TY 2012 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
Anesthesia Consultants of Western C, 1120 Wellington Suite 206GRAND JUNCTIONCO81501	anesthesia svcs	4,063,751
Petroleum Helicopters Inc, 2001 SE Evangeline ThruwayLAFAYETTELA70508	Helicopter Service	3,131,761
Aramark Corporation, 4420 East 142 StGRAND VIEWMO64030	Food Service Mgt	2,548,202
GENERAL SURGEONS OF WESTERN COLORAD, 1001 WELLINGTON AVEGRAND JUNCTIONCO81501	PHYSICIAN SVCS	1,539,868
FCI CONSTRUCTORS, PO BOX 1767GRAND JUNCTIONCO81502	CONSTRUCTION	1,370,707
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 54

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	2,513,065	2,513,065
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	68,619	68,619
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 ....	2,129,106	1,813,884	315,222
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	120,057,721	111,320,432	8,380,775	356,514
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	5,854,290	4,987,541	849,365	17,384
9	Other employee benefits .......	13,970,825	12,184,428	1,704,070	82,327
10	Payroll taxes ...........	9,564,958	8,736,630	802,608	25,720
11	Fees for services (non-employees):
a	Management ......	5,729,771	5,618,957	110,814
b	Legal .........	677,679		677,679
c	Accounting ...........	4,429,565		4,429,565
d	Lobbying ...........	31,357		31,357
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	40,721,701	26,425,800	14,295,901
12	Advertising and promotion ....	683,968	23,755	660,213
13	Office expenses .......	7,737,849	6,609,368	1,128,481
14	Information technology ......	11,473,570	9,613,950	1,859,620
15	Royalties ..	0
16	Occupancy ...........	3,598,664	3,274,634	324,030
17	Travel ............	821,018	766,786	54,232
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	452,399	413,056	39,343
20	Interest ...........	1,557,224		1,557,224
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	32,551,386	28,759,340	3,792,046
23	Insurance ..............	3,051,171	9,742	3,041,429
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	59,394,466	59,318,457	76,009
b	BAD DEBT EXPENSE	22,736,388	22,736,388
c	PROVIDER TAXES	22,241,704	22,241,704
d	INCOME TAXES	464,708		464,708
e	All other expenses	1,169,145	694,414	474,731
25	Total functional expenses. Add lines 1 through 24e	373,682,317	328,130,950	45,069,422	481,945
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 Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	428,235	1	3,265,676
2	Savings and temporary cash investments .........	3,670,318	2	4,957,463
3	Pledges and grants receivable, net ...........	0	3	0
4	Accounts receivable, net .............	52,155,700	4	68,485,337
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	6,608,501	8	6,342,862
9	Prepaid expenses and deferred charges ..........	3,886,943	9	3,249,893
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	602,500,342
b	Less: accumulated depreciation .....	10b	287,664,094	332,059,786	10c	314,836,248
11	Investments—publicly traded securities ..........	109,947,481	11	137,823,467
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	2,500,646	13	3,442,485
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	-35,118	15	-1,396,215
16	Total assets. Add lines 1 through 15 (must equal line 34)......	511,222,492	16	541,007,216
	17	Accounts payable and accrued expenses .........	25,851,305	17	29,099,391
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other 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 ..	0	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....................	37,932,224	25	36,374,726
26	Total liabilities. Add lines 17 through 25.........	63,783,529	26	65,474,117
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	447,438,963	27	475,533,099
28	Temporarily restricted net assets ...........	0	28	0
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........	447,438,963	33	475,533,099
34	Total liabilities and net assets/fund balances ........	511,222,492	34	541,007,216

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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

2012

Open to Public
Inspection

Name of the organization

ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number

84-0425720

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 described in 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. See section 509(a)(4).

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

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. 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—2011. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2012. 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—2011. 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) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(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.)..

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 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. 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—2011. 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) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

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

2012

Name of the organization

ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number

84-0425720

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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization ST MARY'S HOSPITAL & MEDICAL CENTER INC

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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization ST MARY'S HOSPITAL & MEDICAL CENTER INC

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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

Name of organization
ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number

84-0425720

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) (2012)

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

2012

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number

84-0425720

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

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 SchCMd Bullet

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 SchCMd Bullet

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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable 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) 2012

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? .......................

Yes

24,721

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

6,636

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

31,357

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, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
form 990, sch c, PART II-B, LINE 1F:		$6,000 PAYMENT TO McDermott Will & Emery for promotion of rural health related legislation. $17,721 paid to Capstone group for lobbying of health related issues in colorado. $1,000 payment to Club 20 a lobbying group for issues concerning western colorado.
LOBBYING PORTION OF MEMBERSHIP DUES REPORTED BY ASSOCIATIONS	form 990, SCH C, PART II-B, line 1i:	LOBBYING PORTION OF DUES REPORTED ON ASSOCIATION MEMBERSHIP INVOICES, $6,636. ST. MARY'S HOSPITAL HAS NO CONTROL OVER HOW THE FUNDS ARE SPENT OR DIRECTED.

Schedule C (Form 990 or 990EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number

84-0425720

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

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

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

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

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

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

Yes No

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

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

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

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

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

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

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


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

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

Yes No

If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	6,419,628	6,462,683	5,949,382	4,225,092	6,828,227
b	Contributions ........	924,522	168,214	25,481	2,619	24,377
c	Net investment earnings, gains, and losses	686,603	50,698	771,583	1,722,549	-2,535,754
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	81,639	261,967	283,763	878	91,758
f	Administrative expenses ....
g	End of year balance ......	7,949,114	6,419,628	6,462,683	5,949,382	4,225,092

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

Board designated or quasi-endowment SchDMd Bullet

96.400 %

Permanent endowment SchDMd Bullet

3.600 %

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

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

Yes

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

3a(i)

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

3a(ii)

Yes

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

Yes

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

Part VI

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

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	9,395,131		9,395,131
b	Buildings ................	234,306,341	76,531,457	157,774,884
c	Leasehold improvements ............	312,960	305,544	7,416
d	Equipment ................	340,083,888	199,798,789	140,285,099
e	Other .................	18,402,022	11,028,304	7,373,718
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				314,836,248

Schedule D (Form 990) 2012

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

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









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

Part IX

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

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

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

1.(a) Description of liability		(b) Book value
Federal income taxes		-165,858
ACCRUED PROPERTY TAXES		254,946
ACCRUED SALES TAXES		13,617
OTHER DEFERRALS		-210,663
SR PROGRAMS - MEALS		28,171
REIMB SETTLEMENT DUE - MCARE		2,950,793
MINORITY INTEREST		2,710,809
STATE INCOME TAX		24,112
CAPITAL STRUCTURE		31,478,657
ACCRUED EXPENSES & LIABILITIES		34,367
PREPAID MEALS		-6,491
REIMB SETTLE DUE MEDICAID		-737,734
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		36,374,726
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
Endowment Funds	form 990, Sch D, Part V, Line 4:	BOARD ENDOWMENT - QUASI ENDOWMENT USED FOR AREAS OF GREATEST NEED. CUMMINGS FAMILY ENDOWMENT - QUASI ENDOWMENT TO ASSIST LOW INCOME CANCER PATIENTS. SACCOMANNO RESEARCH INSTITUTE - QUASI ENDOWMENT TO FURTHER RESEARCH. BRUCE E. DIXSON PULMONARY REHABILITATION ENDOWMENT - ASSIST LOW INCOME PULMONARY PATIENTS WORLEY FAMILY INFECTION CONTROL ENDOWMENT - INFECTION CONTROL EDUCATION DR. LYNN JAMES PULMONARY ENDOWMENT FUND - ASSIST LOW INCOME PULMONARY PATIENTS ENDOWMENT FUNDS ARE HELD BY THE ST. MARY'S HOSPITAL FOUNDATION.

Schedule D (Form 990) 2012

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

2012

Open to Public Inspection

Name of the organization

ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number

84-0425720

Part I

Financial Assistance 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) as a factor in determining 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 40 %

Did the organization use FPG as a factor in determining 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 used factors other than FPG in determining 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, as a factor in determining 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

Financial Assistance and Means-Tested Government Programs		(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) ..	18,196,209	5,104,206	13,092,003	3.730 %
b	Medicaid (from Worksheet 3, column a) ....	63,711,827	46,994,769	16,717,058	4.760 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	81,908,036	52,098,975	29,809,061	8.490 %
Other Benefits		1,116,343	6,825	1,109,518	0.320 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	1,116,343	6,825	1,109,518	0.320 %
f	Health professions education (from Worksheet 5) ..	6,913,582		6,913,582	1.970 %
g	Subsidized health services (from Worksheet 6) ..	1,602,005		1,602,005	0.460 %
h	Research (from Worksheet 7)	831,960		831,960	0.240 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	877,759		877,759	0.250 %
j	Total. Other Benefits ..	11,341,649	6,825	11,334,824	3.240 %
k	Total. Add lines 7d and 7j .	93,249,685	52,105,800	41,143,885	11.730 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012

Schedule H (Form 990) 2012

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	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	1,983,572	210,991	1,772,581	0.510 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	1,983,572	210,991	1,772,581	0.510 %

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. Explain in Part VI the methodology used by the organization to estimate this amount. ......

8,648,843

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

82,812,246

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

80,111,522

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

2,700,724

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(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1PAVILION IMAGING	OUTPATIENT RADIOLOGY	75.000 %	25.000 %
2GRAND VALLEY SURG	OUTPATIENT SURGERY	50.336 %	49.664 %
3SAN JUAN CANCER CNT	OUPATIENT CANCER TREATMENT	33.333 %	33.333 %
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2012

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Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, and primary website address
1	St Mary's Hospital & Medical Ctr In 2635 N 7th ST GTRAND JUNCTION,CO81502	X	X	X	X

Schedule H (Form 990) 2012

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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	ST MARY'S HOSPITAL & MEDICAL CTR INC
Name of hospital facility or facility reporting group

For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

If “Yes,” indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 ....................

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

If “Yes,” indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2012

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Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 40.% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	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)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	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 website
b	The policy was attached to 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 on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	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?.......	15	Yes
16	Check all of the following 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)
17	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?..........	17		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)

Schedule H (Form 990) 2012

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Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the patients regarding the patients’ bills

Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

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?..........

Yes

If “No,” indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................

If “Yes,” explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? .........................

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

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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?2
Name and address		Type of Facility (describe)
1	Grand Valley Surgical Center LLC 710 Wellington Grand Junction,CO81501	outpatient surgery
2	San Juan Cancer Center LLC 600 SOUTH 5TH STREET MONTROSE,CO81401	outpatient cancer treatment
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2012

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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; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
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.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
FEDERAL POVERTY GUIDELINES	form 990, SCHE H, PART I, LINE 3C:	N/A
COST TO CHARGE RATIO	SCH H PART I, LINE 7:	COST TO CHARGE RATIO. DERIVED FROM WORKSHEET 2 BAD DEBT EXPENSE SUBTRACTED BEFORE CALCULATING PERCENTAGES IN COLUMN (F) WAS $22,736,388.
BAD DEBT FOOTNOTE	PART III, LINE 4:	A COST TO CHARGE RATIO IS USED TO DETERMINE THE AMOUNT REPORTED IN PART III, LINES 2 AND 3. DISCOUNTS AND PAYMENTS APPLIED TO ACCOUNTS. NO METHOD IS USED TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTED TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBLITY. NO PORTION OF BAD DEBT IS INCLUDED IN COMMUNITY BENEFIT. THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. WITHIN THE FINANCIAL STATEMENT OF SCL HEALTH SYSTEM, BAD DEBT EXPENSE IS INCLUDED WITHIN OPERATING EXPENSES, AT THE VALUE OF UNCOLLECTED AND ESTIMATED UNCOLLECTIBLE CHARGES AFTER CONTRACTUAL ALLOWANCES AND SELF-PAY DISCOUNTS ARE APPLIED.
MEDICARE	form 990, sch h, PART III, section b, LINE 8:	MEDICARE ALLOWABLE COSTS ARE DETERMINED BASED ON APPLICABLE MEDICARE RULES AND REGULATIONS. NONALLOWABLE EXPENSES ARE REMOVED VIA AN ADJUSTMENT, AS SHOWN ON WORKSHEET A-8 OF THE MEDICARE COST REPORT.
COLLECTIONS	PART III, LINE 9B:	AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST, AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. ST. MARY'S HOSPITAL & MEDICAL CENTER NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION, DISCHARGE AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. individuals eligibility form 990, sch h, part v, line 19d: The Hospital uses a sliding scale for patients that are under 400% of the FPG. The greatest percentage charged to a qualifying patient is less than the lowest negotiated rate.
NEEDS ASSESSMENT	PART VI, QUESTION 2:	AS OUR MISSION STATES, "WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND THE COMMUNITIES WE SERVE" AND IN ORDER TO DO THIS WE HAVE REGULARLY PARTICIPATED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT SURVEYS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY. IN 2012 THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY THE MESA COUNTY HEALTH DEPARTMENT AND INCLUDED THE COLLABORATIVE EFFORT OF MANY ORGANIZATIONS AND PROVIDERS IN OUR COMMUNITY, INCLUDING ST. MARY'S HOSPITAL & MEDICAL CENTER. WE CONTINUOUSLY ASSESS THE NEEDS OF THE COMMUNITY THROUGH CLOSE WORKING RELATIONSHIPS AND PARTNERSHIPS WITH SERVICE AGENCIES IN THE COMMUNITY, AND BY EVALUATING STATE AND COUNTY HEALTH STATISTICS. CHNA'S WERE ALSO CONDUCTED IN 1998, 2005, 2009. THE HEALTHY MESA COUNTY 2012 CHNA: STRATEGIES TO ADDRESS COMMUNITY HEALTH NEEDS; IS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS, PERCEPTIONS AND NEEDS OF RESIDENTS IN MESA COUNTY. SUBSEQUENTLY, THIS INFORMATION MAY BE USED TO FORMULATE STRATEGIES TO IMPROVE COMMUNITY HEALTH AND WELLNESS. MESA COUNTY HEALTH DEPARTMENT STARTED THE CHNA PROCESS IN 2011 BY CREATING A COMMUNITY HEALTH STEERING COMMITTEE TO LEAD A STRATEGIC PROCESS AND SUGGEST HEALTH PRIORITY AREAS FOR MESA COUNTY. FOLLOWING PRINCIPLES FROM THE COLORADO HEALTH ASSESSMENT AND PLANNING SYSTEM (CHAPS) AND THE PRECEDE/PROCEED MODEL (GREEN AND KREUTER, 2005), THE COMMITTEE DECIDED ON FOUR CRUCIAL STEPS TO ASSESS NEEDS, DETERMINE CAUSES, AND REACH CONSENSUS ON POSSIBLE INTERVENTIONS TO ACHIEVE DESIRED OUTCOMES. THOSE STEPS ARE: COMPILE EXISTING DATA, ENGAGE STAKEHOLDERS AND PRIORITIZE HEALTH PROBLEMS, GATHER PRIMARY DATA FROM COMMUNITY INPUT, AND DETERMINE HEALTH PRIORITIES. IMPLEMENTATION OF PRECEDE/PROCEED AND CHAPS PHASES RESULTED IN WELL-STRUCTURED QUALITATIVE AND QUANTITATIVE HEALTH DATA FOR MESA COUNTY. THOROUGH ANALYSIS OF MESA COUNTY INDICATORS ALLOWED FOR COMPARISON TO COLORADO, AND WHEN AVAILABLE TO THE NATION. THE PURPOSE WAS TO UNDERSTAND TRENDS CONTRIBUTING TO QUALITY OF LIFE, DEATH, DISEASE, ILLNESS, INJURY, AND LIFE CHANGING EVENTS. HEALTH DATA WAS PRESENTED TO THE STAKEHOLDER GROUP IN TEN DIFFERENT CATEGORIES; PARTICIPANTS SCORED EACH CATEGORY BASED ON IMPORTANCE AND ACTION ABILITY. THE RESULTS IDENTIFED SIX HEALTH PRIORITIES THAT CLUSTERED TOGETHER AS MOST IMPORTANT AND ACTIONABLE: MATERNAL AND CHILD HEALTH, MENTAL HEALTH, TOBACCO USE, OBESITY, FAMILY ABUSE AND VIOLENCE, AND SCREENING/DETECTION. TO FURTHER EXPLORE FACTORS CONTRIBUTING TO THE COMMUNITY'S HEALTH AND TO GATHER ADDITIONAL INFORMATION CONCERNING PERSONAL HEALTH NEEDS, THE COMMITTEE FACILITATED SIX SUBJECT-MATTER-EXPERT FOCUS GROUPS, ONE COMMUNITY FOCUS GROUP, AND THREE SUMMITS. GENERAL QUESTIONS ASKED INCLUDED: "HOW MUCH OF AN ISSUE IS... IN OUR COMMUNITY?" AND, "WHAT BARRIERS, SERVICES, OR DATA DO YOU FEEL INFUENCE THIS ISSUE?" COMMUNITY INPUT RESULTED IN A COMPREHENSIVE LIST OF BARRIERS AND POSSIBLE SOLUTIONS RELATED TO THE FOLLOWING THREE CRITICAL ISSUES, IDENTIFED AS MESA COUNTY'S WINNABLE BATTLES: OBESITY, SUICIDE AND UNINTENDED PREGNANCY. THE UNDERLYING APPROACH OF THE PRECEDE/PROCEED MODEL IS TO FRST IDENTIFY FINAL CONSEQUENCES, IN THIS CASE, OBESITY; SUICIDE; AND UNINTENDED PREGNANCY, AND WORK BACKWARDS TO THE CAUSES, KNOWN AS: PREDISPOSING, ENABLING AND REINFORCING FACTORS. A CLOSER LOOK AT THE COMMUNITY INPUT UNDER THIS SCOPE, REVEALED SIGNIFCANT SIMILARITIES AND DETERMINED BUILT ENVIRONMENT, PARENTING, ACCESS TO HEALTH CARE, MENTAL HEALTH, AND BUILDING A SENSE OF COMMUNITY AS CONTRIBUTING FACTORS TO POOR HEALTH OUTCOMES IN MESA COUNTY. RECOGNIZING THEM AS PRIORITIES IS A CRUCIAL STEP IN IDENTIFYING POTENTIAL SOLUTIONS. CHRONIC DISEASE, MATERNAL AND CHILD HEALTH, ORAL HEALTH, COMMUNICABLE DISEASE, AND INJURY AND VIOLENCE ARE FIVE BROAD CATEGORIES THAT ENCOMPASS MORBIDITY AND MORTALITY ISSUES NORMALLY ADDRESSED THROUGH COMMUNITY HEALTH EFFORTS. WHEN EXAMINING THESE ISSUES, SEVERAL ASSOCIATED BEHAVIORAL DETERMINANTS AND ENVIRONMENTAL RISK FACTORS WERE IDENTIFED AND USED TO GUIDE THE MESA COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT THROUGH THE FOLLOWING STEPS: STEP 1: COMPILE EXISTING DATA; IN FEBRUARY 2011, MESA COUNTY HEALTH DEPARTMENT REVIEWED A LIST OF 250 INDICATORS DEVELOPED BY THE PUBLIC HEALTH INDICATOR TASK FORCE AS A STARTING POINT FOR GATHERING LOCAL DATA. MESA COUNTY HEALTH DEPARTMENT STAFF RESEARCHED ALL AVAILABLE DATA FOR MESA COUNTY RELATED TO EACH OF THE 250 INDICATORS AND IDENTIFED WHETHER A STATE STANDARD OR A HEALTHY PEOPLE 2020 OBJECTIVE WAS AVAILABLE FOR COMPARISON. STEP 2: ENGAGE STAKEHOLDERS AND PRIORITIZE HEALTH PROBLEMS: MESA COUNTY HEALTH DEPARTMENT ESTABLISHED THE MESA COUNTY COMMUNITY HEALTH STEERING COMMITTEE, COMPRISED OF SELECTED COMMUNITY REPRESENTATIVES, TO PROVIDE GUIDANCE FOR THE HEALTH ASSESSMENT PROCESS. MEMBERS OF THE STEERING COMMITTEE WERE CHOSEN BASED ON THEIR ABILITIES TO PROVIDE SUBJECT MATTER EXPERTISE, PROVIDE INPUT, SEE THE BIG PICTURE OF COMMUNITY HEALTH, AND REVIEW THE HEALTH-INDICATOR DATA. COMMITTEE MEMBERS WERE ASKED TO COMMIT TO A KICKOFFMEETING, POTENTIALLY PARTICIPATE IN PRIORITY AREA FOCUS GROUPS, AND PROVIDE A REVIEW OF THE FINAL CHNA REPORT. THE FOLLOWING KEY COMMUNITY ORGANIZATIONS PARTICIPATED, REPRESENTING DIVERSITY WITHIN THE PUBLIC HEALTH SYSTEM: CITY OF GRAND JUNCTION, COLORADO WEST REGIONAL MENTAL HEALTH, COMMUNITY HOSPITAL, FAMILY HEALTH WEST, HILLTOP, MARILLAC CLINIC, MESA COUNTY 211, MESA COUNTY DEPARTMENT OF HUMAN SERVICES, MESA COUNTY HEALTH DEPARTMENT, MESA COUNTY LOCAL EMERGENCY PLANNING COMMITTEE (LEPC), MESA COUNTY SCHOOL DISTRICT #51, ST. MARY'S HOSPITAL & REGIONAL MEDICAL CENTER, AND STRIDE. STEP 3: GATHERING PRIMARY DATA: THE STEERING COMMITTEE GATHERED PRIMARY DATA TO FURTHER EXPLORE INFORMATION FOR MESA COUNTY. THIS WAS COMPLETED BY HOLDING FOCUS GROUPS AND BY IDENTIFYING AND REVIEWING DATA AVAILABLE IN A VARIETY OF COMMUNITY PROGRAMS. ONCE THE SUBJECT MATTER EXPERT AND COMMUNITY FOCUS GROUPS WERE COMPLETE, MESA COUNTY HEALTH DEPARTMENT AND COMMUNITY PARTNERS IDENTIFIED KEY PUBLIC HEALTH PRIORITIES THAT WOULD HAVE A LARGE-SCALE IMPACT ON HEALTH AND QUALITY OF LIFE. THESE AREAS BECAME MESA COUNTY'S WINNABLE BATTLES TO BE ADDRESSED OVER THE NEXT SEVERAL YEARS. AS A MEANS TO TRIANGULATE INFORMATION GATHERED IN THE FOCUS GROUPS, LARGE COMMUNITY SUMMITS WERE HELD TO DISCUSS ISSUES RELATED TO MESA COUNTY'S WINNABLE BATTLES. THE SUMMITS ENCOURAGED COMMUNITY PARTNERS, STAKEHOLDERS, AND MEMBERS OF THE PUBLIC TO OFFER IDEAS AND POTENTIAL SOLUTIONS TO BARRIERS. ST. MARY'S CONTINUOUSLY ASSESS THE NEEDS OF THE COMMUNITY THROUGH CLOSE WORKING RELATIONSHIPS AND PARTNERSHIPS WITH SERVICE AGENCIES IN THE COMMUNITY, AND BY EVALUATING STATE AND COUNTY HEALTH STATISTICS. ST. MARY'S UTILIZES THE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY TO HELP PRIORITIZE THE ALLOCATION OF RESOURCES. THE ST. MARY'S BOARD, LEADERSHIP AND SERVICE MANAGERS WILL DEVELOP PROGRAMS, ALTER CURRENT OPERATIONS OR SPONSOR LOCAL EFFORTS TO RESPOND TO THE NEEDS IDENTIFIED IN THE SURVEY.
COLLECTION PRACTICES	PART VI, QUESTION 3:	ST. MARY'S HOSPITAL & MEDICAL CENTER TREATS PATIENTS WITH RESPECT AND DIGNITY REGARDLESS OF THEIR ABILITY TO PAY. ST. MARY'S HOSPITAL & MEDICAL CENTER HAS A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINS ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE AT VARIOUS LEVELS, INCLUDING A 100% DISCOUNT, AND IS BASED ON FEDERAL POVERTY GUIDELINES. WE WORK WITH PATIENTS TO HELP THEM UNDERSTAND THEIR FINANCIAL RESPONSIBILITY FOR CARE RECEIVED, FINANCIAL ASSISTANCE AVAILABLE TO THEM, AND TO ESTABLISH PAYMENT PROGRAMS IN DEMONSTRATION OF OUR CORE VALUE OF RESPECT. AS PART OF OUR RESPONSIBILITY TO EDUCATE, WHEN POSSIBLE, WE INFORM OUR PATIENTS AND THEIR FAMILIES OF THE AVAILABILITY OF ASSISTANCE, INCLUDING GOVERNMENT PROGRAMS. WE COMMUNICATE THIS IN A VARIETY OF WAYS TO ENSURE THAT MESSAGES REACH MULTIPLE AUDIENCES. BEFORE, DURING AND/OR AFTER ADMISSION, WE ENCOURAGE OUR SELF PAY PATIENTS TO VISIT WITH A FINANCIAL COUNSELOR TO DISCUSS QUALIFICATIONS FOR FINANCIAL ASSISTANCE. THE FINANCIAL COUNSELOR WORKS WITH THE PATIENT TO COMPLETE A FINANCIAL ASSISTANCE FORM TO DETERMINE THE LEVEL OF DISCOUNT FOR WHICH THE PATIENT MAY BE ELIGIBLE. WE POST FINANCIAL ASSISTANCE INFORMATION IN EMERGENCY AND ADMISSIONS AREAS, ON BILLINGS INVOICES, IN VARIOUS AREAS AROUND THE HOSPITAL AND CLINIC SITES AND ON THE HOSPITAL WEBSITE. WE PROVIDE WRITTEN MATERIALS TO PATIENTS THAT DETAIL OUR FINANCIAL ASSISTANCE POLICY AND HOW IT IS ADMINISTERED. THIS COVERS ELIGIBILITY, STEPS TO FOLLOW TO DETERMINE IF A PATIENT QUALIFIES FOR ASSISTANCE, TYPICAL CHARGES A PATIENT MAY EXPECT FOR ROUTINE PROCEDURES, AND ASSISTANCE AVAILABLE BASED ON A PATIENT'S INCOME LEVEL. WE PROVIDE, WHEN POSSIBLE, MATERIALS AND EDUCATION WHEN PATIENTS ARE DISCHARGED, AND INCLUDE INFORMATION IN BILLING STATEMENTS, INCLUDING PHONE NUMBERS AND OTHER METHODS TO CONTACT US WITH QUESTIONS. WE ENSURE THAT OUR FINANCIAL COUNSELORS, ADMISSION EMPLOYEES, SOCIAL WORKERS AND OTHER EMPLOYEES UNDERSTAND OUR POLICIES TO BE ABLE TO ASSIST PATIENTS IN THE MOST APPROPRIATE WAY.
COMMUNITY INFORMATION	PART VI, QUESTION 4:	ST. MARY'S IS THE LEADING PROVIDER OF COMMUNITY BENEFIT FOR RESIDENTS OF WESTERN COLORADO AND EASTERN UTAH. THE HOSPITAL IS LOCATED IN GRAND JUNCTION, CO THE LARGEST CITY BETWEEN SALT LAKE CITY, UTAH AND DENVER, COLORADO; THEREFORE, IT SERVES AS A REGIONAL HUB FOR SERVICES AND MEDICAL TECHNOLOGIES. MESA COUNTY LIES ON THE WESTERN BORDER OF COLORADO AND COVERS 3,309 SQUARE MILES. ACCORDING TO THE COLORADO STATE DEMOGRAPHY OFFICE THE ESTIMATED 2013 POPULATION OF MESA COUNTY IS 147,445. MESA COUNTY HAS EXPERIENCED STEADY POPULATION GROWTH RATES AND IS EXPECTING THIS TREND TO CONTINUE. HISTORICALLY, THE AREA HAS GROWN AT 2%, ANNUALLY, AND IS PROJECTED TO CONTINUE TO GROW AT 2.3%, ANNUALLY, THROUGH 2018. THESE PROJECTIONS WERE PROVIDED PRIOR TO AND DURING THE ECONOMIC DOWNTURN. HOW THE RECESSIONARY INFLUENCES WILL AFFECT POPULATION GROWTH AND MOVEMENT WILL BE AN INDICATOR WE WILL INVESTIGATE EACH YEAR AS THE PROJECTIONS ARE MADE AVAILABLE. THE 'BABY-BOOMER' COHORT IS PROJECTED TO BE ONE OF THE FASTEST GROWING POPULATION SEGMENTS AND HISTORICALLY HAS BEEN PROVIDED THE MONIKER FOR BEING THE MOST SIGNIFICANT MARKET FORCE DRIVING DEMAND GROWTH AND CHANGES IN HOW CONSUMERS ENGAGE THE HEALTH CARE DELIVERY SYSTEM. ST. MARY'S WILL CONTINUE STRIVING TO PROVIDE HIGH QUALITY CARE OFFERING A FAVORABLE CONSUMER VALUE PROPOSITION TO MATCH THE COMMUNITY'S RISING EXPECTATIONS. IN CORRELATION WITH ST. MARY'S TREMENDOUS GROWTH IN BIRTHS, TODAY'S GENERATION Z (0-14) NOW REPRESENTS A SUBSTANTIALLY LARGE AND FAST GROWING AGE COHORT. POPULATION BY AGE 2013, 2018, % GROWTH CHANGE PRIMARY SERVICE AREA 0 TO 14 29,286 30,914 5.6% 15 TO 34 39,176 38,718 -1.7% 35 TO 54 36,198 35,153 -2.9% 55 TO 64 19,641 19,929 1.5% 65+ 23,144 26,114 12.8% TOTAL 147,445 150,828 2.3% SECONDARY SERVICE AREA 0 TO 14 29,286 27,856 -0.6% 15 TO 34 32,741 32,415 1.0% 35 TO 54 35,569 32,894 -7.5% 55 TO 64 18,926 18,827 -0.5% 65+ 20,814 23,852 14.6% TOTAL 136,061 135,844 -0.2% TERTIARY SERVICE AREA 0 TO 14 44,172 44,454 0.6% 15 TO 34 62,663 59,615 -7.5% 35 TO 54 66,287 63,330 -4.5% 55 TO 64 33,389 34,773 4.1% 65+ 27,760 35,176 26.7% TOTAL 234,271 237,348 1.3% GRAND TOTAL 517,777 524,020 1.2% 2013 HH INCOME PRIMARY SERVICE COLORADO STATE USA SEGMENT AREA. HH COUNT, %OF TOTAL <$15K 9,507 16.3% $15-25K 9,163 15.7% $25-50K 16,018 27.4% $50-75K 10,932 18.7% $75-100K 6,473 11.1% OVER $100K 6,358 10.9% 2013 RACE/ETHNICITY PRIMARY COLORADO USA SERVICE AREA STATE. 2013, %OF TOTAL, 2018, %OF TOTAL WHITE NON-HISPANIC 121,318 82.2% 122,416 81.11% BLACK NON-HISPANIC 824 0.6% 922 0.6% HISPANIC 20,820 14.1% 22,733 15.1% ASIAN & PACIFIC NON-HISPANIC 1,290 0.9% 1,418 2.3% ALL OTHERS 3,333 2.3% 3,488 2.3% FOR ADDITIONAL COMMUNITY STATISTICAL INFORMATION INCLUDING UNINSURANCE RATES (18%), SPECIAL HEALTH RELATED ISSUES, COMMUNITY RISK FACTORS AND OTHER HEALTH RELATED INDICATORS PLEASE REFER TO THE MOST RECENT COMMUNITY HEALTH ASSESSMENT SURVEY AT HTTP://HEALTH .MESACOUNTY.US/ PROMOTION OF COMMUNITY HEALTH.
PROMOTION OF COMMUNITY HEALTH	PART VI, QUESTION 5:	WE EXTEND OUR CARE BEYOND OUR HOSPITAL'S WALLS IN ORDER TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR COMMUNITY BUILDING ACTIVITIES DEMONSTRATE THIS COMMITMENT. OUR COMMUNITY BUILDING ACTIVITIES TOTALED $1,772,581 COMMUNITY SUPPORT IN 2012 REPORTED IN THE 990. DURING THIS YEAR OUR COMMUNITY SUPPORT ACTIVITIES INCLUDED ST. MARY'S SENIOR PROGRAMS - SENIOR COMPANION, FOSTER GRANDPARENT AND GRAY GOURMET FEDERALLY SUPPORTED PROGRAMS SPONSORED BY ST. MARY'S. ORIGINALLY SPONSORED BY MESA COUNTY, ST. MARY'S ASSUMED SPONSORSHIP AND SUPPORT OF THESE PROGRAMS DURING THE ECONOMIC DOWNTURN OF THE 1980'S WHEN THE COUNTY SUFFERED SEVERE BUDGET CONSTRAINTS FROM THE LOSS OF ENERGY-RELATED REVENUES. ST. MARY'S HAS CONTINUED TO SPONSOR AND SUPPORT THESE PROGRAMS BECAUSE OF THE UNIQUE SERVICES THEY PROVIDE TO THE SENIORS IN NEED IN MESA COUNTY. SENIOR COMPANION PROGRAM: ST. MARY'S SENIOR COMPANION PROGRAM HELPS OLDER ADULTS REMAIN HEALTHY, INDEPENDENT, AND IN THEIR OWN HOMES. THE NEED FOR THIS PROGRAM GROWS OUT OF THE PROBLEMS FACED BY SENIORS WHEN THEY OR THEIR PARTNER DEVELOPS MOBILITY ISSUES AND NEED HELP WITH EVERYDAY TASKS. 62 VOLUNTEER COMPANIONS SERVED 29,158 HOURS HELPING 349 SENIORS WITH DAILY ACTIVITIES, SUCH AS GROCERY SHOPPING, BILL PAYING, AND TRANSPORTATION TO MEDICAL APPOINTMENTS. WITHOUT HELP OF SENIOR COMPANIONS, MANY OLDER ADULTS WOULD BE FORCED TO LEAVE THEIR HOMES FOR ASSISTED LIVING FACILITIES OR NURSING HOMES. MANY WOULD NEED TO RELY ON PUBLIC SUPPORT SUCH AS MEDICAID TO PAY FOR THESE SERVICES. BY PROVIDING LOW-COST, PERSONAL INTERACTION WITH AT-RISK SENIORS, THE PROGRAM HELPS ENSURE SENIORS ARE ABLE TO GET GROCERY SHOPPING, MEDICAL APPOINTMENT AND ERRANDS COMPLETED. THE PROGRAM BENEFITS MORE THAN ST. MARY'S BECAUSE THE GOAL OF THE PROGRAM IS TO KEEP SENIORS LIVING INDEPENDENTLY OUTSIDE OF ASSISTED LIVING AND TO REDUCE THE RISK OF ILLNESS OR ACCIDENT THAT WOULD REQUIRE A HOSPITAL STAY. IN ADDITION TO MAJOR SUPPORT PROVIDED BY ST. MARY'S, THE COMMUNITY PROVIDES ADDITIONAL FINANCIAL SUPPORT THROUGH CONTRIBUTIONS TO ENHANCE THE SERVICES PROVIDED. FOSTER GRANDPARENT PROGRAM: ST. MARY'S FOSTER GRANDPARENT PROGRAM PROVIDES TWO TYPES OF SUPPORT IN THE COMMUNITY: 1) ASSISTANCE FOR AT-RISK YOUTH, AND 2) SOURCE OF INCOME FOR LOW-INCOME SENIORS. 85 QUALIFIED SENIOR VOLUNTEERS RECEIVE A TAX-FREE HOURLY STIPEND. PROVIDING 59,266 HOURS OF INVALUABLE TUTORING, MENTORING AND ONE-ON-ONE EDUCATIONAL SUPPORT FOR 1,509 AT-RISK CHILDREN, THE PROGRAM WORKS IN COLLABORATION WITH A BROAD RANGE OF COMMUNITY AGENCIES INCLUDING: MESA COUNTY SCHOOL DISTRICT; DELTA COUNTY SCHOOL DISTRICT; ROCKY MOUNTAIN HEAD START, MIGRANT HEAD START, KIDS OF THE KINGDOM, CHILD QUEST, LIL'MAVERICKS, AND COLLBRAN JOB CORPS, JUST TO NAME A FEW. WITHOUT THE PROGRAM, MORE YOUTH WOULD LIKELY DROP OUT OF SCHOOL AND REQUIRE PUBLICLY SUPPORTED INTERVENTION, AND SENIORS WOULD RELY MORE HEAVILY ON PUBLICLY AND PRIVATELY SUPPORTED FINANCIAL ASSISTANCE PROGRAMS. THE PRIMARY BENEFICIARIES OF THIS PROGRAM ARE THE PARTICIPATING SENIORS AND STUDENTS AND COMMUNITY AND GOVERNMENT-SUPPORT PROGRAMS, AS THE BENEFITS ACHIEVED ARE OUTSIDE THE REALM OF ST. MARY'S HOSPITAL'S SERVICES. IN ADDITION TO MAJOR SUPPORT PROVIDED BY ST. MARY'S, THE COMMUNITY PROVIDES ADDITIONAL FINANCIAL SUPPORT THROUGH CONTRIBUTIONS TO ENHANCE THE SERVICES PROVIDED. ST. MARY'S GRAY GOURMET PROGRAM GOOD NUTRITION IS HEALTHY FOOD, GOOD COMPANY, AND AN ENJOYABLE DINING EXPERIENCE. GRAY GOURMET, A NUTRITIONAL MEAL PROGRAM FOR SENIORS SPONSORED BY ST. MARY'S HOSPITAL, DELIVERS ALL THREE. WITH NINE COMMUNITY DINING SITES, HOME-DELIVERED MEALS THROUGH 18 DELIVERY ROUTES, AND OTHER NUTRITION-RELATED SERVICES, GRAY GOURMET IS DEDICATED TO THE GOOD HEALTH OF MESA COUNTY SENIORS. MEALS ARE PREPARED FRESH DAILY. SENIORS CURRENTLY RECEIVE HOT, NUTRIENT-DENSE MEALS IN FRIENDLY COMPANY AT NINE MEAL SITES. HOMEBOUND SENIORS 60 YEARS OF AGE AND OLDER CAN ARRANGE FOR HOME-DELIVERY SERVICE. FOR WEEKENDS, FROZEN MEALS ARE AVAILABLE FOR THOSE ENROLLED IN THE HOME DELIVERY SERVICE. IN 2012, 105,520 MEALS WERE SERVED. GRAY GOURMET'S REGISTERED DIETITIAN ASSURES MEALS MEET RECOMMENDED DIETARY STANDARDS. PERSONALIZED DIETARY COUNSELING IS OFFERED TO ALL PARTICIPANTS, AND NUTRITION EDUCATION IS AVAILABLE TO GROUPS. BOTH ARE FREE TO PARTICIPANTS. WITHOUT THE NUTRITIONAL SUPPORT PROVIDED BY GRAY GOURMET, MORE SENIORS WOULD BE PLACED IN ASSISTED LIVING FACILITIES, RELYING ON PUBLIC SUPPORT SUCH AS MEDICAID TO PAY FOR THESE SERVICES. THIS PROGRAM HELPS SENIORS TO CONTINUE TO LIVE INDEPENDENTLY AND REDUCES THE RISK OF A HOSPITAL STAY BECAUSE OF POOR NUTRITION. ROSE HILL SUMMARY 2012 THE MISSION OF ROSE HILL HOSPITALITY HOUSE IS TO PROVIDE A COMFORTABLE AND CONVENIENT LODGING ON A DONATION ONLY BASIS FOR GUESTS OF A LOVED ONE WHO IS HOSPITALIZED AT ST. MARY'S HOSPITAL, OR FOR PATIENTS COMING FOR OUTPATIENT CANCER TREATMENT AT THE ADVANCED MEDICINE PAVILION. 2,122 GUESTS STAYED AT ROSE HILL WITH AN AVERAGE LENGTH OF STAY OF 4.5 NIGHTS. THESE GUESTS CAME FROM 42 DIFFERENT STATES AND 6 FOREIGN COUNTRIES. BECAUSE OF THE GENEROSITY OF BENEFACTORS, A NUMBER OF MAJOR IMPROVEMENTS WERE MADE LAST YEAR. THESE INCLUDED: NEW WOOD FLOORING IN 7 GUEST ROOMS; NEW LIVING ROOM FURNITURE; 2 DINETTE SETS; DRESSERS AND NIGHTSTANDS FOR 11 GUEST ROOMS; LUGGAGE RACKS IN ALL GUEST ROOMS; AND A NEW WASHER AND DRYER. THIS NEW FURNITURE DONATED BY MESA COUNTY MEDICAL SOCIETY AND AMERICAN FURNITURE WAREHOUSE HELPS TO MAKE A WARM AND HOME LIKE ATMOSPHERE FOR ROSE HILL GUESTS. OUR IT STAFF WAS ABLE TO GREATLY INCREASE THE INTERNET CONNECTIVITY BY INSTALLING A GHOST BRIDGE WIRELESS NETWORK. OUR BOARD OF DIRECTORS REPRESENTS MEDICAL AND BUSINESS PROFESSIONALS, AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE DEEPLY INVOLVED IN OUR NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT PEOPLE KNOW ABOUT SERVICES AVAILABLE TO THEM THROUGH OUR HOSPITAL. WHEN ST. MARY'S HOSPITAL & MEDICAL CENTER HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE WE'LL BE HERE TO CARE FOR FUTURE GENERATIONS. WE ALSO SUPPORT OUR EMPLOYEES IN VOLUNTEERING FOR COMMUNITY ORGANIZATIONS, INCLUDING SERVING ON COMMUNITY BOARDS, AND PROVIDE OPPORTUNITIES FOR THEM TO SUPPORT CAUSES THROUGH HOSPITAL EVENTS SUCH AS UNITED WAY CAMPAIGNS AND FOOD AND CLOTHING DRIVES. WE ARE GOOD CITIZENS AND PARTNER WITH OTHER ORGANIZATIONS AND AGENCIES TO SUPPORT A THRIVING COMMUNITY. ST. MARY'S HOSPITAL OR ITS REPRESENTATIVES ARE MEMBERS OF THE CHAMBERS OF COMMERCE, ROTARY CLUB, AND CLUB 20. WE PROVIDE FINANCIAL SUPPORT FOR THE AMERICAN RED CROSS, MARCH OF DIMES,AMERICAN CANCER SOCIETY, GRAND JUNCTION ECONOMIC PARTNERSHIP AND THE DOWNTOWN DEVELOPMENT AUTHORITY, CATHOLIC OUTREACH, GRAND JUNCITON COMMUNITY HOMELESS SHELTER, HOSPICE AND PALLIATIVE CARE OF WESTERN COLORADO, HILLTOP COMMUNITY RESOURCES, MESA STATE COLLEGE, AND COLORADO REGIONAL WEST MENTAL HEALTH. WE PROVIDE FOCUSED SUPPORT FOR MARILLAC CLINIC, THE COMMUNITY'S HEALTH CLINIC FOR THE UNINSURED. WE WORK CLOSELY TOGETHER TO PROVIDE INTEGRATED CARE FOR THOSE WHO COME TO EITHER FACILITY FOR THEIR HEALTH NEEDS. MARILLAC CLINIC PROVIDES QUALITY PRIMARY HEALTH CARE SERVICES FOR UNINSURED, LOW-INCOME PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE CLINIC IS COMMITTED TO PROVIDING ACCESS TO COMPASSIONATE AND TRUSTWORTHY CARE FOR THE UNINSURED POOR. SERVICES THE CLINIC PROVIDES INCLUDE PRIMARY CARE, ONGOING MANAGEMENT OF CHRONIC DISEASES, MEDICATION, OPTICAL, AND DENTAL ASSISTANCE. IN ADDITION TO FINANCIAL SUPPORT, ST. MARY'S HOSPITAL ASSISTS THE CLINIC IN MANY OTHER WAYS INCLUDING STRATEGY AND OPERATIONS GUIDANCE, DONATING SUPPLIES, AND PROVIDING IT AND FINANCIAL SYSTEMS MANAGEMENT.
AFFILIATED HEALTH CARE SYSTEM	PART VI, QUESTION 6:	COMMUNITY BENEFITS PROVIDED IN 2012 THROUGHOUT SCLHS TOTALED $252.8 MILLION. AS PART OF SCL HEALTH SYSTEM, WE PROMOTE THE SHARED MISSION THAT "WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE."
STATE FILING OF COMMUNITY BENEFIT REPORT	PART VI, QUESTION 7:	Montana California and Kansas State filing is not required in Colorado

Schedule H (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number
84-0425720

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance
(1) Colorado West Mental Health 858 Grand Ave Grand Junction,CO81501	84-0625890	501(c)(3)	250,000				OPERATIONAL SUPPORT
(2) Marillac Clinic 2333 N 6th St Grand Junction,CO81501	84-1085822	501(C)(3)		1,197,055	Cost	Supplies, services	SUPPORT FOR OPERATIONS
(3) St Mary's Hospital Foundation 2635 N 7th St Grand Junction,CO81502	84-6037667	501(C)(3)	80,000				DONATION FOR
(4) Colorado Mesa University 1100 North Ave Grand Junction,CO81051	84-6037667	501(C)(3)	81,000				NURSING SCHOLARSHIPS
(5) Hilltop Community Resources 1331 Hermosa Grand Junction,CO81501	74-2321009	501(C)(3)	60,750				PRENATAL EDUCATION, CAPITAL CAMPAIGN
(6) Marillac Clinc 2333 N 6th St Grand Junction,CO81501	13-1846366	501(C)(3)	405,000				OPERATIONAL SUPPORT
(7) March of Dimes Colorado 518 28 Rd Grand Junction,CO81501	84-0972492	501(C)(3)	10,000				OPERATIONAL SUPPORT
(8) Grand Junction Economic Partnership 2828 WALKER FIELD DR Grand Junction,CO81506	84-0972492	501(C)(3)	40,627				COMMUNITY DEVELOPMENT
(9) Hospice & Palliative Care of Western CO 3090b n 12th st Grand Junction,CO81506	84-1207388	501(C)(3)	17,300				OPERATIONAL SUPPORT
(10) Center for Personalized Education 14001 Eiliff Denver,CO80014	98-1621600	501(C)(3)	11,000				Operational Support
(11) American Cancer Society 2754 Compass Dr Grand Junction,CO81506	84-1316555	501(c)(3)	10,000				cancer prevention
(12) Quality Health Network 2764 Compass Drive Suite 203 Grand Junction,CO81506	20-1632384	501(C)(3)	250,000				HEALTH RECORD NETWORKING
(13) Colorado Physicians Health 899 Logan St Denver,CO80210	74-2425019	501(c)(3)	11,000				PHYSICIAN HEALTHCARE
(14) Grand Junction Community Homeless Shelter 2853 North Avenue Grand Junction,CO81501	98-1621600	501(c)(3)		22,313	Cost	Laundry Services	LINEN SVCS
(15) GRAND VALLEY CATHOLIC OUTREACH 245 S 1ST ST GRAND JUNCTION,CO81501	20-0064007	501(c)(3)	9,600				assist needy
(16) HOLY FAMILY CATHOLIC SCHOOL 786 26 1/2 RD GRAND JUNCTION,CO81506	86-0297730	501(c)(3)	15,000				operations support

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2012

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant
(1) ambulance services	31	8,822
(2) pharmacueticals	287	16,467
(3) transportation for indigents	342	11,247
(4) PAYMENTS TO OTHERS	6	31,337
(5) CASH ASSISTANCE	5	746

Part IV

Supplemental Information.

Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Identifier	Return Reference	Explanation
PROCESS FOR MONITORING GRANTS AND AWARDS	SCHEDULE I, PART 1, LINE 2:	The hospital has no mechanisms in place to monitor the use of grant funds.

Schedule I (Form 990) 2012

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

2012

Open to Public Inspection

Name of the organization

ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number

84-0425720

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 of the expenses described above? If "No," complete Part III to explain....

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

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2012

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 (E) amounts for that individual.

(A) Name and Title		(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 and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)Michael McBrideCEO/President	(i) (ii)	0 386,790	0 104,038	0 14,403	0 52,989	0 16,663	0 574,883	0 0
(2)CHRIS WOOLSLEYDirector	(i) (ii)	0 246,492	0 79,696	0 12,372	0 32,601	0 12,374	0 383,535	0 0
(3)REZA KALEELCOO	(i) (ii)	0 266,436	0 0	0 42,938	0 25,667	0 11,345	0 346,386	0 0
(4)Forest BinderCFO/VP Finance	(i) (ii)	0 240,791	0 36,780	0 36,128	0 41,532	0 12,376	0 367,607	0 0
(5)John BeesonMedical Director	(i) (ii)	0 330,319	0 50,351	0 40,886	0 61,623	0 16,663	0 499,842	0 0
(6)BRIAN WITWERPhysician	(i) (ii)	788,365 0	0 0	2,365 0	17,983 0	16,801 0	825,514 0	0 0
(7)John LopezPhysician	(i) (ii)	785,133 0	0 0	1,612 0	18,000 0	16,607 0	821,352 0	0 0
(8)JAMES NARRODPhysician	(i) (ii)	701,478 0	0 0	3,078 0	18,000 0	16,553 0	739,109 0	0 0
(9)SUSAN HEMLEYPhysician	(i) (ii)	668,401 0	4,200 0	12,959 0	18,000 0	16,801 0	720,361 0	0 0
(10)LEONARD LAPKINPhysician	(i) (ii)	581,356 0	0 0	2,897 0	4,813 0	16,789 0	605,855 0	0 0
(11)Robert LadenburgerCEO	(i) (ii)	0 660,676	0 203,467	0 511,903	0 94,171	0 12,465	0 1,482,682	0 0
(12)DORA PETERSONCHIEF NURSING OFFICER	(i) (ii)	0 204,852	0 0	0 56,327	0 20,625	0 4,320	0 286,124	0 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

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

Identifier	Return Reference	Explanation
FORM 990, SCHEDULE J, PART I, LINE 3:		SEE FORM 990, SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, LINES 15A & B REGARDING THE PROCESS USED BY SCLHS TO DETERMINE EXECUTIVE COMPENSATION WHICH IS RELIED UPON BY THIS ORGANIZATION.
Form 990, Schedule J, Part I, Line 4b:		OTHER REPORTABLE COMPENSATION SHOWN IN SCHEDULE J PART II COLUMN (B) (III) CONTAINS AN ANNUAL REPORTING ADJUSTMENT FOR CERTAIN EMPLOYEES WHO PARTICIPATE IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. SCLHS PROVIDES NONQUALIFIED RETIREMENT PLANS FOR EXECUTIVES TO COMPENSATE FOR IRS IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. ON THE ADVICE OF COUNSEL, SCLHS HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR, ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS. AN AMOUNT EQUAL TO THE PARTICIPANT'S EXPECTED INCOME TAX LIABILITY WAS WITHDRAWN FROM THE PARTICIPANT'S ACCOUNT AND REMITTED TO THE IRS AS WITHHOLDING ON THE TAXABLE BENEFIT. THE AMOUNTS WITHDRAWN FROM THE PLAN FOR TAXES IN 2012 WERE: FOREST C. BINDER-$9,722 JOHN C. BEESON-$13,991
Form 990, Schedule J, Part II		THE SCL HEALTH SYSTEM, INC. (SCLHS) CONSISTS OF ELEVEN HOSPITALS AND FOUR CLINICS (AFFILIATES) IN FOUR STATES INCLUDING ST. MARY'S HOSPITAL AND MEDICAL CENTER (ST. MARY'S) IN GRAND JUNCTION, COLORADO. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. ROBERT W. LADENBURGER IS EXECUTIVE VICE PRESIDENT AND CHIEF OPERATING OFFICER OF SCL HEALTH SYSTEM, INC. IN DENVER, COLORADO. HE IS A FORMER PRESIDENT & CHIEF EXECUTIVE OFFICER OF ST. MARY'S. THE COMPENSATION REFLECTED IS THAT OF MR. LADENBURGER'S POSITION AS AN SCLHS EXECUTIVE AND NOT AS A ST. MARY'S EXECUTIVE. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE.

Schedule J (Form 990) 2012

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, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number

84-0425720

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

Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)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 assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2012

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) WESTERN COLORADO LUNG CENTER	DRCTR,>5% WEST CO LUNG	572,381	FEES PAID TO PHYS GROUP		No
(2) COLORADO WEST EMERGENCY PHYSICIANS	DRCTR,>5% WST CO EMERG PH	349,479	FEES FOR CO WEST ER PHYS GRP		No
(3) COLORADO WEST OTOLARYNOLOGISTS	DRCTR,>5% CO WEST OTOLAR	222,986	RENT PAID TO HOSP BY PHYS GRP		No

Part V

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

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2012

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

2012

Open to Public
Inspection

Name of the organization

ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number

84-0425720

Identifier	Return Reference	Explanation
DELEGATE CONTROL OVER MANAGEMENT DUTIES	FORM 990, PART VI SECTION A LINE 3	ALTHOUGH THESE SERVICES MAY NOT ALL RISE TO THE LEVEL OF MANAGEMENT CONTROL AS DEFINED IN THE 990 INSTRUCTIONs, WE HAVE IN THE SPIRIT OF FULL TRANSPARENCY PROVIDED THE FOLLOWING DISCLOSURE. AS A MEMBER OF SCL HEALTH SYSTEM, THIS PROVIDER MAY HAVE INDIVIDUAL AND/OR SYSTEM CONTRACT(S) THAT HAS DELEGATED CONTROL OVER MANAGEMENT DUTIES IN SOME OR ALL OF THE FOLLOWING AREAS: DIETARY AND FOOD SERVICE, HOUSEKEEPING, SUPPLY CHAIN, REVENUE CYCLE, AND SECURITY
BOARD MEMBER	PART VI LINE 6	THE SCL HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE CORPORATE MEMBER OF ELEVEN HOSPITALS AND FOUR CLINICS (AFFILIATES) IN FOUR STATES INCLUDING ST. MARY'S HOSPITAL IN GRAND JUNCTION, COLORADO. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. THROUGHOUT THE YEAR MICHAEL MCBRIDE WAS PRESIDENT & CHIEF EXECUTIVE OFFICER AND FOREST C. BINDER was VICE PRESIDENT & CHIEF FINANCIAL OFFICER FOR ST. MARY'S HOSPITAL AND MEDICAL CENTER (ST. MARY'S). IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE.
MEMBERS	FORM 990 PART VI LINES 7A & 7B	AS THE SOLE CORPORATE MEMBER THE SCL HEALTH SYSTEM HAS THE AUTHORITY TO APPOINT BOARD MEMBERS. CERTAIN DECISIONS MADE BY THE COMMUNITY BOARD ARE SUBJECT TO APPROVAL BY THE CORPORATE MEMBER. THESE DECISIONS ARE PRIMARILY THOSE REGARDING DISSOLUTION.
BOARD REVIEW OF FORM 990	FORM 990 PART VI LINE 11b	PRIOR TO SUBMISSION OF THE 990, THE 990 IS REVIEWED EXTERNALLY BY ERNST & YOUNG, LLP AND THE SYSTEM OFFICE. THE BOARD MEMBERS ARE THEN PRESENTED WITH COPIES OF THE FORM 990. AT A SUBSEQUENT BOARD MEETING, MEMBERS ARE ENCOURAGED TO ASK QUESTIONS REGARDING CLARIFICATION OR EXPRESS OPINIONS ON THE INFORMATION PROVIDED.
CONFLICT OF INTEREST	FORM 990 PART VI SECTION B LINE 12c	SENIOR LEADERSHIP OF ST. MARY'S HOSPITAL AND THE SCL HEALTH SYSTEM REGULARLY MONITOR AND REVIEW THE CONFLICT OF INTEREST STATEMENTS. WHEN CONFLICTS ARISE, BOARD MEMBERS WITH CONFLICTS RECUSE THEMSELVES FROM DISCUSSIONS AND VOTING ON ACTIONS.
JOINT VENTURES	PART VI SECTION B LINE 16b	JOINT VENTURE ARRANGEMENTS ARE REVIEWED WITH INTERNAL AND EXTERNAL LEGAL COUNSEL AT THE LOCAL AND SYSTEM OFFICE LEVELS PRIOR TO ENTERING INTO THE AGREEMENTS.
PUBLIC INSPECTION OF DOCUMENTS	PART VI SECTION C LINE 19	DOCUMENTS ARE AVAILABLE UPON REQUEST FROM ADMINISTRATIVE OFFICES OF ST. MARY'S HOSPITAL.
RECONCILIATION OF NET ASSETS	FORM 990, PART XI, LINE 5:	EQUITY TRANSFER TO MARILLAC CLINIC (3,033,583) EQUITY TRANSFER (TO)/FROM FOUNDATION (1,805,588) UBI INCOME FROM JOINT VENTURE-ELIMINATED IN CONSOLIDATION (1,170,480) UNRECORDED GRANTS (340,188) SYSTEM OFFICE ADJUSTMENTS (163,528) DONATION TO FOUNDTAION FOR GIFT SHOP PROCEEDS 80,000 WOODEN HORSE GIFT SHOP (68,385) PRIOR YEAR ACCRUAL FOR DONATION FROM FOUNDATION (26,480) TOTAL: (6,528,232)
THE PROCESS FOR DETERMINING COMPENSATION:	FORM 990, PART VI, LINE 15A & 15B:	SCLHS EMPLOYS THE EXECUTIVE TEAM AT EACH OF ITS HOSPITAL AFFILIATES. AS PART OF ITS ANNUAL REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF THOSE IN THESE POSITIONS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACTS -COMPENSATION SURVEYS AND STUDIES -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS' EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED IN SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS.
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:SYSTEM OFFICE ALLOCATION TOTAL FEES:9207758
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED SERVICES - OTHER TOTAL FEES:7931435
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:PROFESSIONAL FEES - PHYSICIANS TOTAL FEES:6175323
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT LABOR TOTAL FEES:5690073
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:PUR SERV - MAINT CONTRACTS TOTAL FEES:4310383
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:PUR SERV - OUTSIDE LAB FEES TOTAL FEES:2652596
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:COLLECTION AGENCIES TOTAL FEES:1491672
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:PUR SERV - REP & MAINT TOTAL FEES:1372732
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:PROF FEES - CONSULTING TOTAL FEES:747839
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:PUR SERV - OTHER MED SERVICES TOTAL FEES:722718
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:PROF FEES - OTHER SERVICES TOTAL FEES:305753
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER CONTRACT LABOR TOTAL FEES:102280
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES	FORM 990 PART IX LINE 11G	DESCRIPTION:PROF FEES - MARKETING TOTAL FEES:11139

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

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

2012

Open to Public Inspection

Name of the organization

ST MARY'S HOSPITAL & MEDICAL CENTER INC

Employer identification number

84-0425720

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) SISTERS OF CHARITY LEAVENWORTH HLTH SYST 2420 W 26TH ST SUITE 100D DENVER,CO80211 23-7379161	SUPPORT MMBRS	KS	501(C)(3)	11B-TYPE II	NA		No
(2) CARITAS CLINICS INC 818 NORTH 7TH STREET LEAVENWORTH,KS66048 48-1009910	CLINIC SVCS	KS	501(C)(3)	3	SCLHS	Yes
(3) MARIAN CLINIC INC 1001 SW GARFIELD TOPEKA,KS66604 48-1046905	CLINIC SVCS	KS	501(C)(3)	3	SCLHS	Yes
(4) MARILLAC CLINIC INC 2333 N 6TH STREET GRAND JUNCTION,CO81501 84-1085822	CLINIC SVCS	CO	501(C)(3)	3	SCLHS	Yes
(5) PROVIDENCE MEDICAL CENTER 8929 PARALLEL PARKWAY KANSAS CITY,KS66112 48-0784446	HEALTHCARE	KS	501(C)(3)	3	SCLHS	Yes
(6) ST JOHN HOSPITAL INC 3500 SOUTH FOURTH STREET LEAVENWORTH,KS66048 48-0543768	HEALTHCARE	KS	501(C)(3)	3	PMC	Yes
(7) BETHANY COMMUNITY PLAZA INC 15 NORTH 12TH STREET KANSAS CITY,KS66102 48-1207407	HEALTHCARE	KS	501(C)(3)	3	PMC	Yes
(8) PROVIDENCEST JOHN FOUNDATION INC 8929 PARALLEL PARKWAY KANSAS CITY,KS66112 48-0925688	SUPPORT 501C3	KS	501(C)(3)	7	PMC	Yes
(9) ST FRANCIS HEALTH CENTER INC 1700 SW 7TH STREET TOPEKA,KS66606 48-0547719	HEALTHCARE	KS	501(C)(3)	3	SCLHS	Yes
(10) ST FRANCIS HEALTH CENTER FOUNDATION 1700 SW 7TH STREET TOPEKA,KS66606 48-1092520	SUPPORT 501C3	KS	501(C)(3)	11A-TYPE I	SFHC	Yes
(11) ST MARYS HOSPITAL FOUNDATION 2635 N 7TH STREET GRAND JUNCTION,CO81502 23-7001007	SUPPORT 501C3	CO	501(C)(3)	11A-TYPE I	SMHMC	Yes
(12) SAINT JOSEPH HOSPITAL FOUNDATION 1835 FRANKLIN STREET DENVER,CO80218 84-0735096	SUPPORT 501C3	CO	501(C)(3)	11A-TYPE I	SJH	Yes
(13) HOLY ROSARY HEALTHCARE 2600 WILSON MILES CITY,MT59301 81-0231792	HEALTHCARE	MT	501(C)(3)	3	SCLHS	Yes
(14) HOLY ROSARY HEALTHCARE FOUNDATION INC 2600 WILSON MILES CITY,MT59301 20-2270238	SUPPORT 501C3	MT	501(C)(3)	11A-TYPE I	HRHC	Yes
(15) ST VINCENT HEALTHCARE 1233 NORTH 30TH BILLINGS,MT59101 81-0232124	HEALTHCARE	MT	501(C)(3)	3	SCLHS	Yes
(16) ST VINCENT HEALTHCARE FOUNDATION PO BOX 35200 BILLINGS,MT59107 81-0468034	SUPPORT 501C3	MT	501(C)(3)	7	SVHC	Yes
(17) NORTHWEST RESEARCH & EDUCATION INSTITUTE 315 NORTH 25TH STREET BILLINGS,MT59101 20-1343024	COMM HLTH RES	MT	501(C)(3)	9	SVHC	Yes
(18) ST JAMES HEALTHCARE 400 SOUTH CLARK STREET BUTTE,MT59701 81-0231785	HEALTHCARE	MT	501(C)(3)	3	SCLHS	Yes
(19) ST JAMES HEALTHCARE FOUNDATION 400 SOUTH CLARK STREET BUTTE,MT59701 65-1202190	SUPPORT 501C3	MT	501(C)(3)	11A-TYPE I	SJHC	Yes
(20) SAINT JOHNS HEALTH CENTER 2121 SANTA MONICA BLVD SANTA MONICA,CA90404 95-1684082	HEALTHCARE	CA	501(C)(3)	3	SCLHS	Yes
(21) JOHN WAYNE CANCER INSTITUTE 2000 SANTA MONICA BLVD SANTA MONICA,CA90404 95-4291515	CANCER R&D	CA	501(C)(3)	4	SJHHC	Yes
(22) SAINT JOHNS HOSPITAL & HLTH CENTER FNDTN 2121 SANTA MONICA BLVD SANTA MONICA,CA90404 95-6100079	SUPPORT 501C3	CA	501(C)(3)	11A-TYPE I	SJHHC	Yes
(23) EXEMPLA INC FKA LUTHERAN HOSPITAL 2420 W 26TH AVE SUITE 100D DENVER,CO80211 84-1103606	HEALTHCARE	CO	501(C)(3)	3	SCLHS	Yes
(24) EXEMPLA LUTHERAN MEDICAL CENTER FNDTN 2480 W 26TH AVESUITE 360B DENVER,CO80211 20-8846152	SUPPORT 501C3	CO	501(C)(3)	7	EXEMPLA INC	Yes
(25) EXEMPLA GOOD SAMARITAN MEDICAL CTR FNDTN 200 EXEMPLA CIRCLE LAFAYETTE,CO80026 84-1649162	SUPPORT 501C3	CO	501(C)(3)	7	EXEMPLA INC	Yes
(26) LUTH MED CNTR PRO&GEN LIAB SELF-INS TRST 2480 W 26TH AVESUITE 360B DENVER,CO80211 74-2571584	INSURANCE	CO	501(C)(3)	11A-TYPE I	EXEMPLA INC	Yes
(27) SAINT JOSEPH HOSPITAL 1835 FRANKLIN STREET DENVER,CO80218 84-0417134	HEALTHCARE	CO	501(C)(3)	3	SCLHS	Yes
(28) MOUNT ST VINCENT HOME INC 4159 LOWELL BLVD DENVER,CO80211 84-0405260	RES CARE	CO	501(C)(3)	11A-TYPE I	SCLHS	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) PAVILION IMAGING LL 750 WELLINGTON GRAND JUNCTION,CO81501 03-0516198	RADIOLOGY	CO	ST MARY'S HOSP	RELATED	6,809,456	5,228,192		No	0	Yes		75.000 %
(2) GRAND VALLEY SURGICAL CANTER LLC 710 WELLINGTON GRAND JUNCTION,CO81501 84-1505075	OP SURGERY	CO	ST MARY'S HOSP	RELATED	401,575	1,492,624		No	0	Yes		50.336 %
(3) SAN JUAN CANCER CENTER LLC 600 SOUTH 5TH STREET MONTROSE,CO81401 20-2856331	OP CANCER	CO	ST MARY'S HOSP	RELATED	443,453	154,645		No	0	Yes		33.333 %
(4) BILLINGS MRI CENTER LLC 1041 NORTH 29TH STREET BILLINGS,MT59101 81-0450943	MRI-PET SCAN	MT	N/A
(5) LUTHERAN CAMPUS ASC LLC 3455 LUTHRN PKW SUITE 150 WHEATRIDGE,CO800336028 02-0749532	OP SURGERY	CO	N/A
(6) COLORADO SURGICAL VENTURES LLC 30 S WACKER DR SUITE 2302 CHICAGO,IL60605 20-8038915	OP SURGERY	CO	N/A
(7) COLORADO SURGICAL HOSPITAL LLC 30 S WACKER DR SUITE 2302 CHICAGO,IL60605 20-8038977	OP SURGERY	CO	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) CARITAS INC AND SUBSIDIARIES 2420 W 26TH AVE SUITE 100D DENVER,CO80211 48-0941069	OTHER MEDICAL	KS		C CORP				No
(2) LEAVEN INSURANCE COMPANY LTD 23 LIME TREE BAY AVE PO BOX 1051 GEORGETOWN,GRAND CAYMANKY1-1102 CJ 98-0370522	INSURANCE	CJ						No

Schedule R (Form 990) 2012

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

Yes

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

Yes

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

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

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Yes

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

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

Yes

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

s 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-s)	(c) Amount involved	(d) Method of determining amount involved
(1) GRAND VALLEY SURGICAL CENTER LLC	a	554,389	cost
(2) Pavilion Imaging LLC	a	2,693,949	cost
(3) MARILLAC CLINIC	b	1,602,055	COST
(4) ST MARY'S HOSPITAL FOUNDATION	b	1,513,220	COST
(5) ST MARY'S HOSPITAL FOUNDATION	c	751,239	COST
(6) grand valley surgical center llc	g	17,484	cost
(7) PAVILION IMAGING LLC	j	2,693,949	FMV
(8) grand valley surgical center llc	j	554,389	fmv
(9) GRAND VALLEY SURGICAL CENTER LLC	l	80,168	FMV
(10) PAVILION IMAGING LLC	l	1,934,545	FMV
(11) MARILLAC CLINIC	l	1,197,055	COST
(12) SAN JUAN CANCER CENTER LLC	l	72,000	FMV
(13) ST MARY'S HOSPITAL FOUNDATION	m	751,239	COST
(14) st mary's hospital foundation	n	83,206	cost
(15) marillac clinic	n	30,948	cost
(16) GRAND VALLEY SURGICAL CENTER LLC	o	2,482,902	COST
(17) PAVILION IMAGING LLC	o	2,889,431	COST
(18) san juan cancer center llc	o	416,328	COST
(19) ST MARY'S HOSPITAL FOUNDATION	o	2,906,986	COST
(20) MARILLAC CLINIC	o	3,033,583	COST
(21) pavillion imaging llc	q	1,786,576	cost
(22) san juan cancer center llc	q	302,483	cost
(23) marillac clinic	q	23,393	cost
(24) ST MARY'S HOSPITAL FOUNDATION	q	330,537	CASH
(25) PAVILION IMAGING LLC	s	7,275,000	CASH
(26) SAN JUAN CANCER CENTER LLC	s	270,909	CASH
(27) GRAND VALLEY SURGUCAL CENTER LLC	s	327,150	CASH

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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) 2012

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: WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	2,443
6	Total number of volunteers (estimate if necessary) .............	6	600
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	3,427,598
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	1,430,856

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,502,814	2,096,421
9	Program service revenue (Part VIII, line 2g) .........	366,833,371	378,884,254
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,805,906	11,610,206
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	13,038,393	15,713,804
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	385,180,484	408,304,685
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,177,258	2,581,684
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)	141,167,243	151,576,900
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 481,945
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	212,261,782	219,523,733
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	355,606,283	373,682,317
19	Revenue less expenses. Subtract line 18 from line 12.......	29,574,201	34,622,368
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	511,222,492	541,007,216
21	Total liabilities (Part X, line 26).............	63,783,529	65,474,117
22	Net assets or fund balances. Subtract line 21 from line 20.....	447,438,963	475,533,099

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 188,795,105 including grants of $ ) (Revenue $ 281,581,252 )
	INPATIENT HEALTHCARE - ST. MARY'S HOSPITAL & MEDICAL CENTER, INC, DBA ST. MARY'S HOSPITAL THE REGIONAL MEDICAL CENTER IS A FULL-SERVICE HOSPITAL PROVIDING QUALITY HEALTHCARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS THE LARGEST HEALTHCARE FACILITY IN A 250-MILE RADIUS, ST. MARY'S PROVIDES MANY ADVANCED HEALTHCARE SERVICES NOT OFFERED BY ANY OTHER FACILITIES IN WESTERN COLORADO AND EASTERN UTAH, INCLUDING COMPREHENSIVE CARDIAC SERVICES, OPEN HEART SURGERY, COMPREHENSIVE CANCER CARE, A NEWBORN INTENSIVE CARE, AND LEVEL II TRAUMA SERVICES. ST. MARY'S IS LICENSED FOR 346 BEDS, 310 OF WHICH WERE STAFFED BY YEAR END 2012. 2012 ACUTE ADULT AND PEDIATRIC ADMISSIONS NUMBERED 12,156; 2,175 BIRTHS; SUB-ACUTE ADMISSIONS 277. MEDICARE REPRESENTS 41.9% OF THE PAYOR MIX; MEDICAID REPRESENTS 15.3% OF THE PAYOR MIX THE HOSPITAL PERFORMED 4,202 INPATIENT SURGERIES.

4b	(Code: ) (Expenses $ 89,272,388 including grants of $ ) (Revenue $ 21,662,015 )
	OUTPATIENT HEALTHCARE - MOST OF ST. MARY'S OUTPATIENT HEALTHCARE SERVICES ARE DELIVERED IN CLINIC FACILITIES CONVENIENTLY LOCATED NEAR BUT SEPARATE FROM THE MAIN HOSPITAL CAMPUS. WITH THEIR OWN ENTRANCES AND PARKING LOTS, THESE FACILITIES KEEP PATIENTS OUT OF THE TRAFFIC AND ACTIVITY FLOW OF THE HOSPITAL BUT CLOSE TO THE MAJOR CONCENTRATION OF MEDICAL SERVICES AND PHYSICIAN OFFICES IN THE COUNTY. ST. MARY'S ADVANCED MEDICINE PAVILION HOUSES OUT-PATIENT MEDICAL AND RADIOLOGY CANCER CARE, IMAGING, BLOOD DONATION, AND LABORATORY SERVICES. ST. MARY'S LIFE CENTER CONTAINS REHABILITATION, WELLNESS, AND WEIGHT LOSS/MANAGEMENT SERVICES. A THIRD FREE-STANDING FACILITY HOUSES ST. MARY'S FAMILY MEDICINE RESIDENCY PROGRAM, WHICH TRAINS PHYSICIANS TO CARE FOR FAMILIES IN SMALL TOWNS AND RURAL AREAS; ST. MARY'S FAMILY MEDICINE CENTER, A MEDICAL CLINIC SPECIALIZING IN PRE-NATAL, OBSTETRICAL, PEDIATRIC, FAMILY, AND GERIATRIC CARE; AND ST. MARY'S WOUND CLINIC. ST. MARY'S 2012 OUTPATIENT SERVICES INCLUDED: 360,160 PATIENT VISITS (INCLUDING EMERGENCY ROOM VISITS), 80,050 CLINIC VISITS, AND 3,318 OUTPATIENT SURGERIES.

4c	(Code: ) (Expenses $ 17,117,228 including grants of $ ) (Revenue $ 34,544,098 )
	PROGRAM SERVICE III EMERGENCY & TRAUMA SERVICES - ST. MARY'S OPERATES THE ONLY LEVEL II TRAUMA CENTER BETWEEN DENVER, CO AND SALT LAKE CITY, UT. WITH A 24-7 EMERGENCY DEPARTMENT STAFFED WITH EXPERIENCED EMERGENCY MEDICINE-TRAINED PHYSICIANS AND NURSES, TRAUMA AND NEUROSURGEONS ALWAYS AVAILABLE, AND AIR MEDICAL TRANSPORT SERVICES, ST. MARY'S CARES FOR SERIOUSLY ILL AND INJURED PATIENTS. THE TRANSPORT HELICOPTER ALSO ASSISTS IN RESCUE OR EVACUATION EFFORTS. DURING 2012 ST. MARY'S HELICOPTER MADE 381 TRANSPORT FLIGHTS. THE FIXED-WING AIRCRAFT FLEW 304 TRANSPORTS THERE WERE 32 GROUND TRANSPORTS. OF ST. MARY'S 39,640 EMERGENCY DEPARTMENT VISITS DURING 2012, 6,265 PATIENTS WERE ADMITTED AND 33,375 WERE TREATED AS OUTPATIENTS.

	(Code: ) (Expenses $ 9,958,329 including grants of $ ) (Revenue $ 22,036,677 )
	OUTPATIENT RADIOLOGY

	(Code: ) (Expenses $ 8,458,761 including grants of $ ) (Revenue $ 20,459,271 )
	REHABILITATION

	(Code: ) (Expenses $ 1,560,463 including grants of $ ) (Revenue $ 356,024 )
	WELLNESS CENTER

	(Code: ) (Expenses $ 6,425,538 including grants of $ ) (Revenue $ )
	RESIDENCY PROGRAM

	(Code: ) (Expenses $ 656,590 including grants of $ ) (Revenue $ )
	collaborative clinic

	(Code: ) (Expenses $ 831,960 including grants of $ ) (Revenue $ )
	RESEARCH

	(Code: ) (Expenses $ 2,064,947 including grants of $ ) (Revenue $ 210,992 )
	COMMUNITY BENEFIT PROGRAMS

	(Code: ) (Expenses $ 173,510 including grants of $ ) (Revenue $ 6,825 )
	EDUCATION

	(Code: ) (Expenses $ 234,447 including grants of $ ) (Revenue $ )
	tumor registry

	(Code: ) (Expenses $ 2,581,684 including grants of $ 2,581,684 ) (Revenue $ )
	OTHER CHARITABLE CONTRIBUTIONS

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 32,946,229 including grants of $ 2,581,684 ) (Revenue $ 43,069,789 )
4e	Total program service expenses328,130,950

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) Roy Cromer........................................................................ Chair	1.0 .......................0.0	X	X
(2) Gregg Kampf........................................................................ Vice Chair	1.0 .......................0.0	X	X
(3) Rob Bickley........................................................................ Treasurer	1.0 .......................0.0	X	X
(4) Kristine Ruess........................................................................ Secretary	1.0 .......................0.0	X	X
(5) Michael McBride........................................................................ CEO/President	55.0 .......................1.0	X	X		0	505,231	69,652
(6) Sister Catrina Ann Bones........................................................................ Director	1.0 .......................0.0	X
(7) Bruce Hill........................................................................ Director	1.0 .......................0.0	X
(8) DUANE HARTSHORNE........................................................................ Director	1.0 .......................0.0	X
(9) SISTER JEAN ANNE PANISKO........................................................................ Director	1.0 .......................0.0	X
(10) David James........................................................................ Director	1.0 .......................0.0	X			72,909	0	3,246
(11) MIKE MURRAY........................................................................ Director	1.0 .......................0.0	X
(12) Monique Serra........................................................................ Director	1.0 .......................0.0	X
(13) Sister Phyllis Stowell........................................................................ Director	1.0 .......................0.0	X
(14) CHRIS WOOLSLEY........................................................................ Director	1.0 .......................40.0	X			0	338,560	44,975
(15) Douglas Aden........................................................................ Director	1.0 .......................0.0	X
(16) Forest Binder........................................................................ CFO/VP Finance	55.0 .......................1.0		X		0	313,699	53,908
(17) REZA KALEEL........................................................................ COO	55.0 .......................1.0			X	0	309,374	37,012

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)				(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) John Beeson........................................................................ Medical Director	55.0 .......................0.0	X			0	421,556	78,286
(19) DORA PETERSON........................................................................ CHIEF NURSING OFFICER	55.0 .......................0.0	X			0	261,179	24,945
(20) BRIAN WITWER........................................................................ Physician	42.0 .......................0.0		X		790,730	0	34,784
(21) John Lopez........................................................................ Physician	42.0 .......................0.0		X		786,745	0	34,607
(22) JAMES NARROD........................................................................ Physician	40.0 .......................0.0		X		704,556	0	34,553
(23) SUSAN HEMLEY........................................................................ Physician	42.0 .......................0.0		X		685,560	0	34,801
(24) LEONARD LAPKIN........................................................................ Physician	40.0 .......................0.0		X		584,253	0	21,602
(25) Robert Ladenburger........................................................................ CEO	0.0 .......................55.0			X	0	1,376,046	106,636

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,624,753	3,525,645	579,007

				(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		751,239
e	Government grants (contributions)1e		1,341,690

f	All other contributions, gifts, grants, and similar amounts not included above1f		3,492

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			2,096,421
			Business Code
2a	INPATIENT REVENUE		900099	281,581,252	281,581,252
b	EMERGENCY SERVICES		900099	34,544,098	34,544,098
c	OUTPATIENT RADIOLOGY		621990	22,036,677	22,036,677
d	REHABILITATION		621990	20,459,271	20,459,271
e	OUTPATIENT		621400	19,689,115	19,689,115
f	All other program service revenue .			573,841	573,841
g	Total. Add lines 2a–2f........			378,884,254
3	Investment income (including dividends, interest, and other similar amounts).......			7,452,477	1,972,900	37,391	5,442,186
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	1,604,045	458,521
b	Less: rental expenses	1,053,928	166,673
c	Rental income or (loss)	550,117	291,848
d	Net rental income or (loss).......			841,965		277,937	564,028
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		4,263,965
b	Less: cost or other basis and sales expenses		106,236
c	Gain or (loss)		4,157,729
d	Net gain or (loss)..........			4,157,729			4,157,729
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		206,351
b	Less: cost of goods sold ..b		137,966
c	Net income or (loss) from sales of inventory..			68,385			68,385
Miscellaneous Revenue			Business Code
11a	REFERENCE LAB		541380	2,417,696		2,417,696
b	CAFETERIA SALES		722514	1,557,429			1,557,429
c	BILLING SERVICES		541900	238,420		238,420
d	All other revenue ....			10,589,909		456,154	10,133,755
e	Total. Add lines 11a–11d ......			14,803,454
12	Total revenue. See Instructions......			408,304,685	380,857,154	3,427,598	21,923,512


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			428,235	1	3,265,676
2	Savings and temporary cash investments .........			3,670,318	2	4,957,463
3	Pledges and grants receivable, net ...........			0	3	0
4	Accounts receivable, net .............			52,155,700	4	68,485,337
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			6,608,501	8	6,342,862
9	Prepaid expenses and deferred charges ..........			3,886,943	9	3,249,893
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	602,500,342
b	Less: accumulated depreciation .....	10b	287,664,094	332,059,786	10c	314,836,248
11	Investments—publicly traded securities ..........			109,947,481	11	137,823,467
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			2,500,646	13	3,442,485
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			-35,118	15	-1,396,215
16	Total assets. Add lines 1 through 15 (must equal line 34)......			511,222,492	16	541,007,216
17	Accounts payable and accrued expenses .........			25,851,305	17	29,099,391
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other 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 ..			0	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....................			37,932,224	25	36,374,726
26	Total liabilities. Add lines 17 through 25.........			63,783,529	26	65,474,117
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			447,438,963	27	475,533,099
28	Temporarily restricted net assets ...........			0	28	0
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), 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 ...........			447,438,963	33	475,533,099
34	Total liabilities and net assets/fund balances ........			511,222,492	34	541,007,216