TY 2011 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) SISTER LILLIAN MARIE REITER CHAIRPERSON	1.0	X	X			0	0	0
(2) SISTER EILEEN SCHNEIDER OSB MEMBER	1.0	X				0	0	0
(3) SISTER MONICA SWIRCZYNSKI OSB SECRETARY	1.0	X	X			0	0	0
(4) SISTER DEPORRES POLK VICE CHAIRPERSON	1.0	X	X			0	0	0
(5) WARREN SHULL MEMBER	1.0	X				0	0	0
(6) STEVE COX MEMBER	1.0	X				0	0	0
(7) OH CLOPTON MD MEMBER	1.0	X				0	0	0
(8) BRIAN HYNEMANN MEMBER	1.0	X				0	0	0
(9) JOHN FREEMAN MEMBER	1.0	X				0	0	0
(10) GUY PATTESON CONVENER	1.0	X	X			0	0	0
(11) SISTER LISA O'CONNELL OSB MEMBER	1.0	X				0	0	0
(12) MARK DUCKWORTH MEMBER	1.0	X				0	0	0
(13) GARY WOODWARD CHIEF OF STAFF	1.0	X	X			0	0	0
(14) MICHAEL GIVENS ADMINISTRATOR	40.0		X			219,088	0	8,351
(15) HARRY HUTCHISON CFO	1.0		X			0	225,545	7,943
(16) BRENDA MILLION VP CHIEF NURSING OFFICER	40.0			X		176,795	0	6,389
(17) THOMAS MULLIGAN MEDICAL DIRECTOR SR HEALTH	40.0				X	274,442	0	180

(A) Name and business address	(B) Description of services	(C) Compensation
THERAPY PROVIDERS OF ARK LLC	PHYSICAL THERAPY	6,239,885
EMCARE INC	PHYSICIANS SERVICES	2,973,132
NABHOLZ CLIENT SERVICE	CONSTRUCTION	9,289,076
PHILIPS MEDICAL SYSTEMS	EQUIP MAINTENANCE	1,368,491
MEDICAL INFORMATION	COMPUTER SOFTWARE	1,336,125
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 66

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	1,125,606	1,125,606
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	41,250	41,250
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 ....	408,813	0	408,813	0
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	77,700,884	53,127,933	24,572,951	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	6,020,422	4,116,460	1,903,962	0
9	Other employee benefits .......	8,661,621	5,922,378	2,739,243	0
10	Payroll taxes ...........	5,767,999	3,943,866	1,824,133	0
11	Fees for services (non-employees):
a	Management ......	3,009,342	2,057,636	951,706	0
b	Legal .........	1,300,460	889,189	411,271	0
c	Accounting ...........	134,039	91,649	42,390	0
d	Lobbying ...........	27,255	18,636	8,619	0
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	126,248	86,322	39,926	0
g	Other ..........	26,992,358	18,456,009	8,536,349	0
12	Advertising and promotion ....	316,073	216,115	99,958	0
13	Office expenses .......	4,104,795	2,806,651	1,298,144	0
14	Information technology ......	1,123,841	768,426	355,415	0
15	Royalties ..	0
16	Occupancy ...........	4,326,933	2,958,538	1,368,395	0
17	Travel ............	755,371	516,484	238,887	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	100,065	68,419	31,646	0
20	Interest ...........	256,108	175,114	80,994	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	12,743,911	8,713,641	4,030,270	0
23	Insurance ..............	1,592,052	1,088,565	503,487	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	MEDICAL SUPPLIES	60,138,346	60,138,346	0	0
b	BAD DEBT EXPENSE	37,250,477	37,250,477	0	0
c	EQUIPMENT RENT	6,289,844	4,300,677	1,989,167	0
d	DIETARY SUPPLIES & FOOD	3,136,458	2,144,551	991,907	0
e
f	All other expenses	10,609,804	8,230,295	2,379,509
25	Total functional expenses. Add lines 1 through 24f	274,060,375	219,253,233	54,807,142	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	856,882	1	962,313
2	Savings and temporary cash investments .......	28,250,843	2	42,843,896
3	Pledges and grants receivable, net .........	0	3	0
4	Accounts receivable, net .........	20,971,777	4	22,987,495
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	0	5	0
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........	0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	4,434,800	8	4,822,285
9	Prepaid expenses and deferred charges ............	2,025,732	9	1,760,168
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	212,226,251
b	Less: accumulated depreciation. .....	10b	126,810,065	92,658,124	10c	85,416,186
11	Investments—publicly traded securities ..........	36,997,327	11	37,863,161
12	Investments—other securities. See Part IV, line 11 ......	0	12	0
13	Investments—program-related. See Part IV, line 11 ..	0	13	0
14	Intangible assets .........	0	14	0
15	Other assets. See Part IV, line 11 ...........	4,034,379	15	3,344,016
16	Total assets. Add lines 1 through 15 (must equal line 34)...	190,229,864	16	199,999,520
	17	Accounts payable and accrued expenses .	15,524,190	17	16,761,466
18	Grants payable ..........	0	18	0
19	Deferred revenue ..........	0	19	0
20	Tax-exempt bond liabilities ..........	7,445,000	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	4,995,000
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.....	34,291,118	25	38,148,322
26	Total liabilities. Add lines 17 through 25.....	57,260,308	26	59,904,788
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	131,441,857	27	138,524,795
28	Temporarily restricted net assets .....	1,527,699	28	1,569,937
29	Permanently restricted net assets .....	0	29	0
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	132,969,556	33	140,094,732
34	Total liabilities and net assets/fund balances .....	190,229,864	34	199,999,520

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Type I

Type II

Type III - Functionally integrated

Type III - Other

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

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

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

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

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

Page 2

Part II

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

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

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

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

Section C. Computation of Public Support Percentage

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

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

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

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

Schedule A (Form 990 or 990-EZ) 2011

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

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

Section D. Computation of Investment Income Percentage

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

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

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2011

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

OMB No. 1545-0047

2011

Name of organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2

Name of organization ST BERNARDS HOSPITAL INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

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

Page 4

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

Name of organization
ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Part III

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

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

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

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

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below.
SchCMd Bullet

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

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2011

Page 2

Part II-A

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

A Check if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check if the filing organization checked box A and "limited control" provisions apply.

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) Total

2a	Lobbying non-taxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2011

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

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

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

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

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

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

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

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

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

Yes

6,000

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

Other activities? ..........................

Yes

20,757

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

26,757

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Identifier	Return Reference	Explanation
OTHER ACTIVITIES	FORM 990, SCHEDULE C, PAGE 3, PART II-B, LINE 1I	PERCENTAGE OF DUES TO VARIOUS PROFESSIONAL ASSOCIATIONS ALLOCABLE TO LOBBYING EXPENSES $20,757

Schedule C (Form 990 or 990EZ) 2011

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

2011

Open to Public Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

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 170(h)(4)(B)(ii)? ....................................

Yes No

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

Part III

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

If the organization elected, as permitted under SFAS 116 (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 XIV, 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 Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2011

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

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


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

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

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

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

		(a)Current Year	(b)Prior Year	(c)Two Years Back	(d)Three Years Back	(e)Four Years Back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses ...
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

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)

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

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

Part VI

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 .................	4,310,168		4,310,168
b	Buildings ................	102,380,601	56,585,785	45,794,816
c	Leasehold improvements ............	3,227,087	1,920,276	1,306,811
d	Equipment ................	101,359,832	68,304,004	33,055,828
e	Other .................	948,563		948,563
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				85,416,186

Schedule D (Form 990) 2011

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		0
DUE TO AFFILIATES		279,124
ASSET RETIREMENT OBLIGATION		398,031
EST 3RD PARTY SETTLEMENTS		5,312,211
PENSION LIABILITY		32,158,956
OTHER LIABILITIES		0




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		38,148,322
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2011

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	291,693,199
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	274,060,375
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	17,632,824
4	Net unrealized gains (losses) on investments ..........................	4	1,172,805
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV.) .................................	8	-11,680,453
9	Total adjustments (net). Add lines 4 through 8 .........................	9	-10,507,648
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	7,125,176

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	255,127,938
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	1,172,805
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV.) ............	2d
e	Add lines 2a through 2d .....................			2e	1,172,805
3	Subtract line 2e from line 1.....................			3	253,955,133
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV.) ...........	4b	37,738,066
c	Add lines 4a and 4b.......................			4c	37,738,066
5	Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	291,693,199

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............			1	236,809,898
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV.) ............	2d
e	Add lines 2a through 2d......................			2e
3	Subtract line 2e from line 1.....................			3	236,809,898
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV.) ............	4b	37,250,477
c	Add lines 4a and 4b.......................			4c	37,250,477
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	274,060,375

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
FIN 48 FOOTNOTE	FORM 990, SCHEDULE D, PART X, LINE 2	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
OTHER CHANGES IN NET ASSETS	FORM 990, SCHEDULE D, PAGE 4, PART XI, LINE 8	CHANGE IN PENSION LIABILITY $(2,134,059) TRANSFER TO AFFILIATE $(9,591,043) CHANGE IN INTEREST IN NET ASSETS OF ST. BERNARDS DEVELOPMENT FOUNDATION, INC. $ 42,238 PET CENTER, LLC INCOME VS. BOOK INCOME $ (9,735) AR MEDICAL CYCLOTRON INCOME VS. BOOK INCOME $ 12,146 ----------- $(11,680,453)
OTHER REVENUE ON AUDITED FINANCIALS, BUT NOT IN INCOME ON RETURN	FORM 990, SCHEDULE D, PART XII, LINE 4B	PET CENTER, LLC LOSS VS. BOOK LOSS $ 9,735 AR MEDICAL CYCLOTRON INCOME VS. BOOK INCOME $ (12,146) CONTRIBUTIONS RECORDED TO NET ASSETS $ 490,000 PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 37,250,477 ------------ $37,738,066
OTHER EXPENSES ON RETURN, NOT INCLUDED AS EXPENSES ON AUDITED FINANCIALS	FORM 990, SCHEDULE D, PART XIII, LINE 4B	PROVISION FOR UNCOLLECTIBLE ACCOUNTS $37,250,477

Schedule D (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other

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

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

Yes

200% 250% 300% 350% 400% Other

If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

	(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Financial Assistance at cost (from Worksheet 1) ..		72,379	12,586,479	0	12,586,479	5.320 %
b Medicaid (from Worksheet 3, column a) .....		32,238	27,878,881	13,999,528	13,879,353	5.860 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .
dTotal Financial Assistance and Means-Tested Government Programs .....		104,617	40,465,360	13,999,528	26,465,832	11.180 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	23	236,662	266,882	34,593	232,289	0.190 %
f Health professions education (from Worksheet 5) ..	4	287	229,213	0	229,213	0.100 %
g Subsidized health services (from Worksheet 6) ..
h Research (from Worksheet 7)
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....	5	115,088	1,474,078	0	1,474,078	0.620 %
jTotal Other Benefits ...	32	352,037	1,970,173	34,593	1,935,580	0.910 %
kTotal. Add lines 7d and 7j. ..	32	456,654	42,435,533	14,034,121	28,401,412	12.090 %

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

Schedule H (Form 990) 2011

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	1	120	21,100	0	21,100	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	1	10	468	0	468
9	Other
10	Total	2	130	21,568	0	21,568	0.010 %

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........

37,250,477

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

3,725,048

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

Section B. Medicare

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

96,932,739

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

83,627,498

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

13,305,241

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

Management Companies and Joint Ventures

(see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2011

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest) How many hospital facilities did the organization operate during the tax year?3 Name and address		Other (Describe)
1	ST BERNARDS MEDICAL CENTER 225 E JACKSON AVE JONESBORO,AR72401	X	X	X	X	X	X	FAST TRACK ER
2	ST BERNARDS MEDICAL CENTER TCF 225 E JACKSON AVE JONESBORO,AR72401	X						SKILLED NURSING
3	ST BERNARDS MED CTR BEHAVIORAL HEALTH 2712 E JOHNSON JONESBORO,AR72401	X						ADULT PSYCH

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

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

ST BERNARDS MEDICAL CENTER

Name of Hospital Facility:

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1		No
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet the community health needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. ....		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 100% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

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

ST BERNARDS MEDICAL CENTER TCF

Name of Hospital Facility:

Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1		No
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet the community health needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. ....		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 100% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

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

ST BERNARDS MED CTR BEHAVIORAL HEALTH

Name of Hospital Facility:

Line Number of Hospital Facility (from Schedule H, Part V, Section A):3

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1		No
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet the community health needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. ....		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 100% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18	Yes
	If “No,” indicate why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?41
Name and address		Type of Facility (describe)
1	ST BERNARD'S IMAGING CENTER 1144 EAST MATTHEWS JONESBORO,AR72401	IMAGING CENTER
2	REFERENCE LAB 300 EAST MATTHEWS JONESBORO,AR72401	REFERENCE LAB
3	DIALYSIS 540 EAST WASHINGTON JONESBORO,AR72401	DIALYSIS
4	ST BERNARD'S BEHAVIORAL HEALTH UNIT 2712 EAST JOHNSON AVE JONESBORO,AR72401	BEHAVIORAL HEALTH
5	PHYSICAL THERAPY 225 EAST JACKSON JONESBORO,AR72401	PHYSICAL THERAPY
6	ST BERNARD'S WOUND HEALING CENTER 505 EAST MATTHEWS SUITE 201 JONESBORO,AR72401	WOUND HEALING
7	ST BERNARD'S HOME HEALTH 1726A MARIE CIRCLE JONESBORO,AR72401	HOME HEALTH
8	ST BERNARD'S HOSPICE 1726 MARIE CIRCLE JONESBORO,AR72401	HOSPICE
9	ST BERNARDS SENIOR HEALTH CLINIC 303 EAST MATTHEWS SUITE 202 JONESBORO,AR72401	SENIOR HEALTH
10	PHYSICAL THERAPY SPORTS MEDICINE 1416 EAST MATTHEWS JONESBORO,AR72401	PHYSICAL THERAPY
11	DIALYSIS - WYNNE 310 S FALLS BLVD WYNNE,AR72396	DIALYSIS
12	FLO & PHIL JONES HOSPICE HOUSE 1148 EAST MATTHEWS JONESBORO,AR72401	HOSPICE HOUSE
13	PHYSICAL THERAPY ASUSPORTS MEDICINE 333 STADIUM BLVD JONESBORO,AR72401	PHYSICAL THERAPY
14	PHYSICAL THERAPY PARKER ROAD 1001 PARKER ROAD JONESBORO,AR72401	PHYSICAL THERAPY
15	PHYSICAL THERAPY PARAGOULD 1105 WEST COURT PARAGOULD,AR72450	PHYSICAL THERAPY
16	PHYSICAL THERAPY SPEECH THERAPY 225 EAST JACKSON JONESBORO,AR72401	SPEECH THERAPY
17	PHYSICAL THERAPY - OCCUPATIONAL 4334 EAST HIGHLAND SUITE C JONESBORO,AR72401	OCCUPATIONAL THERAPY
18	PHYSICAL THERAPY TRUMANN 1300 INDUSTRIAL DR TRUMANN,AR72472	PHYSICAL THERAPY
19	CENTER FOR WEIGHT LOSS HMR 1416 EAST MATTHEWS JONESBORO,AR72401	WEIGHT LOSS
20	PHYSICAL THERAPY INDUSTRIAL REHAB 4334 EAST HIGHLAND SUITE C JONESBORO,AR72401	PHYSICAL THERAPY
21	PRE-ADMISSION TESTING 105 EAST MATTHEWS JONESBORO,AR72401	COUNSELING CENTER
22	PHYSICAL THERAPY MANILA 600 HWY 18 MANILA,AR72442	PHYSICAL THERAPY
23	ST BERNARDS BEHAVIORAL COUNSELING CENTE 615A EAST MATTHEWS JONESBORO,AR72401	COUNSELING CENTER
24	CARDIAC REHABILITATION 1416 EAST MATTHEWS JONESBORO,AR72401	CARDIAC REHAB
25	ST BERNARD'S DAYPLACE 700 EAST WASHINGTON JONESBORO,AR72401	ADULT DAY CARE
26	DIABETES MANAGEMENT CENTER 1416 EAST MATTHEWS JONESBORO,AR72401	DIABETES MANAGEMENT
27	SENIOR LIFE CENTER - JONESBORO 700 EAST WASHINGTON JONESBORO,AR72401	SENIOR CARE
28	SENIOR LIFE CENTER - MONETTE 504 S WILLIAMS MONETTE,AR72447	SENIOR CARE
29	SENIOR LIFE CENTER - LAKE CITY 401 WALNUT ST LAKE CITY,AR72437	SENIOR CARE
30	SENIOR LIFE CENTER - HARRISBURG 300 FAIR GROUND ROAD HARRISBURG,AR72432	SENIOR CARE
31	SENIOR LIFE CENTER - TRUMANN 351 CAMPBELL ST TRUMANN,AR72472	SENIOR CARE
32	SENIOR LIFE CENTER - LEPANTO 100 STEVENS SQUARE LEPANTO,AR72354	SENIOR CARE
33	SENIOR LIFE CENTER - MARKED TREE 212 10TH ST MARKED TREE,AR72365	SENIOR CARE
34	ST BERNARD'S PET CENTER LLC PO BOX 13267 MAUMELLE,AR72113	PET SCANNING
35	WOUND HEALING - PARAGOULD ONE MEDICAL DRIVE SUITE 201 PARAGOULD,AR72450	WOUND HEALING
36	SENIOR LIFE CENTER - WEST MEMPHIS 103 SOUTH AVALON WEST MEMPHIS,AR72301	SENIOR CARE
37	SENIOR LIFE CENTER - MERYER 713 E CANAL ST WYNNE,AR72396	SENIOR CARE
38	SENIOR LIFE CENTER - FORREST CITY 2550 S WASHINGTON FORREST CITY,AR72335	SENIOR CARE
39	SENIOR LIFE CENTER - NEWPORT 947 HOUT CIRCLE NEWPORT,AR72112	SENIOR CARE
40	SENIOR LIFE CENTER - WOODRUFF CO 303 W CACHE ST PATTERSON,AR72123	SENIOR CARE
41	SENIOR LIFE CENTER - CARAWAY 305 N NEW YORK AVE CARAWAY,AR72419	SENIOR CARE

Schedule H (Form 990) 2011

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
PERCENT OF TOTAL EXPENSE	PART I, LINE 7, COLUMN F	BAD DEBT EXPENSE IN THE AMOUNT OF $37,250,477 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) ("TOTAL FUNCTIONAL EXPENSES"), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN.
CHARITY CARE	PART I, LINE 7	THE AMOUNTS ON LINE 7A AND 7B WERE CALCULATED USING THE COST TO CHARGE RATIO.
BAD DEBT FOOTNOTE	PART III, LINE 4	BAD DEBT FOOTNOTE TO FINANCIAL STATEMENTS: THE MEDICAL CENTER PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE MEDICAL CENTER BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. SCHEDULE H, PART III, LINE 2 WAS DETERMINED USING THE OVERALL COST TO CHARGE RATIO FOR THE MOST RECENT "AS FILED" MEDICARE COST REPORT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3 WAS DETERMINED BY ANALYZING ACCOUNTS THAT HAVE BEEN DENIED FINANCIAL ASSISTANCE DUE TO A LACK OF DOCUMENTATION. MANY TIMES WE ARE UNABLE TO GET PATIENTS WHO WE THINK WOULD QUALIFY FOR CHARITY TO COMPLETE OUR CHARITY APPLICATION. OFTEN TIMES WE DON'T CLASSIFY SOMEONE AS CHARITY WHO WOULD EASILY QUALIFY IF THEY WOULD JUST COMPLETE THE PAPER WORK. SOMETIMES, DUE TO FAULTY ADDRESSES, WE CANNOT CONTACT THESE PATIENTS TO ATTEMPT TO QUALIFY THEM AS CHARITY. THERE IS A SIGNIFICANT AMOUNT OF BAD DEBT THAT IS, IN REALITY, CHARITY.
SOURCE USED	PART III, LINE 8	THE AMOUNTS WERE PULLED FROM THE MOST RECENT "AS FILED" MEDICARE COST REPORT. THE ORGANIZATION FOLLOWS CHA COMMUNITY BENEFIT GUIDELINES AND DOES NOT COUNT MEDICARE SHORTFALL AS COMMUNITY BENEFIT.
COLLECTION PRACTICES	PART III, LINE 9B	ACCOUNTS WHICH ARE DEEMED UNCOLLECTIBLE ARE REFERRED TO AN OUTSIDE AGENCY FOR COLLECTING. AN ACCOUNT IS CONSIDERED UNCOLLECTIBLE WHEN THE GUARANTOR HAS HAD SUFFICIENT NOTICE AND TIME TO PAY A BILL OR MAKE ARRANGEMENTS TO PAY A BILL, BUT HAS FAILED TO DO SO. MEDICARE BAD DEBT IS DEFINED ACCORDING TO CENTERS FOR MEDICARE AND MEDICAID SERVICES GUIDELINES.
NEEDS ASSESSMENT	PART VI, LINE 2	ST. BERNARDS HEALTHCARE PARTNERS WITH SOUTHWIND HEALTH PARTNERS EVERY TWO YEARS TO CONDUCT A PHYSICIAN NEEDS ASSESSMENT. PHYSICIAN NEEDS ASSESSMENTS ARE ESSENTIAL MANAGEMENT TOOLS THAT HELP ALIGN A HEALTHCARE ORGANIZATION'S PHYSICIAN STRATEGY WITH ITS MISSION AND GOALS. THE PRINCIPAL OBJECTIVES OF A PHYSICIAN NEEDS ASSESSMENT ARE TO FIND SURPLUSES OR DEFICITS OF PHYSICIANS IN A COMMUNITY, DOCUMENT COMMUNITY NEED IF IT EXISTS AND ASSIST HEALTHCARE ORGANIZATIONS IN DETERMINING THEIR ROLES IN ALTERING THE MIX OR SUPPLY OF PHYSICIANS IN A COMMUNITY. BASIC COMPONENTS OF THE ASSESSMENT INCLUDE: I. SERVICE AREA DEFINITION AND DEMOGRAPHICS THE SERVICE AREA DEFINITION IS A BREAKDOWN OF THE ORGANIZATION'S SERVICE AREA BY IDENTIFIABLE BOUNDARIES THAT MAY INCLUDE ZIP CODES OR COUNTY LINES. THE SERVICE AREA FOR SBHC IS COMPRISED OF A PRIMARY SERVICE AREA FROM WHICH A MAJORITY OF THE PATIENT BASE ORIGINATES AND THEN A SECONDARY SERVICE AREA FROM WHICH A SMALLER, BUT SIGNIFICANT, PORTION OF THE PATIENT BASE ORIGINATES. SBMC ALSO HAS A TERTIARY SERVICE AREA INCLUDED IN THE ANALYSES. CRITERIA USED TO DETERMINE WHETHER OR NOT A ZIP CODE OR COUNTY IS INCLUDED IN THE TOTAL SERVICE AREA MAY INCLUDE 1) MARKET SHARE IN THAT AREA MEETS A SPECIFIC TARGET; 2) RESIDENTS WITHIN A COMMUNITY CONTRIBUTE A CERTAIN PERCENTAGE TO OVERALL VISITS/DISCHARGES: AND/OR 3) THE AREA MEETS OTHER REQUIREMENTS DEFINED BY SBHC, SUCH AS BEING WITHIN A CERTAIN DISTANCE OR DRIVING TIME. ONCE THE SERVICE AREA IS DETERMINED, DEMOGRAPHICS OF THE SERVICE AREA ARE STUDIED TO DETERMINE FACTORS OR CHARACTERISTICS THAT WILL AFFECT THE HEALTH CARE RESOURCES NEEDED IN THAT COMMUNITY. THESE FACTORS MAY INCLUDE, BUT ARE NOT LIMITED TO, A LARGE MEDICARE OR MEDICAID POPULATION, OVERALL HEALTHCARE INSURANCE COVERAGE, GEOGRAPHIC BARRIERS, MEDIAN/AVERAGE HOUSEHOLD INCOME, HEALTHCARE UTILIZATION, PAYER MIX, MANAGED CARE PENETRATION, AND MARKET-SHARE DISTRIBUTION. II. PHYSICIAN DEMOGRAPHICS AFTER ANALYZING COMMUNITY DEMOGRAPHICS, THE PHYSICIAN INFRASTRUCTURE OF THE SERVICE AREA IS ASSESSED. A ROSTER OF EVERY ACTIVE PHYSICIAN IN THE COMMUNITY, DETAILING EACH PHYSICIAN'S SPECIALTY OR SUBSPECIALTY, ADDRESS, AGE, MEDICAL STAFF STATUS AND FULL-TIME EQUIVALENCY (FTE) IN THE COMMUNITY IS DEVELOPED. THIS DETERMINES THE SIZE AND MAKEUP OF THE PHYSICIAN COMMUNITY BY SPECIALTY AND IDENTIFIES WHICH SPECIALTIES/SERVICES ARE AREAS OF STRENGTH AND WHICH AREAS MAY BENEFIT FROM STRATEGIC ACTION INCLUDING RECRUITMENT AND/OR INVESTMENT OF TIME AND RESOURCES. III. PHYSICIAN NEED DETERMINATION ONCE THE SERVICE AREA IS BETTER UNDERSTOOD IN TERMS OF COMMUNITY DEMOGRAPHICS AND PHYSICIAN INFRASTRUCTURE, THE APPROPRIATE SUPPLY AND MIX OF PHYSICIANS IS ASSESSED. SEVERAL DIFFERENT METHODS, INCLUDING SUPPLY-BASED PLANNING, NEED-BASED PLANNING, INTERVIEWING/SURVEYING, DEMAND-BASED PLANNING AND BENCHMARKING ARE USED TO DETERMINE PHYSICIAN NEED. IV. CALCULATION OF PHYSICIAN SURPLUSES AND DEFICITS USING THE CURRENT SUPPLY AND PROJECTED PHYSICIAN NEEDS, PHYSICIAN SURPLUSES AND DEFICITS ARE DETERMINED FOR A COMMUNITY. THE RATIONALE IS THAT THERE SHOULD BE 1.0 FTE PHYSICIAN SUPPLY, OR A COMBINATION OF PART-TIME PHYSICIANS THAT EQUAL A 1.0 FTE, IN THE COMMUNITY FOR EVERY 1.0 FTE PHYSICIANS THAT IS NEEDED. IF NOT, A SURPLUS OR DEFICIT EXISTS. V. RECOMMENDATIONS AND CONCLUSIONS THE SURPLUSES AND DEFICITS THAT ARE CALCULATED IN THE PHYSICIAN NEEDS ASSESSMENT ARE RANKED AND EVALUATED TO DETERMINE RECRUITMENT PRIORITIES FOR SBHC. QUANTITATIVE PLANNING ANALYSIS, MEDICAL STAFF INTERVIEWS/SURVEY RESULTS, MARKET SHARE POTENTIAL AND SERVICE LINE PRIORITY ARE ALL CONSIDERED IN MAKING RECOMMENDATIONS AND SETTING PRIORITIES REGARDING PHYSICIAN NEED. RESULTS IN 2010, THE FOLLOWING SPECIALTIES WERE RECRUITED: PLASTIC SURGERY (1), FAMILY PRACTICE (1), HOSPITALIST (4), NEPHROLOGY (1), INTERVENTIONAL CARDIOLOGY (1), EMERGENCY MEDICINE (4), PSYCHIATRY (1), AND NEUROSURGERY (1). *REFER TO 2010 PHYSICIAN NEEDS ASSESSMENT FOR COMPLETE DETAILS.
PATIENT EDUCATION	PART VI, LINE 3	ALL REGISTRATION AREAS HAVE OUR FINANCIAL ASSISTANCE NOTICE EITHER ON THE REGISTRATION DESK, ON THE WALL AT REGISTRATION OR IN A DISPLAY CASE IN REGISTRATION. THIS INCLUDES, GENERAL ADMISSIONS, RADIOLOGY, ER (ALSO EVERY ROOM IN THE ER), DIALYSIS, RADIATION ONCOLOGY AND HEARTCARE CENTER, IMAGING CENTER AND WOUND CENTER. UPON REGISTRATION, IF REGISTERED AS A SELF PAY, A FINANCIAL APPLICATION AUTOMATICALLY PRINTS AND IS GIVEN TO THE PATIENT. APPLICATIONS ALONG WITH SBHC ENVELOPES ARE DISPLAYED AT THE DESK FOR ANYONE TO PICK UP. INFORMATION AND TELEPHONE NUMBERS ARE ON THE BACK OF ALL OUR STATEMENTS AND LETTERS THAT GO OUT TO PATIENTS. A THIRD PARTY LOOKS AT ALL INPATIENTS THAT ARE SELF PAY AND CONTACTS THE PATIENT TO SEE IF THEY WOULD BE ELIGIBLE FOR MEDICAID, CHARITY, OR ANY OTHER ASSISTANCE. OUR FINANCIAL ASSISTANCE APPLICATION AND PHONE NUMBER ARE ALSO AVAILABLE ON OUR WEB SITE WWW.STBERNARDS.INFO AND FINANCIAL ASSISTANCE INFORMATION IS PRINTED ON EACH STATEMENT MAILED TO PATIENTS.
COMMUNITY INFORMATION	PART VI, LINE 4	ST. BERNARDS HEALTHCARE (SBHC), A NOT-FOR-PROFIT HEALTH SYSTEM, IS GUIDED BY A COMMUNITY-BASED CHARITABLE MISSION. ALTHOUGH THE ORGANIZATION'S FIRST PRIORITY IS TO PROVIDE QUALITY HEALTHCARE, AS A CORPORATE LEADER, SBHC RECOGNIZES THE POSITIVE AND CRITICAL IMPACT OF ITS COMMUNITY HEALTH INITIATIVES FOR THE RESIDENTS OF NORTHEAST ARKANSAS AND SOUTHEAST MISSOURI. THE SERVICE AREA IS DEFINED AS 23 COUNTIES, 17 IN ARKANSAS AND SIX IN MISSOURI. THE COUNTIES HAVE BEEN DIVIDED INTO PRIMARY, SECONDARY AND TERTIARY SERVICES BASED ON ADMISSIONS BY COUNTY. OF THE 23 COUNTIES, 18 COUNTIES ARE HEALTH PROFESSIONAL SHORTAGE AREAS AND 22 COUNTIES INCLUDE MEDICALLY UNDERSERVED AREAS OR MEDICALLY UNDERSERVED POPULATIONS. BASED ON 2000 CENSUS DATA, THE TOTAL SERVICE AREA POPULATION IS ESTIMATED AT 623,552 IN 2007 WITH A FORECASTED POPULATION OF 626,470 BY 2014. THE MEDIAN HOUSEHOLD INCOME FOR THE PRIMARY SERVICE AREA IS $33,701 WHICH IS APPROXIMATELY 86% OF THE ARKANSAS MEDIAN INCOME LEVEL AT $39,079 AND IS 66% OF THE UNITED STATES MEDIAN HOUSEHOLD INCOME AT $51,287. BOTH THE SECONDARY AND TERTIARY SERVICE AREAS FALL BELOW THAT OF THE PRIMARY SERVICE AREA. ST. BERNARDS HEALTHCARE ADDRESSES COMMUNITY HEALTH NEEDS BY IMPLEMENTING HEALTH PROMOTION, PREVENTION INTERVENTION, AND HEALTHCARE SERVICES TO THE UNINSURED, UNDERINSURED, AND UNDERSERVED POPULATIONS IN OUR PRIMARY SERVICE AREAS.
PROMOTION OF COMMUNITY HEALTH	PART VI, LINE 5	THE HOSPITAL COORDINATES THE ARKANSAS HOSPITAL PREPAREDNESS PROGRAM FOR THE NORTHEAST REGION OF THE STATE. THE PURPOSE IS TO ENHANCE THE CAPACITIES AND CAPABILITIES OF HEALTHCARE SYSTEMS AND FOR EXERCISING AND IMPROVING PREPAREDNESS PLANS FOR ALL-HAZARDS INCLUDING PANDEMIC INFLUENZA. THE COUNTIES WITHIN THE REGION ARE CLAY, CRAIGHEAD, CRITTENDEN, CROSS, GREENE, LAWRENCE, LEE, MISSISSIPPI, MONROE, PHILLIPS, POINSETT, PRAIRIE, RANDOLPH AND ST. FRANCIS COUNTIES. THE REGION PARTICIPATES IN TESTING AND USING THE TANDBERGS VIDEO CONFERENCING SYSTEM. THE REGION WORKS WITH ADH TO COORDINATE AND ENSURE MAINTENANCE OF THE LINE FOR THE TANDBERGS. THE REGION USES EMSYSTEMS EMRESOURCE FOR HOSPITAL BED TRACKING. ST BERNARDS PROVIDES A BIOTERRORISM PREPAREDNESS COORDINATOR WHO SERVES AS A CENTRAL POINT OF CONTACT FOR EMERGENCY PREPAREDNESS ACTIVITIES OF THE ARKANSAS DEPARTMENT OF HEALTH & HUMAN SERVICES. THE HOSPITAL CONDUCTS BIOTERRORISM TRAINING AND EDUCATION ACTIVITIES FOR HOSPITAL STAFF AND OTHER EMERGENCY MEDICAL RESPONDERS. THE HOSPITAL PARTICIPATES IN REGIONAL DRILLS AND TESTING OF HAM & AWIN RADIOS AND THE FACILITY MUST BE 100% NIMS COMPLIANT. THE HOSPITAL COORDINATES WITH LOCAL OEM, EMS, PUBLIC HEALTH, COMMUNITY HEALTH CENTERS, LONG TERM HEALTH CARE, INCLUDING NURSING HOMES, AND OTHERS AS APPROPRIATE.
AFFILIATED HEALTH CARE SYSTEM	PART VI, LINE 6	SBHC SYSTEM FOCUSES ITS ENERGIES AND RESOURCES ON PARTNERSHIPS THAT HAVE THE GREATEST POTENTIAL FOR A POSITIVE IMPROVEMENT IN THE HEALTH AND QUALITY OF LIFE FOR INDIVIDUALS AND COMMUNITIES. AREAS WHERE CONSIDERABLE ACTIVITY IS EXPENDED INCLUDE: - COMMUNITY HEALTH EDUCATION, PREVENTION, EARLY DETECTION, AND INTERVENTION ACTIVITIES THAT WOULD REDUCE THE INCIDENCE AND SERIOUSNESS OF ILLNESS, THEREBY MINIMIZING THE NEED FOR PREVENTABLE AND EXPENSIVE MEDICAL INTERVENTIONS. - CHRONIC DISEASE MANAGEMENT ACTIVITIES, WHICH, WHEN DONE EFFECTIVELY, MINIMIZE THE NEED FOR MEDICAL INTERVENTIONS. - PROACTIVE HEALTH GRANT PROGRAMS THAT FUND COMMUNITY BASED HEALTH PROGRAMS AND INITIATIVES. - INCREASING ACCESS TO HEALTH COVERAGE FOR ELIGIBLE RESIDENTS IN PROGRAMS SUCH AS AR KIDS FIRST. - INCREASING ACCESS TO HEALTHCARE SERVICES FOR THOSE IN NEED REGARDLESS OF ABILITY TO PAY. - COLLABORATIVE PARTNERSHIPS THAT SUPPORT THE PURPOSE OF INCREASING INDIVIDUAL AND COMMUNITY CAPACITY TO ACHIEVE THE HEALTHY COMMUNITY VISION. - HEALTH RESEARCH, EDUCATION AND TRAINING PROGRAMS. - DONATIONS OF FOOD, SURPLUS EQUIPMENT AND STAFF TIME TO ORGANIZATIONS ADDRESSING THE HEALTH NEEDS OF THE COMMUNITY. - PARTNERSHIPS WHICH MOTIVATE RESIDENTS TO GIVE BACK TO THEIR COMMUNITIES TO MOVE THE COMMUNITY CLOSER TO THE HEALTHY COMMUNITY VISION.
ACTIONS PRIOR TO COLLECTION	PART V, LINE 17E	THE FOLLOWING STATEMENT APPLIES TO ALL THREE LICENSED HOSPITAL FACILITIES LISTED IN PART V, SECTION A. ATTEMPTS MADE TO CONTACT THE PATIENT PRIOR TO PLACING WITH COLLECTIONS. (PHONE CALLS, STATEMENTS/LETTERS)
GROSS CHARGE TO PATIENTS	PART V, LINE 21	THE FOLLOWING STATEMENT APPLIES TO ALL THREE LICENSED HOSPITAL FACILITIES LISTED IN PART V, SECTION A. SELF PAY PATIENTS RECEIVE AN AUTOMATIC DISCOUNT. GROSS CHARGES ARE BILLED TO INSURANCE. PATIENT OWES DIEFFERENCE IN ALLOWED AND PAID.
PUBLICIZE THE POLICY	PART V, LINE 13G	THE FOLLOWING STATEMENT APPLIES TO ALL THREE LICENSED HOSPITAL FACILITIES LISTED IN PART V, SECTION A. SOCIAL WORKERS PROVIDE THE POLICY TO PATIENTS THEY WORK WITH.
EFFORTS THE HOSPITAL FACILITY MADE	PART V, LINE 17	FOR EACH OF THE THREE FACILITIES, LINE 17 WAS ANSWERED SHOWING THE ACTIONS THAT THE HOSPITAL FACILITY TOOK BEFORE INITIATING ANY OF THE COLLECTION ACTIONS LISTED IN LINE 16.

Schedule H (Form 990) 2011

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

2011

Open to Public
Inspection

Name of the organization
ST BERNARDS HOSPITAL INC

Employer identification number
71-0290019

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance
(1) AHEC - UAMS223 EAST JACKSON JONESBORO,AR72401	71-6046242	501(C)(3)	1,050,000	N/A	N/A	GENERAL SUPPORT
(2) AR HOSPITAL EDUCATION & RESEARCH TRUST419 NATURAL RESOURCES DR LITTLE ROCK,AR72205	71-0563245	501(C)(3)	45,645	N/A	N/A	GENERAL SUPPORT
(3) ARKANSAS STATE UNIVERSITY2713 PAWNEE STREET UNVERSITY,AR72467	71-6000556	501(C)(3)	10,000	N/A	N/A	GENERAL 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 Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2011

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance
(1) SCHOLARSHIP	7	41,250	N/A	N/A

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
MONITORING PROCEDURES FOR THE USE OF GRANT FUNDS	FORM 990, SCHEDULE I, PART I, LINE 2	THE ORGANIZATION MAKES ONE TIME GRANTS TO ORGANIZATIONS QUALIFYING AS A CHARITY IN THE U.S. BASED ON APPLICATIONS RECEIVED BY THE ORGANIZATION. GRANTS ARE FOR A SPECIFIC PURPOSE OR USE AND POST GRANT MONITORING IS PERFORMED ON AN AS NEEDED BASIS.

Schedule I (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

Yes

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. 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? ........

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

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

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

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

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

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

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

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

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

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

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

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

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2011

Page 2

Part II

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

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1) BRENDA MILLION	(i) (ii)	176,795 0	0 0	0 0	0 0	6,389 0	183,184 0	0 0
(2) THOMAS MULLIGAN	(i) (ii)	271,481 0	2,961 0	0 0	0 0	180 0	274,622 0	0 0
(3) DAVID L PYLE	(i) (ii)	246,781 0	0 0	0 0	0 0	8,351 0	255,132 0	0 0
(4) BENJAMIN SHAW	(i) (ii)	290,376 0	0 0	0 0	0 0	8,351 0	298,727 0	0 0
(5) DON HOWARD	(i) (ii)	358,629 0	0 0	0 0	0 0	8,351 0	366,980 0	0 0
(6) MICHAEL GIVENS	(i) (ii)	219,088 0	0 0	0 0	0 0	8,351 0	227,439 0	0 0
(7) HARRY HUTCHISON	(i) (ii)	0 225,545	0 0	0 0	0 0	0 7,943	0 233,488	0 0
(8) KHALED AL KHASAWNEH	(i) (ii)	268,982 0	20,000 0	0 0	0 0	105 0	289,087 0	0 0

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

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

Identifier	Return Reference	Explanation
EXPENSE REIMBURSEMENT POLICY	FORM 990, SCHEDULE J, PART I, LINE 1B	THE ORGANIZATION IS CONSIDERING IMPLEMENTING A WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF THE EXPENSES ON SCHEDULE J, PART I, LINE 1A.
DEFINED BENEFIT PENSION PLAN	FORM 990, SCHEDULE J, PART II, COLUMN D	THE INCREASE OF THE ACTUARIAL VALUE OF THE DEFINED BENEFIT PENSION PLAN IS NOT CALCULATED ON AN INDIVIDUAL EMPLOYEE BASIS BUT RATHER ON THE EMPLOYEE GROUP TAKEN AS A WHOLE. THE INCREASE IN EACH INDIVIDUAL'S BALANCE WOULD HAVE TO BE ESTIMATED USING ASSUMPTIONS UNIQUE TO THAT INDIVIDUAL RATHER THAN THE PLAN AS A WHOLE. THIS INFORMATION IS NOT AVAILABLE AT THIS TIME. HOWEVER, WE BELIEVE THE INCREASE TO EACH INDIVIDUAL'S ACCOUNT WOULD NOT MATERIALLY CHANGE THE COMPENSATION REPORTED. WE WILL WORK WITH OUR ACTUARY TO DETERMINE THE ANNUAL INCREASE IN FUTURE PERIODS.

Schedule J (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

NonCash Contributions

Complete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Part I

Types of Property

	(a) Check if applicable	(b) Number of Contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .	X	55	49,010	COST
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( RADIOS )	X	176	25,389	COST
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it

must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ............................

32a

If "Yes," describe in Part II.

If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) 2011

Page 2

Part II

Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33 and whether the organization is reporting in Part I, column (b) the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Identifier	Return Reference	Explanation

Schedule M (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Identifier	Return Reference	Explanation
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	FORM 990, PAGE 3, PART III(a)	ST. BERNARDS MEDICAL CENTER (SBMC) BEGAN SERVING THE CITIZENS OF NORTHEAST ARKANSAS IN THE YEAR 1900. THROUGH ITS MISSION OF PROVIDING CHRIST-LIKE-HEALING TO THE COMMUNITY THROUGH EDUCATION, TREATMENT, AND HEALTH SERVICES IT IS THE SAFETY NET PROVIDER FOR A 23 COUNTY AREA THAT INCLUDES SOUTHEAST MISSOURI. IN ACCORDANCE WITH ITS STATED MISSION AND VALUES OF PROVIDING CHRIST-LIKE HEALING SBMC IS COMMITTED TO PROVIDING HEALTHCARE SERVICES REGARDLESS OF A PERSON'S ABILITY TO PAY. CHARITY IS A CORE COMPONENT OF THE MISSION OF THE OLIVETAN BENEDICTINE SISTERS AND ITS HEALTHCARE MINISTRY. IN THE FISCAL YEAR WHICH ENDED SEPTEMBER 30, 2012, SBMC PROVIDED $11,731,000 IN CHARITY CARE. THE TOTAL AMOUNT OF QUANTIFIABLE COMMUNITY BENEFITS PROVIDED BY ST. BERNARDS MEDICAL CENTER WAS $28,401,412 IN FISCAL YEAR 2012 THROUGH 456,654 ENCOUNTERS WITH INDIVIDUALS INVOLVING HEALTH SCREENINGS, EDUCATION, DONATIONS, AND VOLUNTEER ACTIVITIES. IN PROVIDING EDUCATION, TREATMENT AND HEALTHCARE SERVICES SBMC BELIEVES FINANCIAL MATTERS ARE SECONDARY TO THE RENDERING OF THESE SERVICES. NO PERSON WHO SEEKS THESE SERVICES WILL BE TURNED AWAY. SBMC PROVIDES DIRECT FINANCIAL ASSISTANCE (CHARITY) USING A SLIDING SCALE BASED UPON INCOME LEVELS OF THE CURRENT FEDERAL INCOME POVERTY GUIDELINES AS ESTABLISHED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. PATIENTS WHO HAVE NO INSURANCE WILL RECEIVE A DISCOUNT FROM CHARGES AND SBMC DOES NOT TAKE LEGAL ACTION AGAINST ANY DEBTOR FOR SERVICES PROVIDED THROUGH ITS MISSION. IN FISCAL YEAR 2012 SBMC PROVIDED 80,485 PATIENT DAYS OF CARE. 46,794 PATIENT DAYS WERE PROVIDED TO THE ELDERLY WHILE 10,287 WERE PROVIDED TO THE MEDICALLY INDIGENT OR WHO HAD MEDICAID COVERAGE. 52,135 PATIENTS WERE SEEN IN THE SBMC EMERGENCY ROOM DURING THE SAME TIME PERIOD. TODAY, AS WELL INTO THE FUTURE, SBMC WILL CONTINUE TO PUT PATIENTS AND COMMUNITY NEEDS FIRST BY FOCUSING ON QUALITY, SAFETY, COST CONTROL, SERVICE, AND DIVERSITY.
MEMBER INFORMATION	FORM 990, PART VI, LINES 6, 7a, & 7b	ST. BERNARDS HEALTHCARE, INC. IS THE SOLE MEMBER OF ST. BERNARDS MEDICAL CENTER. THE MEMBER RESERVES POWER OVER THE FOLLOWING ACTS: A. ANY AGGREGATE BORROWING BY THE CORPORATION OF FUNDS IN EXCESS OF $1 MILLION FOR ANY SINGLE TRANSACTION OR PROJECT. B. ANY PURCHASE, SALE, LEASE, DISPOSITION, EXCHANGE, GIFT PLEDGE, OR MORTGAGE OF REAL ESTATE PROPERTY VALUED IN EXCESS OF $1 MILLION. C. ANY VARIANCE WITH CONGREGATIONL POLICY, PHILOSOPHY, OR ETHICS OF THE MEMBER. D. ANY AMENDMENT, ALTERATION, OR REPEAL OF THE BYLAWS. E. THE POWER OF THE MEMBER TO REMOVE ANY MEMBER OF THE GOVERNING BOARD IF IN THE SOLE DISCRETION OF MEMBER THE GOVERNING BOARD MEMBER ACTS AT VARIANCE WITH CONGREGATIONAL POLICY, PHILOSOPHY, OR THE ETHICS OF THE MEMBER. ALL OF THE DESCRIBED MATTERS SHALL BE SUBJECT TO APPROVAL BY A MAJORITY VOTE OF THE MEMBERS OF THE COUNCIL OF OLIVETAN BENEDICTINE SISTERS, INC.
REVIEW PROCEDURES FOR FORM 990	FORM 990, PART VI, LINE 11B	THE FORM 990 IS REVIEWED BY THE FOLLOWING PERSONS OR GROUPS: CONTROLLER OF ST. BERNARDS HEALTHCARE, INC., VICE PRESIDENT OF FINANCE OF ST. BERNARDS HEALTHCARE, INC., PRESIDENT/CEO OF ST. BERNARDS HEALTHCARE, INC., LEGAL COUNSEL, AND THE AUDIT COMMITTEE OF ST. BERNARDS HEALTHCARE, INC. PRIOR TO FILING.
CONFLICT OF INTEREST MONITORING POLICY	FORM 990, PART VI, LINE 12C	DIRECTORS AND ABOVE ANNUALLY SUBMIT A WRITTEN STATEMENT DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST. MANAGEMENT INVESTIGATES ANY POTENTIAL CONFLICTS AND TAKES APPROPRIATE ACTION DEPENDING ON THE NATURE OF THE CONFLICT. LEGAL COUNSEL ALSO REVIEWS ANY POTENTIAL CONFLICTS OF INTEREST AND ADVISES MANAGEMENT.
COMPENSATION REVIEW & DETERMINATION PROCEDURES	FORM 990, PART VI, LINE 15A & 15B	THE BOARD OF DIRECTORS SELECTS DIRECTORS TO SERVE ON THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES THE INITIAL SALARY AND ANY SUBSEQUENT SALARY ADJUSTMENTS OF ALL MANAGEMENT. THE COMPENSATION COMMITTEE OBTAINS AN INDEPENDENT SALARY SURVEY FROM CLARK CONSULTING ON AN ANNUAL BASIS FOR USE IN DETERMINING THE APPROPRIATE SALARY RANGES FOR MANAGEMENT. THE COMPENSATION COMMITTEE PRESENTS THE INFORMATION TO THE BOARD FOR APPROVAL. IN 2009, COMPENSATION OF ALL MANAGEMENT PERSONNEL AND ALL OTHER EMPLOYEES OF THE ORGANIZATION WAS REVIEWED BY CLARK CONSULTING.
PARTICIPATION IN JOINT VENTURE ARRANGEMENTS	FORM 990, PART VI, LINE 16B	ALL OPERATING AGREEMENTS OF JOINT VENTURE ARRANGEMENTS IN WHICH THE ORGANIZATION PARTICIPATES CONTAIN A CLAUSE THAT SAFEGUARDS THE ORGANIZATION'S EXEMPT STATUS.
AVAILABILITY OF GOVERNING DOCUMENTS	FORM 990, PART VI, LINE 19	THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC.
OTHER CHANGES IN NET ASSETS	FORM 990, PART XI, LINE 5	CHANGE IN PENSION LIABILITY $(2,134,059) TRANSFER TO AFFILIATE $(9,591,043) CHANGE IN INTEREST IN NET ASSETS OF ST. BERNARDS DEVELOPMENT FOUNDATION, INC. $ 42,238 CHANGE IN UNREALIZED GAINS ON INVESTMENTS $ 1,172,805 PET CENTER, LLC INCOME VS. BOOK INCOME $ (9,735) AR MEDICAL CYCLOTRON INCOME VS. BOOK INCOME $ 12,146 ------------ $(10,507,648)
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:HARRY HUTCHISON TITLE:CFO HOURS:40

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) ST BERNARDS HEALTHCARE INC (SBHCI) 225 EAST JACKSON JONESBORO,AR72401 71-0853900	HEALTHCARE	AR	501(C)(3)	9	OBS		No
(2) OLIVETAN BENEDICTINE SISTERS INC PO DRAWER 130 JONESBORO,AR72403 71-0654621	CONVENT	AR	501(C)(3)	N/A	NA		No
(3) ST BERNARDS COMM HOSPITAL 310 SOUTH FALLS BLVD WYNNE,AR72396 71-0835247	HEALTHCARE	AR	501(C)(3)	3	SBHCI		No
(4) ST BERNARDS VILLAGE INC 225 EAST JACKSON JONESBORO,AR72401 71-0805203	HOUSING	AR	501(C)(3)	9	SBHCI		No
(5) BENEDICTINE MANOR I 225 EAST JACKSON JONESBORO,AR72401 20-8030553	HOUSING	AR	501(C)(3)	7	VILLAGE		No
(6) BENEDICTINE MANOR II 225 EAST JACKSON JONESBORO,AR72401 20-8030603	HOUSING	AR	501(C)(3)	7	VILLAGE		No
(7) JONESBORO REAL ESTATE HOLDINGS INC 225 EAST JACKSON JONESBORO,AR72401 71-0835010	REAL ESTATE	AR	501(C)(3)	11	SBHCI		No
(8) TOTAL LIFE HEALTHCARE 700 EAST WASHINGTON AVE JONESBORO,AR72401 26-0262745	HEALTHCARE	AR	501(C)(3)	9	SBHCI		No
(9) ST BERNARDS DEVELOPMENT FOUNDATION 400 EAST STREET JONESBORO,AR72401 71-0563245	SUPPORT	AR	501(C)(3)	7	OBS		No
(10) MATTHEWS MEDICAL MILE 225 EAST JACKSON JONESBORO,AR72401 27-3865388	ADVERTISING	AR	501(C)(3)	9	SBHCI		No
(11) AUX TO ST BERNARDS MEDICAL CENTER 225 E JACKSON JONESBORO,AR72401 71-0493824	FUNDRAISING	AR	501(C)(3)	11A	SBHI	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2011

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(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) PET CENTER LLC PO BOX 13267 MAUMELLE,AR72113 71-0876911	P.E.T. SCANS	AR	NA	RELATED	111,735	336,255		No	0		No	51.000 %
(2) ALLCARE OF ARKANSAS 225 EAST JACKSON JONESBORO,AR72401 20-3315907	HEALTHCARE	AR	NA	NONE	0	0		No	0		No	0 %
(3) OUTPATNT SRGRY CTR 1100 E MATTHEWS JONESBORO,AR72401 74-3052826	HEALTHCARE	AR	NA	NONE	0	0		No	0		No	0 %
(4) PAIN CENTER LLC 505 EAST MATTHEWS STE 103 JONESBORO,AR72401 33-1048492	PAIN MGT	AR	NA	NONE	0	0		No	0		No	0 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)
(1) REGIONAL HEALTHCARE HOLDINGS INC PO BOX 9320 JONESBORO,AR72403 73-1650896	HOLDING CO	AR	NA	C CORP
(2) JONESBORO ANESTHESIA INC 221 HUGHES STE C JONESBORO,AR72401 02-0644209	ANESTHESIOLOG	AR	NA	C CORP
(3) HEART SURGERY ASSOCIATION PO BOX 9320 JONESBORO,AR72403 20-0120406	HEALTHCARE	AR	NA	C CORP
(4) MID SOUTH NEUROSURGERY PO BOX 9320 JONESBORO,AR72403 20-1345149	NEUROSURGERY	AR	NA	C CORP
(5) JONESBORO NEUROSURGERY CLINIC PO BOX 9320 JONESBORO,AR72403 20-5938180	NEUROSURGERY	AR	NA	C CORP
(6) DOCTORS HEALTH GROUP PO BOX 9320 JONESBORO,AR72403 71-0788355	HEALTHCARE	AR	NA	C CORP
(7) REGIONAL HEALTHCARE SERVICES PO BOX 9320 JONESBORO,AR72403 71-0780305	HEALTHCARE	AR	NA	C CORP
(8) SURGICAL ASSOCIATES OF JONESBORO PO BOX 9320 JONESBORO,AR72403 26-3827817	HEALTHCARE	AR	NA	C CORP
(9) HEALTH NET INC PO BOX 9320 JONESBORO,AR72403 71-0792538	HEALTHCARE	AR	NA	C CORP
(10) THE HEARTCARE CENTER INC 225 EAST JACKSON JONESBORO,AR72401 20-2061837	HEALTHCARE	AR	NA	C CORP
(11) JONESBORO PLASTIC SURGERY 800 S MAIN STREET JONESBORO,AR72401 27-1450995	PLASTIC SURGE	AR	NA	C CORP
(12) OB-GYN ASSOC OF JONESBORO 800 S MAIN STREET JONESBORO,AR72401 27-2717909	OB-GYN	AR	NA	C CORP
(13) CARDIOLOGY ASSOCIATES OF JONESBORO 800 S MAIN ST JONESBORO,AR72401 27-3757274	CARDIOLOGY	AR	NA	C CORP
(14) CLOPTON CLINIC OF JONESBORO INC 800 S MAIN ST JONESBORO,AR72401 27-3722124	HEALTHCARE	AR	NA	C CORP

Schedule R (Form 990) 2011

Page 3

Part V

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

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

Yes

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

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

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

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) ST BERNARDS PET CENTER	K	181,608	FMV
(2) ST BERNARDS PET CENTER	A	27,300	FMV
(3)
(4)
(5)
(6)

Schedule R (Form 990) 2011

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2011

Page 5

Part VII

Supplemental Information

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

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE CHRIST-LIKE HEALING TO THE COMMUNITY THROUGH EDUCATION, TREATMENT, AND HEALTH SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	12
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	2,295
6	Total number of volunteers (estimate if necessary) ....	6	571
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	3,169,926
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	928,732	1,331,117
9	Program service revenue (Part VIII, line 2g) .........	254,204,773	276,903,136
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,810,111	723,709
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	7,535,864	12,735,237
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	264,479,480	291,693,199
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,148,828	1,166,856
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)	98,524,901	98,559,739
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	157,005,513	174,333,780
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	256,679,242	274,060,375
19	Revenue less expenses. Subtract line 18 from line 12.......	7,800,238	17,632,824
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	190,229,864	199,999,520
21	Total liabilities (Part X, line 26).............	57,260,308	59,904,788
22	Net assets or fund balances. Subtract line 21 from line 20.....	132,969,556	140,094,732

Sign Here

	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 219,253,233 including grants of $ 1,154,856 ) (Revenue $ 274,461,466 )
	SINCE 1900, ST BERNARDS HAS SERVED AS OUR COMMUNITY'S TRUSTED PROVIDER OF COMPREHENSIVE, COMPASSIONATE HEALTHCARE. WITH OUR DEDICATED AND EXPERIENCED EMPLOYEES, ADVANCED TECHNOLOGY, AND THE LARGEST MEDICAL STAFF IN THE REGION, ST BERNARDS IS THE MEDICAL CENTER OF CHOICE. TODAY, AS WELL AS IN THE FUTURE, ST BERNARDS WILL CONTINUE TO PUT PATIENTS AND COMMUNITY NEEDS FIRST BY FOCUSING ON QUALITY, SAFETY, COST CONTROL, SERVICE, AND DIVERSITY. DURING FISCAL YEAR 2012, $28,401,412 WAS SPENT FOR COMMUNITY BENEFIT AND 456,654 PERSONS WERE SERVED THROUGH HEALTH SCREENINGS, DONATIONS, EDUCATIONAL CLASSES, AND VOLUNTEER EFFORTS.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 219,253,233

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,855,093	225,545	48,021

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) DAVID L PYLE VP OF MEDICAL AFFAIRS	40.0	X	246,781	0	8,351
(19) BENJAMIN SHAW HOSPITALIST	40.0	X	290,376	0	8,351
(20) DON HOWARD INTENSIVIST	40.0	X	358,629	0	8,351
(21) KHALED AL KHASAWNEH INTENSIVIST	40.0	X	288,982	0	105

				(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		964,131
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		366,986
g	Noncash contributions included in lines 1a-1f:$ 74,399
h	Total. Add lines 1a-1f.......			1,331,117
			Business Code
2a	PATIENT REVENUE		621,110	260,498,765	260,498,765	0	0
b	MEDICAID ASSESSMENT FEE		621,110	12,607,593	12,607,593	0	0
c	SENIOR HEALTH SERVICES		621,110	1,355,108	1,355,108	0	0
d	REFERENCE LAB		621,500	2,441,670	0	2,441,670	0
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			276,903,136
3	Investment income (including dividends, interest
	and other similar amounts).....			1,437,535	0	0	1,437,535
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7,626,611	1,874,071
b	Less: cost or other basis and sales expenses	7,684,391	2,530,117
c	Gain or (loss)	-57,780	-656,046
d	Net gain or (loss)..........			-713,826	0	0	-713,826
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	CAFETERIA/GUEST MEALS		900,099	1,311,867	0	0	1,311,867
b	PURCHASE DISCOUNTS		900,099	871,473	0	0	871,473
c	VENDING MACHINE INCOME		900,099	232,268	0	0	232,268
d	All other revenue ....			10,319,629	0	728,256	9,591,373
e	Total. Add lines 11a–11d ......			12,735,237
12	Total revenue. See Instructions....			291,693,199	274,461,466	3,169,926	12,730,690


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			856,882	1	962,313
2	Savings and temporary cash investments .......			28,250,843	2	42,843,896
3	Pledges and grants receivable, net .........			0	3	0
4	Accounts receivable, net .........			20,971,777	4	22,987,495
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			0	5	0
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........			0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			4,434,800	8	4,822,285
9	Prepaid expenses and deferred charges ............			2,025,732	9	1,760,168
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	212,226,251
b	Less: accumulated depreciation. .....	10b	126,810,065	92,658,124	10c	85,416,186
11	Investments—publicly traded securities ..........			36,997,327	11	37,863,161
12	Investments—other securities. See Part IV, line 11 ......			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets .........			0	14	0
15	Other assets. See Part IV, line 11 ...........			4,034,379	15	3,344,016
16	Total assets. Add lines 1 through 15 (must equal line 34)...			190,229,864	16	199,999,520
17	Accounts payable and accrued expenses .			15,524,190	17	16,761,466
18	Grants payable ..........			0	18	0
19	Deferred revenue ..........			0	19	0
20	Tax-exempt bond liabilities ..........			7,445,000	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	4,995,000
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.....			34,291,118	25	38,148,322
26	Total liabilities. Add lines 17 through 25.....			57,260,308	26	59,904,788
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			131,441,857	27	138,524,795
28	Temporarily restricted net assets .....			1,527,699	28	1,569,937
29	Permanently restricted net assets .....			0	29	0
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			132,969,556	33	140,094,732
34	Total liabilities and net assets/fund balances .....			190,229,864	34	199,999,520