center Department of Mental Health Department of social services Elder services of the Merrimack valley Emergency nurses association Emergency nurses care prevention program Genesis HCC (Heritage) Girl Scouts Greater Lowell Chamber of Commerce Greater Lowell CISM Team Greater Lowell Health Alliance Greater Lowell Partners against Sexual Assault Greater Lowell Technical High School Greater Lowell WIB Youth Council Greater Lowell YMCA Greenhalge School International critical incident stress foundation International institute of Lowell LHI (Latino Health Institute) Life Care Center - Merrimack Valley Lowell Board of Health Lowell City Manager's Office Lowell Community Health Center Lowell community health partnership Lowell council on aging Lowell firefighter's local 853 Lowell house Inc. Lowell police department Lowell public schools Lowell senior center Lowell Southeast Asian water festival Lowell visiting nurses association Lowell women's week Lowell YMCA/YWCA Lowell youth services MA chapter of Angkor hospital for children March of dimes Mass council of comm. hospitals Massachusetts assoc. for Portuguese speakers Massachusetts department of public health Massachusetts hospital association Mass immigration & refuge advocacy coalition Merrimack valley AHEC Merrimack valley critical care consortium Merrimack valley health services Middlesex community college MSPCC the healthy family initiative New England organ bank Northeast center for healthy communities Northeast coalition against trafficking Northeast EMS Northeast homeland security council One Lowell Radius Northwood Saint Michael's school Sisters of St. Francis Southbay mental health St. Jeanne d'arc elementary school St. Louis elementary school St. Patrick education center St. Patrick parish The Lowell plan The Salvation Army United teen equality center University of Massachusetts Lowell VNA of greater Lowell Westford council on aging WIC Women working wonders fund Yankee alliance Young professionals of greater Lowell Greater Lowell community health needs assessment 2010 executive summary On behalf of Lowell general hospital (LGH), saint's medical center (SMC) and the greater Lowell health alliance (GLHA), a team of UMASS Lowell Researchers and students conducted a community health needs assessment Study to distinguish the unmet medical and public health needs within the Greater Lowell community. The geographic area assessed included the Communities of Lowell, Billerica, Chelmsford, Dracut, Dunstable, Tewksbury, Tyngsborough and Westford. The study had two objectives: 1. Meet state and federal requirements that the two hospitals conduct a comprehensive health needs assessment every three years 2. Conduct a study that would provide a foundation for the GLHA and its partners, including LGH and SMC, in working to build consensus on the area's health needs and plan coordinated activities to improve the health of the area's residents. Part VI, line 3: 1. Eligibility for financial assistance is posted throughout the hospital. 2. Notice of availability of free care is included with all patient statements that are mailed. 3. Inpatient information package provides information on financial assistance. 4. At the time of registration patients are advised on the availability of financial assistance. 5. All patients classified as self-pay who cannot afford to pay will be screened for financial assistance eligibility. Part VI, line 4: form 990 Schedule H, part VI, supplemental community information 4. Community information - saint's medical center is a nonprofit, full service, acute care community hospital serving greater Lowell since 1839. A 157-bed licensed medical center, saints provides advanced health services to 315,000 residents in 25 towns. Through 6/30/12, saints discharged 6,385 inpatients, with an average length of stay of 3.94 days. Total hospital outpatient visits and procedures for FY 2012 are 158,707 of which 32,775 are emergency department encounters; laboratory testing for patient, community physicians and other facilities totaled 950,145; and saints surgeons performed over 926 inpatient and 2,016 outpatient surgeries. With nearly 250 physicians and 1,100 employees, saint's medical center is well known for outstanding medical care and patient-centered facilities including our cancer center, orthopedic center and cardiovascular services. Saints offers convenient community-based care at several ambulatory sites and is dedicated to promoting health and wellness in the community. Since 2001, saints has provided the greater Lowell community with over $26 million dollars in free community benefit and community service programs, local sponsorships and employee volunteerism efforts. The medical center has clinical affiliations with the leading Boston academic medical centers and is proud to be one of the top-rated hospitals in Massachusetts according to the joint commission for the accreditation of healthcare organizations. Saints continues to provide comprehensive, holistic health services to all people, especially the poor and disadvantaged, in accordance with our mission. Approximately 35% of Lowell's population (105,167) is documented as belonging to an ethnic minority. Lowell has sizable Asian (22%) and Hispanic (15.5%) populations. Over the last several years, Lowell has experienced a large influx of Brazilian, Portuguese and African immigrants. Many of these populations are included in the uninsured and underinsured groups. Additionally, 34% of Lowell households speak a primary language other than English at home. 13% of households have an income less than $10,000; 20% have an income less than $15,000. (Source: MASSCHIP CHNA Health status indicators report). A recent study sponsored by the centers for disease control and prevention found: 36.2% of southeast Asian, 33.9% of Hispanic, and 21.8% of African respondents in the greater Lowell area reported being in "fair or poor" health, in contrast to only 12.1% of the overall population; 14.1% of southeast Asian respondents, 17.5% of African respondents and 29.9% of Hispanic respondents reported being unable to see a doctor because of inability to pay, as opposed to 6.5% in the overall population; only 37.4% of minority respondents report ever having their cholesterol level checked, compared to 82.4% of the general population. Only 18.8% of minority respondents over 65 reported ever receiving a pneumococcal vaccination, vs. 63.5% of the overall population. In keeping with its mission, saints works to continue identifying health Needs and health risks specific to each community in greater Lowell, as well as maintains active participation in outreach activities within Greater Lowell communities. Saints medical center provides community education through the distribution of information about access to care, provides assistance to enroll individuals in appropriate public assistance programs, provides referrals to primary care physicians, and promotes cultural awareness of beliefs, values and practices for specific minority populations. Ultimately, the staff at saints aims to recognize a decreasing trend in the number of individuals within the greater Lowell community without a primary care physician, as well as develop and maintain culturally-appropriate services to facilitate access to care, thus increasing overall access to care, with the goal of improving the health of the greater Lowell population. Part VI, line 5: expanding access to care especially to the underserved is the highest priority at saints. Our initiative includes several components: outreach efforts to improve accessibility and communication, referrals to primary care physicians, education and assistance with obtaining health coverage and providing culturally appropriate education materials, provide for open medical staff, address the needs of the community board and ability to support programs with surplus funds. Identified barriers to adequate medical care and services include: cultural, ethnic, linguistic barriers, religious barriers, financial barriers, barriers to information about access to care and lack of programs/services that directly address specific health care needs. Short term goals and objectives: -Educate members of the targeted minority populations

Schedule H (Form 990) 2011

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

2011

Open to Public Inspection

Name of the organization

SAINTS MEMORIAL MEDICAL CENTER INC

Employer identification number

04-2104885

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 or provision 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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed 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? ...............

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations 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) 2011

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.

(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 as deferred in prior Form 990
(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)	(F) Compensation reported as deferred in prior Form 990
(1) STEPHEN GUIMOND	(i) (ii)	401,871	19,563			18,586	440,020
(2) ROBERT COCHRANE	(i) (ii)	220,280				17,988	238,268
(3) JUDY CASAGRANDE	(i) (ii)	301,534				18,075	319,609
(4) HELENE THIBODEAU	(i) (ii)	190,518				18,680	209,198
(5) RICHARD MA	(i) (ii)	465,859				17,585	483,444
(6) SIVASUBRAMANIAN RAMYA	(i) (ii)	256,128				2,020	258,148
(7) GABRIELE SOUTHGATE	(i) (ii)	305,648	9,941			18,355	333,944
(8) SANJAY BASU	(i) (ii)	248,943				17,535	266,478
(9) MICHAEL ABELE	(i) (ii)	249,320				17,508	266,828
(10) MICHAEL GULEY	(i) (ii)	520,138				19,183	539,321
(11) STEPHEN O'CONNOR	(i) (ii)	241,294				18,075	259,369

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
Part I, Line 4A		MICHAEL GULEY, FORMER CEO/PRESIDENT RECEIVED SEVERANCE PAYMENTS OF SALARY AND BENEFITS IN FY2012 IN THE AMOUNT OF $539,321. THE PERIOD COVERED BY THE SEVERANCE PLAN WAS 24 MONTHS, MAY 2010 - MAY 2012. NO SEVERANCE PAYMENTS WERE MADE IN CALENDAR YEAR 2011 FOR THE OFFICERS LISTED BELOW. NO SEVERANCE PAYMENTS WERE MADE UNTIL THE SECOND HALF OF CALENDAR 2012, AS DISCUSSED BELOW. SEVERANCE PAYMENTS WILL BE DISCLOSED AS REQUIRED IN THE FUTURE. STEPHEN GUIMOND, PRESIDENT & CEO THROUGH 6/29/12, IS COVERED BY A SEVERANCE PLAN FROM JULY 2012 - DECEMBER 2013. ROBERT COCHRANE, CFO & TREASURER THROUGH 6/30/12, IS COVERED BY A SEVERANCE PLAN FROM AUGUST 2012 - AUGUST 2013. JUDY CASAGRANDE, COO & ASSISTANT TREASURER THROUGH 6/30/12, IS COVERED BY A SEVERANCE PLAN FROM AUGUST 2012 - AUGUST 2014. PART I, QUESTION 3: SAINTS MEDICAL CENTER IS A MEMBER OF SAINTS HEALTH SYSTEM (HEALTH SYSTEM). THE COMPENSATION OF THE CEO/PRESIDENT IS ESTABLISHED BY THE SYSTEM. THIS IS AN EXERPT FROM THE HEALTH SYSTEM BYLAWS: 5.4 COMPENSATION COMMITTEE: THE COMPENSATION COMMITTEE SHALL CONSIST OF AT LEAST FIVE (5) TRUSTEES, INCLUDING FOUR (4) TRUSTEES APPOINTED BY THE BOARD OF TRUSTEES (NONE OF WHOM SHALL BE A PERSON PROVIDING A MATERIAL AMOUNT OF SERVICES, OTHER THAN AS AN UNCOMPENSATED VOLUNTEER, TO OR ON BEHALF OF THE CORPORATION OR ANY OF ITS AFFILIATES), AND THE CHAIRPERSON OF THE MEMBERS. THE RESPONSIBILITIES OF THE COMPENSATION COMMITTEE INCLUDE: (1) MONITORING CURRENT NATIONAL, REGIONAL AND LOCAL TRENDS IN EXECUTIVE COMPENSATION WITHIN THE HEALTH CARE INDUSTRY; (2) RECOMMENDING TO THE BOARD OF TRUSTEES A COMPREHENSIVE CORPORATE-WIDE EXECUTIVE COMPENSATION STRATEGY, WHICH WILL SERVE AS A FRAMEWORK FOR THE CORPORATION; (3) PERIODICALLY REVIEWING THE COMPREHENSIVE CORPORATE EXECUTIVE COMPENSATION STRATEGY, INCLUDING HOW THE CORPORATION SHOULD POSITION ITSELF WITHIN THE COMPETITIVE MARKETPLACE RELATED TO EXECUTIVE COMPENSATION, AND MAKING APPROPRIATE RECOMMENDATIONS TO THE BOARD OF TRUSTEES; (4) IN RESPONSE TO THE CONCLUSIONS FROM THE CHIEF EXECUTIVE OFFICER'S ANNUAL EVALUATION PROCES, RECOMMENDING TO THE BOARD OF TRUSTEES THE CHIEF EXECUTIVE OFFICER'S ANNUAL BENEFITS PACKAGE; AND (5) REVIEWING AND APPROVING THE COMPENSATION PACKAGES RECOMMENDED BY THE CHIEF EXECUTIVE OFFICER FOR THE SENIOR MANAGERS IF THEY ARE CONSISTENT WITH THE OVERALL CORPORATE STRATEGY.

Schedule J (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

SAINTS MEMORIAL MEDICAL CENTER INC

Employer identification number

04-2104885

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

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

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

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2011

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) GARY CAMPBELL	BOARD MEMBER	93,034	SEE PART V		No
(2) MARK O'NEIL	BOARD MEMBER	13,724	SEE PART V		No
(3) DORIS PLISKIN MD	PHYSICIAN AND BOARD MEMBE	48,600	SEE PART V		No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation
SCH L, Part IV	BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:	(A) NAME OF PERSON: GARY CAMPBELL (B) RELATIONSHIP BETWEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER (C) AMOUNT OF TRANSACTION $93,034. (D) DESCRIPTION OF TRANSACTION: THE MEDICAL CENTER LEASES REAL ESTATE THROUGH MILK STREET ASSOCIATES. PRINCIPALS OF MILK STREET ASSOCIATES INCLUDE FAMILY OF GARY CAMPBELL, A BOARD MEMBER. (E) SHARING OF ORGANIZATION REVENUES? = NO (A) NAME OF PERSON: MARK O'NEIL (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: BOARD MEMBER (C) AMOUNT OF TRANSACTION $13,724. (D) DESCRIPTION OF TRANSACTION: PRESIDENT, LOWELL PUBLISHING CO. LOWELL PUBLISHING PROVIDES ADVERTISING TO SAINTS MEDICAL CENTER. (E) SHARING OF ORGANIZATION REVENUES? = NO (A) NAME OF PERSON: DORIS PLISKIN, MD (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: PHYSICIAN AND BOARD MEMBER FOR SAINTS HEALTH SERVICES, INC (C) AMOUNT OF TRANSACTION $48,600. (D) DESCRIPTION OF TRANSACTION: SAINTS MEDICAL CENTER LEASES MEDICAL OFFICE SPACE THROUGH AWAC REALTY TRUST. DORIS PLISKIN IS A PRINCIPAL OF AWAC REALTY TRUST. (E) SHARING OR ORGANIZATION REVENUES? = NO

Schedule L (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE N
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Liquidation, Termination, Dissolution or Significant Disposition of Assets

Complete if the organization answered "Yes" to Form 990, Part IV, lines 31 or 32 or Form 990-EZ, line 36.
bullet

Attach certified copies of any articles of dissolution, resolutions or plans.
bullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
SAINTS MEMORIAL MEDICAL CENTER INC

Employer identification number
04-2104885

Part I

Liquidation, Termination or Dissolution. Complete if the organization answered "Yes" to Form 990, Part IV, line 31, or Form 990-EZ, line
36. Use Part III if additional space is needed. Click to see list of attachments

1(a)Description of asset(s) distributed or transaction expenses paid	(b)Date of distribution	(c)Fair market value of asset(s) distributed or amount of transaction expenses	(d)Method of determining FMV for asset(s) distributed or transaction expenses	(e)EIN of recipient	(f)Name and address of recipient	(g)IRC section of recipient(s) (if tax-exempt) or type of entity

Yes

Did or will any officer, director, trustee, or key employee of the organization:

Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .

Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .

Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . .

Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? . . . . .

If the organization answered "Yes" to any of the questions in this line, provide the name of the person involved and explain in Part III. bullet

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

Cat. No. 50087Z

Schedule N (Form 990 or 990-EZ) 2011

Page 2

Part I

Liquidation, Termination or Dissolution (continued)

Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.

Yes

Did the organization distribute its assets in accordance with its governing instrument(s)? If “No,” describe in Part III . . . . . . . . . . .

Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? . . . . . .

If “Yes,” did the organization provide such notice? . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization discharge or pay all of its liabilities in accordance with state laws? . . . . . . . . . . . . . . . . .

Did the organization have any tax-exempt bonds outstanding during the year? . . . . . . . . . . . . . . . . . . . .

Did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws? .

If ‘Yes’ to line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If “No,” explain in Part III.

Part II

Sale, Exchange, Disposition or Other Transfer of More Than 25% of the Organization's Assets. Complete if the organization answered "Yes" to Form 990, Part IV, line 32, or Form 990-EZ, line 36. Use Part III if additional space is needed.

1(a)Description of asset(s) distributed or transaction expenses paid	(b)Date of distribution	(c)Fair market value of asset(s) distributed or amount of transaction expenses	(d)Method of determining FMV for asset(s) distributed or transaction expenses	(e)EIN of recipient	(f)Name and address of recipient	(g)IRC section of recipient(s) (if tax-exempt) or type of entity
TRANSFER OF CASH, S/T INVEST, A/R	07-01-2012	24,540,024	INDEPENDENT THIRD PARTY	04-2103590	LOWELL GENERAL HOSPITAL 295 VARNUM AVENUE LOWELL,MA01854	501(C)3

Yes

Did or will any officer, director, trustee, or key employee of the organization:

Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .

Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .

Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .

Receive, or become entitled to, compensation or other similar payments as a result of the organization’s significant disposition of assets? . . . . . . .

If the organization answered "Yes" to any of the questions in this line, provide the name of the person involved and explain in Part III.

Schedule N(Form 990 or 990-EZ) 2011

Schedule N (Form 990 or 990-EZ) 2011

Page 3

Part III

Supplemental Information. Complete to provide the information required by Parts I and II,
and any additional information.

Identifier	Return Reference	Explanation
PART I, LINE 6C		ON JULY 1, 2012, LOWELL GENERAL HOSPITAL ACQUIRED THE ASSETS AND LIABILITIES OF SAINTS MEDICAL CENTER. ON SEPTEMBER 1, 2012 LOWELL GENERAL HOSPITAL, AN AFFILIATE OF CIRCLE HEALTH, INC ENTERED INTO AN AGREEMENT WITH THE MASSACHUSETTS DEVELOPMENT FINANCE AUTHORITY TO ISSUE MDFA REVENUE BONDS, LOWELL GENERAL HOSPITAL, SERIES E AND F BONDS IN THE AMOUNT OF $25,000,000 AND $12,500,000, RESPECTIVELY. THE PROCEEDS FROM THE BONDS WERE USED TO REFINANCE AND DEFEASE THE 1993 SERIES A MEHFA BONDS WHICH WERE ISSUED BY SAINTS MEDICAL CENTER, INC.

Schedule N (Form 990 or 990-EZ) 2011

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

2011

Open to Public
Inspection

Name of the organization

SAINTS MEMORIAL MEDICAL CENTER INC

Employer identification number

04-2104885

Identifier	Return Reference	Explanation
FORM 990, PART I, LINE 1		DESCRIPTION OF ORGANIZATION MISSION: health services to all people, especially the poor and disadvantaged. See also Community Benefits below. FORM 990, PART III, PROGRAM SERVICES Community Benefits Mission Statement Improve the overall health status of Underserved Greater Lowell (CHNA-10) Residents through a proactive response to multifaceted healthcare needs: with a strong focus on prevention, follow-up care, wellness, and community and professional education. Saints is committed to treating members of our community with dignity, respect and compassion. Target Populations Name of Target Population: Medically Underserved (Refugees/Immigrants): Iraqi/Nepalese/Bhutanese/Burnese/Hispanic/Southeast Asian/African/Brazillian Basis for Selection: 17.5% African residents & 30% Hispanic residents unable to see MD due to inability to pay; 18% of minority groups >65 yrs are vaccinated for flu; >35% of Greater Lowell's Population= ethnic minority; 34% of Greater Lowell households speak language other than English; 20% income less than $15,000; Lowell deemed refugee resettlement area, current wait for health assessment/immunizations = >90 days. Name of Target Population: Residents at High Risk of Heart Disease Basis for Selection: Coronary Heart Disease mortality rate is 75% higher in the Asian community than the state rate; Cerebrovascular mortality rate is 128% higher than the state rate in the Asian community, and 88% higher in the Black/Non-Hispanic Community. Name of Target Population: Residents at risk of Diabetes Basis for Selection: Compared to state rates, the mortality rate is 189% higher in Black/Non-Hispanic residents, 276% higher in Hispanic residents and 215% higher in the Asian population. The Paso y Paso Clinical Trial states that 50% of children (Hispanic) born in the year 2000 will develop Diabetes in their lifetime. Name of Target Population: Residents who smoke Basis for Selection: The smoking rate in Lowell is 47% higher than the MA state rate, and the highest rate in New England. COPD mortality rate in the Black/Non-Hispanic population (65+) is 103% higher than the state rate, and the COPD mortality rate for Hispanic residents 65+ is 227% higher than the state rate. Lung cancer rates are also very high in Black/Non-Hispanic women and Hispanic Males. Name of Target Population: Women age 12+ Basis for Selection: Breast Cancer is the most common cancer among American Women (1 in 8), except for skin cancers. Breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer. The rate of young women (20-40) with Breast Cancer is increasing, therefore community prevention education is greatly needed. Name of Target Population: First Responders/Health Care Workers/Advocates - Domestic Violence/Sexual Assault Basis for Selection: Of the 1402 domestic assaults that occured in Lowell in FY2008, 80% were simple assaults and 20% were aggravated assaults. IN accordance with Catholic healthcare values, namely, respect for human dignity and sacredness of life, a community-wide anti-violence program was initiated by Saints in FY2010, and Saints took an active role in local anti-violence collaborations. Name of Target Population: Healthcare workers/professionals Basis for Selection: Continuing Education for Healthcare professionals is based upon current education needs within the community. Name of Target Population: Parents/Family Members of Opiate Addicts; First Responders/Healthcare workers who work with Opiate Addicts and their families Basis for Selection: Currently there is a crisis, an epidemic of OC and Heroin use in Massachusetts. Most of the users are high school are between 17-26 years old, starting while they are in high school. The rules have changed in society, because Heroin is now 80-90% pure, and available in a form used for snorting, the stigma of injections is gone, Young people do not realize that they will become addicted by experimenting just once. Name of Target Population: Low-income local young women age 7-17 Basis for Selection: Saints is a partner with the local Girls Inc. Chapter, Providing growth and empowerment activities for Young women who primarily hail from low-income, single parent households in Greater Lowell. Name of Target Population: Low-income Families in Greater Lowell Basis for Selection: Saints is an active partner with Catholic Charities of Greater Lovoell, providing a supply of food donations on a monthly basis as part of our community benefit program. Name of Target Population: Immigration/Refugee Children Basis for Selection: Access to Immunizations and Primary Care; Entrance into school (based on health exams); Safety and preventative health education needs; Flu/H1N1; Window Safety/Fall Prevention; Smoking Cessation/Prevention; Healthy Weight. Hospital/HMO Web Page Publicizing Target Pop. www.saintsmedicalcenter.com Key Accomplishments of Reporting Year Comprehensive Community Health Needs Assessment for FY11-13 was completed in July 2010; presented publicly October 4, 2010. Continued Immunization program expansion, Completed RFR for Refugee and Immigrant Health. Worked with Greater Lowell Health Alliance (GLHA) on grant research to implement the Kid's Can't Fly program in 2011-1013. Provided a variety of strength and cardio training programs to combat obesity, heart disease, diabetes and stroke (Race Across the Globe, Fitness for Flexibility, Yoga FEVA, Chair Yoga). Continued to provide Smoking Cessation programs and COPD support group. Continued Diabetes Support/Education Program. Maintained involvement in all Domestic Violence/Sexual Assault partnerships and task force groups. Expanded heart health programs to include Go Red for Women and Know Your Numbers campaign. Continued to donate space for support groups to meet weekly. Expanded community education/health professional training opportunities.
FORM 990, PART III, PROGRAM SERVICES...		Plans for Next Reporting Year As of July 1, 2012, Saints Memorial Medical Center merged with Lowell General Hospital and is currently recognized as Lowell General Hospital Saints Campus. For FY 2013 Plans/Goals refer to Lowell General Hospital's FY 2012 Attorney General's Community Benefit Report. Community Benefits Process Community Benefits Leadership/Team -Community Benefit Chairperson -Senior Management Team -Manager, Financial Planning and Reimbursement -Controller -Director, CWI -Director Cardiac Services -Director Cancer Center -Director, Emergency Services -Administrator, Physician Network -Director, Security -Marketing Assistant -Donor Relations Liaison -Director, Dialysis -Outreach Specialist (Khmer) -Interpreter Services Coordinator -Director of Marketing Community Benefits Team Meetings The Community Benefit team meets quarterly to review progress. The team meets on an ad-hoc basis when a need arises in the community to determine how it will be met. All community benefit planning is done with the team, presented to Senior Management for approval and then to the Board of Trustees. Once planning receives Board approval it is made public via the Saints Medical Center and social media outlets. Community Partners -African Assistance Center -Alternative House Women's Services -American Cancer Society -American Heart Association -American Lung Association -Asian American Business Association -Cambodian Mutual Assistance Association (CMAA) -Cancer Center for Lowell -Chamber of Commerce -Catholic Collaborative of Lowell -Chelmsford Council on Aging -Healthy Chelmsford -CHNA-10 -City Manager's Office -Community Teamwork, Inc. -D'Youville Senior Care -Department of Health -Department of Social Services -Elder Services of Merrimack Valley -Emergency Nurses Association -Genesis HealthCare -Greater Lowell CISM Team -Greater Lowell Health Alliance (GLHA) -GLPASA -Greater Lowell Technical High School -GLWIB Youth Council -Greater Lowell Workforce Investment Board -Greater Lowell YMCA/YWCA -Greenhalge School -ICISF -International Institute -Latino Health Institute -Life Care of Merrimack Valley -Lowell Board of Health -Lowell Community Health Center (LCHC) -Lowell Council on Aging -Lowell House -Lowell Police Department -Lowell VNA -March of Dimes -MA Council of Community Hospitals -Massachusetts Hospital Association -MAPS -Merrimack Valley AHEC -Merrimack Valley High School -MVCCC -Middlesex Community College -Massachusetts Society for the Prevention of Cruelty to Children (MSPCC) -NE Organ Bank -NCHC -Northeast EMS -NHSC -OneLowell -South Bay -The Lowell Plan -UTEC -Salvation Army -Westford Council on Aging -Westford Board of Health -WIC -Women Working Wonders Fund -Lowell Women's Week -Yankee Alliance -YPGI -UMass Lowell Community Health Needs Assessment Date Last Assessment Completed and Current Status Community Health Needs Assessment conducted January 2010 - July 2010. Health assessment completed Summer 2010, presented to the public October 2010. Consultants/Other Organizations Partner organization include Lowell General Hospital, UMass Lowell and the Greater Lowell Health Alliance.
FORM 990, PART III, PROGRAM SERVICES...		Data Sources Community Focus Groups, Hospital, Interviews, MassCHIP, Public Health Personnel, Surveys, CHNA Community Benefits Programs Program Type Community Education, Direct Services, Health Screening Outreach to Underserved, Prevention Brief Description or Objective Saints Medical Center's Access to Healthcare program provides prevention, medical services and education opportunities to underserved immigrant/refugee groups. Target Population -Regions Served: County-Middlesex, Other-Merrimack Valley -Health Indicator: Access to Health Care, Immunization, Other: Cancer, Other: Cancer-Breast, Other: Cancer-Lung, Other: Cardiac Disease, Other: Cultural Competency, Other: Diabetes, Other: Domestic Violence, Other: Education/Learning Issues, Other: Nutrition, Other: Smoking/Tobacco, Other: Stroke, Overweight and Obesity, Physical Activity, Substance Abuse, Tobacco Use -Sex: All -Age Group: Adult -Ethnic Group: Asian, Black/African American, Hispanic/Latina -Language: Cambodian, English, Other, Portuguese, Spanish, Vietnamese Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations, Reducing Health Disparity Goal Description: Designate Saints Medical Center as a refugee and immigrant health care site Goal Status: Ongoing Goal Description: Increase immunization clinic hours/locations to better serve need Goal Status: Accomplished and continuing Goal Description: Provide staff instant access to culturally competent information re: patient care when needed Goal Status: Accomplished and continuing; portal on all desktops Goal Description: Consolidate immunization, TB, growth and nutrition clinics in a pedestrian/immigrant friendly location Goal Status: Ongoing Partners Partner Name, Description, Web Address Lowell Health Department - http://www.lowellma.gov/depts/health Cambodian Mutual Assistance Association - www.cmaalowell.org Latino Health Institute - www.lhi.org St. Patrick's Parish - www.stpatricklowell.org Alternative House - www.alternative-house.org International Institute Greenhalge School Girls Inc. St. Michael's Parish Lowell Public Schools Center for Hope & Healing - www.centerfor hopehealing.org Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, heather.hilbert@lowellgenral.org Program Type Community Education, Community Participation/Capacity Building Initiative, Direct Services Outreach to Underserved, Prevention School/Health Center Partnership Brief Description or Objective Saints Medical Center partnered with the Lowell Health Department to create an education program around Window Safety/Fall Prevention. Also, Saints Medical Center provided three free education programs for the community, and participated on two community Task Forces. Target Population -Regions Served: County-Middlesex. Other-Merrimack Valley -Health Indicator: Access to Health Care, Immunization. Other: Cancer- Breast, Other: Cancer-Lung, Other: Cardiac Disease, Other: Chronic Pain, Other: Diabetes, Other: First Aid/ ACLS/CPR, Other: Nutrition, Other: Public Safety, Other: Pulmonary Disease/Tuberculosis, Other: Safety - Auto/Passenger, Other: Safety- Home, Other: Safety - Sports, Other: Smoking/Tobacco, Other: Stress Management, Other: Stroke, Overweight and Obesity, Physical Activity, Substance Abuse, Tobacco Use -Sex: All -Age Group: All -Ethnic Group: All -Language: Cambodian, English, Portuguese, Spanish, Vietnamese
FORM 990, PART III, PROGRAM SERVICES...		Goals Statewide Priority: Not Specified Goal Description: Create a PSA on Fall Safety Goal Status: Accomplished and currently active Goal Description: Collaborate with Lowell Health Department to provide continuing resources at local health fairs about Fall Safety Goal Status: Accomplished and continuing Goal Description: Participate in Lowell's MassCALL2 Opiate Overdose prevention task force Goal Status: Accomplished and continuing Goal Description: Collaborate with Lcam2Cope to offer space for a 50+ member support group for family members of opiate addicts Goal Status: Accomplished and continuing Goal Description: Assist with promotion of MassCALL2 educational programs Goal Status: Accomplished and continuing Partners Partner Name, Description, Web Address Lowell Health Department - www.lowellma.gov/dept/health Greater Lowell Health Alliance - www.greaterlowellhealthalliance.org Body Destinations - www.bodydestinations.com Middlesex Sheriff's Department - www.middlesexsheriff.org Lowell Police Department - www.lowellpolice.com Lowell Fire Department - http://ecommunity.uml.edu/lowellfd/ Patriot Ambulance - http://patriotambulance.com/patriot/ Trinity Ambulance - www.trinitycms.com Pridestar EMS - www.pridestarems.com Shriner's - www.shrinershq.org Lowell Community Health Center - www.lchc.org Lowell General Hospital - www.lowellgeneral.org City of Lowell - www.lowellma.gov Pawtucket Pharmacy Northeast Center for Healthy Communities - http://glfhc.org/nc4hcwp/ Center for Hope & Healing - www.centerforhopehealing.org Lowell House Inc. - www.lowellhouseinc.com Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, heather.hilbert@lowellgeneral.org Program Type Community Education, Community Education, Community Education, Community Education, Community Education, Prevention, Prevention, Prevention, Prevention, Prevention Brief Description or Objective SMC aims to provide opportunities for local residents to prevent heart disease through exercise, nutrition and education Target Population -Regions Served: County-Middlesex, Other Merrimack Valley -Health Indicator: Other: Cardiac Disease, Other: Stress Management -Sex: All -Age Group: All -Ethnic Group: All -Language: Cambodian, English, Portuguese, Spanish, Vietnamese Goals Statewide Priority: Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations Goal Description: Provide educational opportunities about Cardiac Health and Heart Disease to the Greater Lowell community Goal Status: Ongoing Goal Description: Offer fitness programs to Greater Lowell community to manage obesity/heart health risks Goal Status: Accomplished and continuing Partners Partner Name, Description, Web Address American Heart Association - www.heart.org Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital. 295 Varnum Avenue, Lowell, MA 01854, heather.hilbert@lowellgeneral.org Program Type Community Education, Community Education, Community Education, Community Education, Community Education, Direct Services, Direct Services, Direct Services, Direct Services, Direct Services, Prevention, Prevention, Prevention, Prevention, Prevention, Support Group, Support Group, Supper Group, Support Group, Support Group Brief Description or Objective Through support groups, education and community partnerships, SMC aims to combat the high incidence of Diabetes in Greater Lowell, especially in the Asian/Hispanic populations. Target Population -Regions Served: County-Middlesex, Other-Merrimack Valley -Health Indicator: Other: Diabetes -Sex: All -Age Group: All -Ethnic Group: All -Language: Cambodian, English , Portuguese, Spanish, Vietnamese
FORM 990, PART III, PROGRAM SERVICES...		Goals Statewide Priority: Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations Goal Description: Provide monthly support group for Diabetes patients/residents Goal Status: Accomplished and continuing Goal Description: Provide monthly education forum for residents with diabetes Goal Status: Accomplished and continuing Partners Partner Name, Description, Web Address Greater Lowell Health Alliance - www.greaterlowellhealthalliance.org Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, heather.hilbert@lowellgeneral.org Program Type Community Education, Direct Services, Support Group Brief Description or Objective The COPD rate in Greater Lowell is remotely higher than the state rate in both black/non-hispanic 65+ and Hispanic 65+. The city of Lowell has a 50% higher smoking rate than Massachusetts overall. Target Population -Regions Served: County-Middlesex, Other-Merrimack Valley -Health Indicator: Access to Health Care, Other: Pulmonary Disease/Tuberculosis, Other: Smoking/Tobacco, Tobacco Use -Sex: All -Age Group: All Adults -Ethnic Group: All -Language: Cambodian, English, Portuguese, Spanish, Vietnamese Goals Statewide Priority: Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations Goal Description: Provide smoking cessation program for local residents Goal Status: Accomplished and currently active Goal Description: Provide free smoking cessation counseling to all inpatient/outpatient contacts Goal Status: Accomplished and continuing Goal Description: Provide access to smoking cessation print materials/online education for all patients Goal Status: Accomplished and continuing Goal Description: Provide monthly COPD/Pulmonary support group to local residents Goal Status: Accomplished and continuing Partners Partner Name, Description, Web Address Greater Lowell Health Alliance - www.greaterlowellhealthalliance.org Lowell Health Department - www.lowellma.gov/dept/health Lowell Public Schools - http://www.lowell.k12ma.us/schools Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, heather.hilbert@lowellgeneral.org Program Type Community Education, Community Participation/Capacity Building Initiative, Prevention Brief Description or Objective Saints Medical Center has taken a proactive role in educating the Greater Lowell community in terms of Bullying, Domestic Violence, Sexual Assault awareness, opportunities for support services and actions to prevent. Target Population -Regions Served: County-Middlesex, Other-Merrimack Valley -Health Indicator: Injury and Violence, Mental Health. Other: Domestic Violence, Other: Public Safety, Other: Rape, Other: Safety -Sex: All -Age Group: All -Ethnic Group: All -Language: Cambodian, English, Portuguese, Spanish, Vietnamese Goals Statewide Priority: Promoting Wellness of Vulnerable Populations Goal Description: Provide educational forum for local parents, educators, health workers and community members about bullying Goal Status: Accomplished and continuing Partners Partner Name, Description, Web Address Alternative house - www.alternative-house.org Middlesex County District Attorney's Office Academy of Notre Dame Tyngsboro - www.ndatyngsboro.org Lowell High School - www.lowell.k12.ma.us Deana's Educational Theatre - www.deansaseducationaltheatre.org Greater Lowell Health Alliance - www.greaterlowellhealthalliance.org UMass Lowell - www.uml.edu City manager's DV Task Force Greater Lowell Partnership Against Sexual Assault F.O.C.U.S Lowell Community Health Center - www.lchc.org Lowell General Hospital - www.lowellgeneral.org Middlesex Community College- www.middlsex.mass.edu United Teen Equality Center - www.uteeclowell.org Greater Lowell Technical High School - www.glths.org Asian Task Force DV Middlesex Sheriff's Office Lowell Council on Aging/Senior Center Center for Hope & Healing - www.centerforhopehealing.org
FORM 990, PART III, PROGRAM SERVICES...		Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, heather.hilbert@lowellgeneral.org Program Type Community Education, Outreach to Underserved Brief Description or Objective Lowell faces high cancer rates within its Asian and African Communities. Saints Medical Center has seen its Radiation and Oncology volume increase over the past 3 years, with the Majority of patients/families being on fixed or low incomes, with trouble accessing/affording treatment. Target Population -Regions Served: County-Middlesex, Other-Merrimack Valley -Health Indicator: Other: Cancer -Sex: All -Age Group: All -Ethnic Group: All -Language: Cambodian, English, Portuguese, Spanish, Vietnamese Goals Statewide Priority: Promoting Wellness of Vulnerable Populations Goal Description: Provide support group for cancer survivors/patients that meets monthly Goal Status: Accomplished and continuing Goal Description: Provide support group to local caregivers Goal Status: Accomplished and continuing Goal Description: Provide free alternatives therapy options to patients (i.e. massage therapy) Goal Status: Accomplished and continuing Partners Partner Name, Description, Web Address Barbara Perticone, Therapeutic Massage American Cancer Society - www.cancer.org Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, heather.hilbert@lowellgeneral.org Program Type Community Education, Health Professional/Staff Training Brief Description or Objective Through the Caring Well Institute, Saints Medical Center provides an assortment of clinical and community education opportunities. Target Population -Regions Served: All Massachusetts -Health Indicator: Other: Education/Learning Issues -Sex: All -Age Group: All Adults -Ethnic Group: All -Language: Cambodian, English, Portuguese, Spanish, Vietnamese Goals Statewide Priority: Promoting Wellness of Vulnerable Populations Goal Description: Partner with American Heart Association, American Lung Association and local educational institutions to provide health care professional education at an affordable rate, in a local venue Goal Status: Accomplished and continuing Partners Partner Name, Description, Web Address American Heart Association - www.heart.org American Lung Association - www.lung.org American Cancer Society - www.cancer.org Society of Critical Care Medicine Greater Lowell EMS Trinity EMS - www.trinityems.com Greater Lowell Health Alliance - www.greaterlowellhealthalliance.org Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, heather.hilbert@lowellgeneral.org Program Type: Direct Services Brief Description or Objective Through a collaboration of Saints Medical Center and the Mass DPH, SMC offers a TB Clinic and Growth & Nutrition Clinic, targeting immigrants/minorities, especially Southeast Asian residents. Target Population -Regions Served: Other Merrimack Valley -Health lndicator: Access to Health Care, Other: Nutrition, Other: Parenting Skills -Sex: All -Age Group: All Children -Ethic Group: All -Language: All Goals Statewide Priority: Address Unmet Health Needs of the Uninsured, Promoting Wellness of Vulnerable Populations, Reducing Health Disparity Goal Description: Increase rate of immunization for local youth Goal Status: Accomplished and continuing Goal Description: Educate local immigrant groups about the importance of proper immunizations and preventative health care Goal Status: Accomplished and continuing Goal Description: Increase case of use for uninsured/under-insured families to receive proper immunization Goal Status: Accomplished and continuing Goal Description: Lower TB rates within Greater Lowell and continue to educate populations about TB Goal Status: Ongoing Partners Partner Name, Description, Web Address Lowell Health Department MA Department of Health - www.lowellma.gov//dept/health Lowell Public Schools - www.lowell.k12.ma.us/schools Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, heather.hilbert@lowellgeneral.org Program Type Community Participation/Capacity Building Initiative, Support Group Brief Description or Objective Saints Medical Center provides free space for a number of local organizations for client/community support services. Target Population -Regions Served: County-Middlesex, Other-Merrimack Valley -Health Indicator: Access to Health Care -Sex: All -Age Group: Not Specified -Ethnic Group: All -Language: Cambodian, English, Portuguese, Spanish, Vietnamese Goals Statewide Priority: Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations Goal Description: Provide a safe, welcoming environment for residents seeking support system around health issues Goal Status: Ongoing Partners Partner Name, Description, Web Address Overeater's Anonymous Alcoholics Anonymous Parents of Murdered Children Learn 2 Cope Beacon Hospice Merrimack Valley Hospice Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, heather.hilbert@lowellgeneral.org Program Type: Community Education, Direct Services, Support Group Brief Description or Objective Saints Medical Center aims to educate local women on both breast health and GYN health, as well as general preventative health care.
FORM 990, PART III, PROGRAM SERVICES...		Target Population -Regions Served: County-Middlesex, Other-Merrimack Valley -Health lndicator: Access to Health Care, Other: Cancer- Breast, Other: Cancer- Cervical, Other: Cancer- Ovarian, Other: Cancer- Skin, Other: Cardiac Disease, Other: Chronic Pain, Other: Cultural Competency, Other: Diabetes, Other: Domestic violence, Other: Education/Learning Issues, Other: Rape, Other: Safety, Other: Smoking/Tobacco, Other: Stress Management, Overweight and Obesity, Physical Activity, Tobacco Use -Sex: Female -Age Group: Adult, Adult-Young -Ethnic Group: All -Language: Cambodian, Chinese, English, Korean, Laotian, Other, Portuguese, Spanish, Vietnamese Goals State Priority: Address Unmet Health Needs of the Uninsured, Promoting Wellness of Vulnerable Populations, Reducing Health Disparity Goal Description: Provide monthly women's cancer support group Goal Status: Accomplished and continuing Goal Description: Provide a variety of educational forums about breast cancer, tomosynthesis, preventative health, etc. Goal Status: Ongoing Goal Description: Take part in National Pink Glove Campaign for Breast Cancer Awareness Goal Status: Accomplished and continuing Contact Information Heather Hilbert, Coordinator-Center for Community Health & Wellness, Lowell General Hospital, 295 Varnum Avenue, Lowell, MA 01854, heathcr.hilbert@lowellgeneral.org Expenditures Community Benefits Programs Expenditures Amount Direct Expenses $59,690 Associated Expenses $53,500 Determination of Need Expenditures 0 Employee Volunteerism $7,568 Other Leveraged Resources 0 Net Charity care Expenditures Amount HSN Assessment $937,286 HSN Denied Claims 0 Free/Discount Care $1,658,786 Total Net Charity Care $2,596,072 Corporate Sponsorships $9,080 Total Expenditures $2,725,910 Total Revenue for 2012 $103,871,388 Total Patient care-related expenses for 2012 $96,640,230 Approved Program Budget for 2013 Not Specified (*Excluding expenditures that cannot be projected at the time of the report.) Comments: There is no Approved Program Budget for 2013 due to affiliation between Saints Medical Center and Lowell General Hospital. FY 2013 Budget Plan can be found under Lowell General Hospital's FY 2012 Community Benefit Report.
FORM 990, PART VI, SECTION A, LINE 2:		RAYMOND ANTISS, JR. DIRECTOR, BOARD OF TRUSTEES IS A PARTNER WITH AN ACCOUNTING FIRM IN LOWELL, MASSACHUSETTS THAT PROVIDES ACCOUNTING SERVICES TO OTHER BOT MEMBERS. FORM 990, PART III, LINE 3, CHANGES IN PROGRAM SERVICES: ON JULY 1, 2012, THE ASSETS AND LIABILITIES OF SAINTS MEDICAL CENTER WERE ACQUIRED BY LOWELL GENERAL HOSPITAL EIN 04-2103590. THE ACQUISITION RESULTED IN A FULL FMV ASSET PURCHASE AND ASSUMPTION OF SAINTS MEDICAL CENTER'S LIABILITIES. THE HOSPITALS PHYSICAL LOCATION WILL OPERATE AS A CAMPUS OF LOWEEL GENERAL HOSPITAL. SAINTS MEDICAL CENTER EIN 04-2104885 CEASED OPERATIONS ON 6/30/12 BUT WILL REMAIN AS A SHELL CORPORATION. FORM 990, PART VI, SECTION A, LINE 6: SAINTS HEALTH SYSTEM, INC EIN 04-2901852 IS THE SOLE MEMBER OF SAINTS MEDICAL CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A: THE MEMBER SHALL HAVE THE FOLLOWING POWERS AND RIGHTS, IN ADDITION TO SUCH OTHER POWERS AND RIGHTS AS ARE VESTED IN IT BY LAW, THE ARTICLES OF ORGANIZATION OR THESE BYLAWS, AND THE CORPORATION SHALL NOT EFFECT ANY OF THE FOLLOWING MATTERS WITHOUT THE APPROVAL OF THE MEMBER: (C) IN THE CASE OF ANY SUBSIDIARY OF THE CORPORATION WHOSE BYLAWS PROVIDE FOR TRUSTEES OR DIRECTORS TO BE ELECTED OR APPOINTED BY THE CORPORATION, TO APPROVE THE PERSONS PROPOSED TO BE ELECTED OR APPOINTED AS TRUSTEES OR DIRECTORS OF SUCH SUBSIDIARY OF THE CORPORATION PRIOR TO THEIR ELECTION APPOINTMENT BY THE BOARD OF TRUSTEES OF THE CORPORATION, AND TO SUSPEND OR REMOVE ANY TRUSTEE OR DIRECTOR OF SUCH SUBSIIARY OF THE CORPORATION WITH OR WITHOUT CAUSE; (D) TO APPROVE THE CHAIRPERSON AND VICE CHAIRPERSON OF THE BOARD OF TRUSTEES OF THE CORPORATION AND THE CHAIRPERSON AND VICE CHAIRPERSON OF THE GOVERNING BOARD OF ANY SUBSIDIARY OF THE CORPORATION, AND TO SUSPEND OR REMOVE THEM WITH OR WITHOUT CAUSE; (E) TO APPROVE THE PRESIDENT OF THE CORPORATION AND THE PRESIDENT OF ANY SUBSIDIARY OF THE CORPORATION, AND TO SUSPEND OR REMOVE HIM WITH OR WITHOUT CAUSE. FORM 990, PART VI, SECTION A, LINE 7B: YES, CERTAIN DECISIONS ARE SUBJECT TO THE APPROVAL OF THE "MEMBER" WHICH IS SAINTS HEALTH SYSTEM. SEE SECTION 3.3 OF THE BYLAWS BELOW WHICH LISS THE ITEMS REQUIRING SUCH APPROVAL: 3.3 POWERS AND RIGHTS. THE MEMBER SHALL HAVE THE FOLLOWING POWERS AND RIGHTS, IN ADDITION TO SUCH OTHER POWERS AND RIGHTS AS ARE VESTED IN IT BY LAW, THE ARTICLES OF ORGANIZATION OR THESE BYLAWS, AND THE CORPORATION SHALL NOT EFFECT ANY OF THE FOLLOWING MATTERS WITHOUT THE APPROVAL OF THE MEMBER: (A) TO APPROVE ANY CHANGE IN THE WRITTEN STATEMENTS OF PHILOSOPHY AND MISSION OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION AND TO MONITOR COMPLIANCE WITH SAME; (B) TO AMEND AND TO REPEAL THE ARTICLES OF ORGANIZATION AND THE BYLAWS OF THE CORPORATION, AND TO APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE CHARTER AND THE BYLAWS (OR OTHER GOVERNING INSTRUMENTS0 OF ANY SUBSIDIARY OF THE CORPORATION; (C) IN THE CASE OF ANY SUBSIDIARY OF THE CORPORATION WHOSE BYLAWS PROVIDE FOR TRUSTEES OR DIRECTORS TO BE ELECTED OR APPOINTED BY THE CORPORATION, TO APPROVE THE PERSONS PROPOSED TO BE ELECTED OR APPOINTED AS TRUSTEES OR DIRECTORS OF SUCH SUBSIDIARY OF THE CORPORATION PRIOR TO THEIR ELECTION APPOINTMENT BY THE BOARD OF TRUSTEES OF THE CORPORATION, AND TO SUSPEND OR REMOVE ANY TRUSTEE OR DIRECTOR OF SUCH SUBSIDIARY OF THE CORPORATION WITH OR WITHOUT CAUSE; (D) TO APPROVE THE CHAIRPERSON AND VICE CHAIRPERSON OF THE BOARD OF TRUSTEES OF THE CORPORATION AND THE CHAIRPERSON AND VICE CHAIRPERSON OF THE GOVERNING BOARD OF ANY SUBSIDIARY OF THE CORPORATION, AND TO SUSPEND OR REMOVE THEM WITH OR WITHOUT CAUSE; (E) TO APPROVE THE PRESIDENT OF THE CORPORATION AND THE PRESIDENT OF ANY SUBSIDIARY OF THE CORPORATION, AND TO SUSPEND OR REMOVE HIM WITH OR WITHOUT CAUSE; (F) TO APPROVE ALL PLANS OF MERGER, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION, OR THE SALE, LEASE, ASSIGNMENT, TRANSFER OR ECUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION OR OF ANY PROPERTY OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION VALUED IN EXCESS OF $1,000,000 (OR SUCH OTHER AMOUNT AS IS SET BY THE MEMBER IN WRITING FROM TIME TO TIME), OR THE PURCHASE OR ACQUISITION BY THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION OF AN INTEREST IN ANY CORPORATION, PARTNERSHIP, JOINT VENTURE OR OTHER ENTITY, WHETHER NEWLY CREATED OR PREVIOUSLY EXISTING, WHICH INTEREST, IN THE CASE OF A FOR PROFIT ENTITY, REPRESENTS TWENTY-FIVE PERCENT OR MORE OF THE VOTING POWER THEREOF OR EQUITY INTEREST THEREIN, OR, IN THE CASE OF A NON-PROFIT ENTITY, REPRESENTS TWENTY-FIVE PERCENT OR MORE OF THE VOTING POWER THEREOF OR MEMBERSHIP INTEREST THEREIN; (G) TO APPROVE ALL DEBT OF THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION IN EXCESS OF $2,000,000 (OR SUCH OHER AMOUNT AS IS SET BY THE MEMBER IN WRITING FROM TIME TO TIME) BEFORE SUCH DEBT IS INCURRED, AND TO APPROVE ALL CHANGES TO THE TERMS OF ANY SUCH DEBT; (H) TO APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER OR ENCUMBRANCE OF ANY REAL ESTATE OR THE CONSTRUCTION OR DESTRUCTION OF ANY IMPROVEMENTS THEREON, BY THE CORPORATION OR ANY SUBSIDIARY OF THE CRPORATION VALUED IN EXCESS OF $1,000,000 (OR SUCH OTHER AMOUNT AS IS SET BY THE MEMBER IN WRITING FROM TIME TO TIME); (I) TO APPROVE THE SALE, ASSIGNMENT OR TRANSFER BY THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION OF ANY EQUITY INTEREST OR MEMBERSHIP INTEREST IN ANY SUBSIDIARY OF THE CORPORATION; TO APPROVE ANY RECLASSIFICATION OR OTHER CHANGE OF ANY CAPITAL STOCK OR OTHER EQUITY SECURITY OF ANY SUBSIDIARY OF THE CORPORATION, OR ANY RECAPITALIZATION OF ANY SUBSIDIARY OF THE CORPORATION; AND TO APPROVE TE ISSUANCE OF, OR THE CREATION OF ANY OBLIGATION TO ISSUE, ANY EQUITY SECURITY OF ANY SUBSIDIARY OF THE CORPORATION, OR ANY INCREASE OR DECREASE IN THE TOTAL NUMBER OF SHARES OF AUTHORIZED CAPITAL STOCK OR OTHER EQUITY SECURITY OF ANY SUBSIDIARY OF THE CORPORATION; (J) TO ENTER INTO OR TERMINATE A FORMAL INSTITUTIONAL AFFILIATION WITH A HOSPITAL SYSTEM BY THE CORPORATION OR ANY SUBSIDIARY OF THE CORPORATION; (K) TO APPROVE THE BYLAWS OF THE CORPORATION'S MEDICAL STAFF AND ANY AMENDMENTS THERETO; AND (L) TO EXERCISE ALL POWERS OF AND AUTHORIZE ALL ACTIONS BY THE CORPORATION IN ITS CAPACITY AS THE INCORPORATOR OR MEMBER OF ANY SUBSIDIARY OF THE CORPORATION, OTHER THAN THE POWER TO APPOINT OR ELECT TRUSTEES OR DIRECTORS OF ANY SUBSIDIARY OF THE CORPORATION, WHICH POWER AND AUTHORITY SHALL BE EXERCISED BY THE BOARD OF TRUSTEES OF THE CORPORATION, SUBJECT TO THE APPROVAL OF THE MEMBER UNDER SECTION 3.3(C) (AND TO THE EXTENT THAT THE TRUSTEES OF THE CORPORATION MAY HAVE ANY SUCH POWER OR AUTHORITY WITH RESPECT THERETO UNDER LAW OR OTHERWISE, ALL SUCH POWER AND AUTHORITY SHALL BE DEEMED TO BE DELEGATED EXCLUSIVELY TO AND MAY BE EXERCISED SOLELY BY THE MEMBER). FOR PURPOSES OF THESE BYLAWS, THE TERM "SUBSIDIARY" SHALL INCLUDE ANY CORPORATION, LIMITED LIABILITY COMPANY, PARTNERSHIP, JOINT VENTURE OR OTHER ENTITY IN WHICH THIS CORPORATIN HAS, EITHER DIRECTLY OR INDIRECTLY THROUGH ONE OR MORE SUBSIDIARIES, AN INTEREST REPRESENTING, IN THE CASE OF A FOR-PROFIT ENTITY, TWENTY-FIVE PERCENT (25%) OR MORE OF THE VOTING POWER THEREOF OR EQUITY INTEREST THEREIN, OR, IN THE CASE OF A NON-PROFIT ENTITY, TWENTY-FIVE PERCENT (25%) OR MORE OF THE VOTING POWER THEREOF OR MEMBERSHIP INTEREST THEREIN.
FORM 990, PART VI, SECTION B, LINE 11:		FORM 990 IS PREPARED BY THE CONTROLLER AND REVIEWED BY ERNST & YOUNG, LLP. THE CHAIRPERSON OF THE BOARD OF TRUSTEES IS RESPONSIBLE FOR THE REVIEW OF THE DRAFT FORM 990 PRIOR TO FILING. THE CHAIRPERSON OF THE BOARD OF DIRECTORS IS PROVIDED A COPY AND IS ULTIMATELY RESPONSIBLE FOR ACCEPTANCE OF THE DRAFT FORM 990 AND ITS APPROVAL FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C: THE CONFLICT OF INEREST POLICY IS APPROVED BY SAINTS HEALTH SYSTEM BOARD AND ADOPTED BY ALL MEMBERS OF WHICH SAINTS MEDICAL CENTER IS A MEMBER. SAINTS ASKS ALL BOARD OF TRUSTEE MEMBERS, OFFICERS AND VICE PRESIDENTS TO ACKNOWLEDGE THOSE CONFLICTS BASED ON ISSUES DISCUSSED AT BOARD MEETINGS. MEMBERS INVOLVED WITH ANY CONFLICTS EXCUSE THEMSEVES FROM ITEMS AND VOTES ON THOSE ISSUES. ADMINISTRATION WILL TRACK AND FOLLOW-UP ON UNRETURNED CONFLICT OF INTEREST STATEMENTS. AN ANNUAL DISCLOSURE FORM IS REQUIRED OF ALL NEW MEBERS OF THE BOT WITHIN TWO MONTHS OF THEIR APPOINTMENT. THE BOARD WILL TAKE APPROPRIATE DDISCIPLINARY AND CORRECTIVE ACTION WITH RESPECT TO ANY PERSON WITH A COI WHO VIOLATED THIS POLICY. IF ANY MEMBER OF THE BOARD OF TRUSTEES BELIEVE A POTENTIAL CONFLICT MAY EXIST ON ANY GIVEN MATTER OR BELIEVES ANOTHER MEMBER OF THE BOARD OF TRUSTEES HAS A CONFLICT, THE MATTER SHOULD BE BROUGHT TO THE ATTENTION OF THE PRESIDENT, COO OR CFO PRIOR TO ANY CONSIDERATION OF THE MATTER INVOLVING THE POTENTIAL CONFLICT. BOARD AND THE PESIDENT SHALL RESOLVE WHETHER A CONFLICT DOES OR DOES NOT EXIST. THE MEMBER OF THE BOARD OF TRUSTEES WITH THE POTENTIAL CONFLICT SHALL NOT BE PRESENT OR PARTICIPATE DURING THE DETERMINATION. IF IT IS DETERINED THAT A CONFLICT EXISTS, THE INDIVIDUAL HAVING THE CONFLICT OF INTEREST IS NOT COUNTED IN DETERMINING THE EXISTANCE OF A QUORUM WITH RESPECT TO ANY VOTE ON THE MATTER. THE BOARD SHALL DETERMINE, BY A MAJORITY VOTE OF NON-INTERESTED TRUSTEES, WHETHER THE TRANSACTION IS IN THE MEDICAL CENTER'S BEST INTEREST AND FOR ITS OWN BENEFIT; IS FAIR AND REASONABLE TO THE MEDICAL CENTER; AND SHALL DETERMINE, AFTER EXERCISING DUE DILIGENCE, WHETHER THE MEDICAL CENTER SHOULD OBTAIN A MORE ADVANTAGEIOUS TRANSACTION WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES, REVIEWING COMPARABLE DATA, AS APPROPRIATE. FORM 990, PART VI, SECTION B, POLICIES, QUESTION 13: THE WHISTLEBLOWER POLICY IS APPROVED BY SAINTS HEALTH SYSTEM BOARD ON BEHALF OF ALL MEMBERS. FORM 990, PART VI, SECTION B, POLICIES, QUESTION 14: THE RECORD RETENTION POLICY HAS NOT BEEN APPROVED BY THE HEALTH SYSTEM OR THIS ORGANIZATION'S BOARD. PART VI, SECTION B, QUESTION 15: THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF SAINTS HEALTH SYSTEM MEETS ANNUALLY TO REVIEW COMPENSATION OF THE CEO AND SENIOR MANAGEMENT. THE COMMITTEE IS COMPRISED OF DISINTERESTED PERSONS WHO WILL REVIEW INDEPENDENT MARKET DATA TO SET EXECUTIVE COMPENSATION. PHYSICIAN COMPENSATION IS PRESENTED TO THE BOARD OF TRUSTEES FOR APPROVAL ALONG WITH NEW HIRES AND INCREASES IN EXCESS OF INFLATION. FORM 990, PART VI, SECTION C, LINE 18: 990 AND 990-T ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS ARE PROVIDED TO AND MADE AVAILABLE ON THE SECRETARY OF STATE WEBSITE AND MADE AVAILABLE UPON REQUEST ALONG WITH CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS. FORM 990, PART XI, LINE 5, CHANGES IN NET ASSETS: ACQUISITION BY LOWELL GENERAL HOSPITAL 24,540,024 SPECIAL SERVICES -10,546 TRANS TO HEALTH SERVICES -2,232,166 ADVANCE FROM AFFIL HEALTH SYSTEM 1,481,456 PENSION IMPAIRMENT -2,712,233 TEMP RESTRICTED ASSETS 27,551 UNREALIZED LOSS 53,877 ROUNDING -367 TOTAL TO FORM 990, PART XI, LINE 5 21,147,596

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

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

2011

Open to Public Inspection

Name of the organization

SAINTS MEMORIAL MEDICAL CENTER INC

Employer identification number

04-2104885

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) LOWELL GENERAL HOSPITAL SPECIAL SERVICES ONE HOSPITAL DRIVE LOWELL,MA01852 04-2749428	CANCER CARE	MA	501(c)(3)	9	LOW GEN HOSP	Yes
(2) LGH PHYSICAN ASSOCIATES INC ONE HOSPITAL DRIVE LOWELL,MA01852 04-3190747	FAMILY MED PR	MA	501(c)(3)	9	CIR HLTH PHY		No
(3) LOWELL GENERAL FOUNDATION INC ONE HOSPITAL DRIVE LOWELL,MA01852 26-2320016	SUPP + FUNDR	MA	501(c)(3)	7	CIRCLE HLTH		No
(4) SAINTS HEALTH SYSTEM INC ONE HOSPITAL DRIVE LOWELL,MA01852 04-2901852	SUPP + FUNDR	MA	501(c)(3)	11B, II	NA		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2011

Page 2

Part III

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

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

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership

Schedule R (Form 990) 2011

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Yes

r Other transfer of cash or property from related 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) SAINTS MEMORIAL HEALTH SERVICES INC	Q	10,546	CHGE IN N/A ACC
(2) LGH PHYSICIAN ASSOCIATES	Q	2,232,166	CHGE IN N/A ACC
(3) SAINTS HEALTH SYSTEM	R	1,481,456	CHGE IN N/A ACC
(4)
(5)
(6)

Schedule R (Form 990) 2011

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

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

Schedule R (Form 990) 2011

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: SAINTS MEDICAL CENTER GENERATES PATIENT SERVICE REVENUE FROM ACUTE CARE AND GENERAL HOSPITAL SERVICES INCLUDING DIALYSIS, CANCER CENTER, AND CARDIAC CATHERIZATION. SAINTS PROVIDES COMPREHENSIVE HOLISTIC
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	11
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	1,395
6	Total number of volunteers (estimate if necessary) ....	6	130
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	1,317,142
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	71,504

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,186,691	750,287
9	Program service revenue (Part VIII, line 2g) .........	133,990,246	105,042,374
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	285,853	-548
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,167,473	913,798
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	136,630,263	106,705,911
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	24,625	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)	70,474,547	52,184,721
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	74,499,570	53,049,819
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	144,998,742	105,234,540
19	Revenue less expenses. Subtract line 18 from line 12.......	-8,368,479	1,471,371
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	70,464,030	0
21	Total liabilities (Part X, line 26).............	93,082,997	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	-22,618,967	0

Sign Here

	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 41,029,607 including grants of $ ) (Revenue $ 41,484,007 )
	ACUTE HOSPITAL INPATIENT SERVICES LICENSED BEDS = 157 INPATIENT DISCHARGES = 6,385 INPATIENT DAYS = 20,350 SEE ATTACHED COMMUNITY BENEFIT REPORT IN SCHEDULE O

4b	(Code: ) (Expenses $ 56,196,951 including grants of $ ) (Revenue $ 63,273,587 )
	OUTPATIENT SERVICES EMERGENCY VISITS = 32,775 ALL OTHER OUTPATIENT VISITS AND PROCEDURES = 127,824 SEE ATTACHED COMMUNITY BENEFIT REPORT IN SCHEDULE O

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$ 97,226,558

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,431,037	0	183,590

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) GABRIELE SOUTHGATE PHYSICIAN/HIGHEST PAID	50.0	X		315,589	18,355
(19) SANJAY BASU PHYSICIAN/HIGHEST PAID	50.0	X		248,943	17,535
(20) MICHAEL ABELE PHYSICIAN/HIGHEST PAID	50.0	X		249,320	17,508
(21) MICHAEL GULEY FORMER CEO/PRESIDENT	0.0		X	520,138	19,183
(22) STEPHEN O'CONNOR VP FINANCE/FRM TREASURER	0.0		X	241,294	18,075

				(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		69,204

f	All other contributions, gifts, grants, and similar amounts not included above1f		681,083
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			750,287
			Business Code
2a	PATIENT CARE SERVICES		621,500	104,251,085	104,251,085
b	LABORATORY SERVICES		621,500	791,289		791,289
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			105,042,374
3	Investment income (including dividends, interest
	and other similar amounts).....			85			85
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	1,355,731
b	Less: cost or other basis and sales expenses	1,356,364
c	Gain or (loss)	-633
d	Net gain or (loss)..........			-633			-633
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..			0
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...			0
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..			0
Miscellaneous Revenue			Business Code
11a	OTHER OPERATING REVENUE		900,099	466,971		466,971
b	RENTAL INCOME		531,190	58,882		58,882
c	CAFETERIA SALES		722,210	387,945	387,945
d	All other revenue ....
e	Total. Add lines 11a–11d ......			913,798
12	Total revenue. See Instructions....			106,705,911	104,639,030	1,317,142	-548


			(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........		0	1	0
2	Savings and temporary cash investments .......		928,205	2	0
3	Pledges and grants receivable, net .........		0	3	0
4	Accounts receivable, net .........		17,690,291	4	0
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		0	5	0
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 ..........		0	6	0
7	Notes and loans receivable, net .............		50,129	7	0
8	Inventories for sale or use ..............		2,355,599	8	0
9	Prepaid expenses and deferred charges ............		874,007	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation. .....	10b	34,937,097	10c
11	Investments—publicly traded securities ..........		0	11	0
12	Investments—other securities. See Part IV, line 11 ......		1,883,444	12	0
13	Investments—program-related. See Part IV, line 11 ..		0	13	0
14	Intangible assets .........		0	14	0
15	Other assets. See Part IV, line 11 ...........		11,745,258	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)...		70,464,030	16	0
17	Accounts payable and accrued expenses .		22,954,636	17	0
18	Grants payable ..........		0	18	0
19	Deferred revenue ..........		0	19	0
20	Tax-exempt bond liabilities ..........		44,891,086	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..		2,958,882	23	0
24	Unsecured notes and loans payable to unrelated third parties ....		0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....		22,278,393	25	0
26	Total liabilities. Add lines 17 through 25.....		93,082,997	26	0
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....		-22,656,695	27	0
28	Temporarily restricted net assets .....		37,728	28	0
29	Permanently restricted net assets .....		0	29	0
	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 .....		-22,618,967	33	0
34	Total liabilities and net assets/fund balances .....		70,464,030	34	0