TY 2012 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) KOGER PROPST........................................................................ DIRECTOR, VICE CHAIR	0.0 .......................2.0	X	X		0	0	0
(2) FELIX W COOK SR........................................................................ DIRECTOR	0.0 .......................2.0	X			0	0	0
(3) SISTER AMY WILLCOTT........................................................................ Vice Chair	0.0 .......................2.0	X	X		0	0	0
(4) ROBERT LADENBURGER........................................................................ PRESIDENT&CEO-EXEMPLA	0.0 .......................40.0	X	X		0	1,376,046	106,636
(5) MICHAEL A SLUBOWSKI........................................................................ CHAIR, SYSTEM PRESIDENT & CEO	0.0 .......................40.0	X	X		0	1,513,703	36,584
(6) MARLA J WILLIAMS........................................................................ DIRECTOR	0.0 .......................2.0	X			0	0	0
(7) SALLY WOOLSEY........................................................................ DIRECTOR	0.0 .......................2.0	X			0	0	0
(8) STEVE COBB MD........................................................................ President EPN	0.0 .......................40.0	X			0	272,196	60,439
(9) LYDIA JUMONVILLE........................................................................ SVP Finance & CFO	0.0 .......................40.0	X			0	665,251	89,581
(10) RICK LOPES MD........................................................................ SVP HEALTH NETWORKS	0.0 .......................40.0	X			0	917,605	55,755
(11) BRUCE WARING MD........................................................................ DIRECTOR THROUGH 10/20/12	2.0 .......................	X			0	0	0
(12) BAIN FARRIS........................................................................ PRESIDENT & CEO-ESJH	0.0 .......................40.0		X		0	618,414	211,829
(13) BRADLEY KEITH LUDFORD........................................................................ VP-FINANCE (ESJH)	0.0 .......................40.0			X	0	250,345	39,015
(14) MARY E SHEPLER........................................................................ VP-CHIEF NURSING OFFICER	0.0 .......................40.0			X	0	228,135	50,571
(15) BARBARA A JAHN........................................................................ CHIEF OPRTG OFCR-ESJH	40.0 .......................0.0			X	0	283,074	51,079
(16) ALWIN F STEINMANN........................................................................ CHIEF ACADEMIC MEDICINE	0.0 .......................40.0			X	0	346,127	65,200
(17) SHAWN P DUFFORD........................................................................ VP-MED AFFIARS & CMO	0.0 .......................40.0			X	424,437	0	63,239

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	185,482	185,482
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	424,437		424,437
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	141,394,787	124,829,716	16,565,071
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	6,974,735	6,139,183	835,552
9	Other employee benefits .......	15,964,747	14,052,219	1,912,528
10	Payroll taxes ...........	9,793,639	8,620,391	1,173,248
11	Fees for services (non-employees):
a	Management ......	47,036,922	2,038,939	44,997,983
b	Legal .........	232,365		232,365
c	Accounting ...........	0
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	23,508,804	17,447,045	6,061,759
12	Advertising and promotion ....	380,962		380,962
13	Office expenses .......	1,180,516	682,111	498,405
14	Information technology ......	134,766	5,756	129,010
15	Royalties ..	0
16	Occupancy ...........	9,198,296	6,436,752	2,761,544
17	Travel ............	219,450	163,901	55,549
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	125,351	93,683	31,668
20	Interest ...........	-1,083,388		-1,083,388
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	35,682,785	25,240,658	10,442,127
23	Insurance ..............	3,223,988		3,223,988
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	BAD DEBT EXPENSE	9,058,921	9,058,921
b	MEDICAID PROVIDER FEE	22,501,872	22,501,872
c	MEDICAL SUPPLIES	81,452,619	80,550,372	902,247
d	SYSTEM EQUALIZATION EXPENSE	1,801,555	1,801,555
e	All other expenses	5,563,723	4,125,179	1,438,544
25	Total functional expenses. Add lines 1 through 24e	414,957,334	323,973,735	90,983,599	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 Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	2,365,144	1	3,584,937
2	Savings and temporary cash investments .........	10,792,526	2	1,046,041
3	Pledges and grants receivable, net ...........	0	3	0
4	Accounts receivable, net .............	50,169,401	4	25,052,778
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	60,000,000	7	60,000,000
8	Inventories for sale or use ..............	5,273,610	8	6,232,292
9	Prepaid expenses and deferred charges ..........	1,521,771	9	3,387,994
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	671,995,412
b	Less: accumulated depreciation .....	10b	340,172,163	241,934,230	10c	331,823,249
11	Investments—publicly traded securities ..........	55,740,467	11	36,700,594
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	34,968,252	13	29,345,204
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	26,989,893	15	30,710,752
16	Total assets. Add lines 1 through 15 (must equal line 34)......	489,755,294	16	527,883,841
	17	Accounts payable and accrued expenses .........	27,887,243	17	28,440,977
18	Grants payable .................	0	18	0
19	Deferred revenue ................	4,266	19	2,873
20	Tax-exempt bond liabilities .............	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	70,396,342	25	54,643,140
26	Total liabilities. Add lines 17 through 25.........	98,287,851	26	83,086,990
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	391,282,077	27	444,603,517
28	Temporarily restricted net assets ...........	185,366	28	193,334
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	391,467,443	33	444,796,851
34	Total liabilities and net assets/fund balances ........	489,755,294	34	527,883,841

- 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

2012

Open to Public
Inspection

Name of the organization

SAINT JOSEPH HOSPITAL

Employer identification number

84-0417134

Part I

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

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

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

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

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

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

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

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

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

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

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

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

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

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

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

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

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

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

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

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

Yes

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

11g(i)

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

11g(ii)

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

11g(iii)

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) .........

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

16a

33 1/3% support test—2012. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

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

17a

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2012

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) .........

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

Section D. Computation of Investment Income Percentage

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

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

19a

33 1/3% support tests—2012. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2011. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

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

Schedule A (Form 990 or 990-EZ) 2012

Page 4

Part IV

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

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

OMB No. 1545-0047

2012

Name of the organization

SAINT JOSEPH HOSPITAL

Employer identification number

84-0417134

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

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

Page 2

Name of organization SAINT JOSEPH HOSPITAL

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

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

Page 3

Name of organization SAINT JOSEPH HOSPITAL

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

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

Page 4

Name of organization
SAINT JOSEPH HOSPITAL

Employer identification number

84-0417134

Part III

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

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

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

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

SAINT JOSEPH HOSPITAL

Employer identification number

84-0417134

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

Page 2

Part II-A

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

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2012

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

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

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

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

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

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

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

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

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

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

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

Yes

2,361

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

2,361

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
LOBBYING EXPENDITURES	SCHEDULE C, PART II-B, QUESTION 1I	ST JOSEPH HOSPITAL INCURRED $2,361 IN LOBBYING EXPENDITURES. THIS INCLUDES PORTIONS OF VARIOUS MEMBERSHIP DUES THAT ARE DESIGNATED AS LOBBYING EXPENSE BY THOSE ORGANIZATIONS IN WHICH ST JOSEPH HOSPITAL IS A MEMBER.

Schedule C (Form 990 or 990EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

SAINT JOSEPH HOSPITAL

Employer identification number

84-0417134

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

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


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

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

Yes No

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

Part V

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

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
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 current year end balance (line 1g, column (a)) 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 XIII the intended uses of the organization's endowment funds.

Part VI

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

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	13,543,038		13,543,038
b	Buildings ................	159,909,688	78,615,450	81,294,238
c	Leasehold improvements ............	52,519,530	15,486,987	37,032,542
d	Equipment ................	296,632,007	246,069,726	50,562,281
e	Other .................	154,144,956	2,972,492	151,172,465
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				331,823,249

Schedule D (Form 990) 2012

Page 3

Part VII

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

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








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

Part VIII

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

(a) Description of investment type	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) INVESTMENT IN SYSTEM	29,345,204	C








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	29,345,204

Part IX

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

(a) Description				(b) Book value
(1) INTEREST RCVBLE FROM EXEMPLA				27,440,179
(2) DEFERRED COMPENSATION ANNUITY				1,913,483
(3) PHARMACY SUPPLY DEPOSIT				1,357,090






Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				30,710,752

Part X

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

1.(a) Description of liability		(b) Book value
Federal income taxes		0
ESTIMATED THIRD PARTY PAYER SE		-1,303,969
CURRENT MATURITIES OF LONG TERM DEBT		1,675,716
ASBESTOS MITIGATION LIABILITY		3,281,280
MALPRACTICE LIABILITY		1,842,511
NOTES PAYABLE TO SCLHS		49,079,551
OTHER LIABILITIES		68,051



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		54,643,140
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

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

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

Part XIII

Supplemental Information

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

Identifier	Return Reference	Explanation

Schedule D (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

SAINT JOSEPH HOSPITAL

Employer identification number

84-0417134

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

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

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

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

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	1	17,120,417		17,120,417	4.110 %
b	Medicaid (from Worksheet 3, column a) ....	1	20,560,764	15,812,482	4,748,282	1.140 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	2	37,681,181	15,812,482	21,868,699	5.250 %
Other Benefits		8	688,582		688,582	0.170 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	8	688,582		688,582	0.170 %
f	Health professions education (from Worksheet 5) ..	3	18,694,929	6,414,083	12,280,846	2.950 %
g	Subsidized health services (from Worksheet 6) ..	1	42,858,629	25,014,553	17,844,076	4.280 %
h	Research (from Worksheet 7)	1	163,622		163,622	0.040 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	4	175,779		175,779	0.040 %
j	Total. Other Benefits ..	17	62,581,541	31,428,636	31,152,905	7.480 %
k	Total. Add lines 7d and 7j .	19	100,262,722	47,241,118	53,021,604	12.730 %

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

Schedule H (Form 990) 2012

Page

Part II

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

		(a) Number of activities or programs (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	1	24,250	24,250	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1	7,234	7,234
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	2	31,484	31,484	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. Explain in Part VI the methodology used by the organization to estimate this amount. ......

9,058,921

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

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

Section B. Medicare

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

16,946,571

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

18,141,745

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

-1,195,174

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(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) 2012

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, and primary website address
1	ST JOSEPH HOSPITAL 1835 FRANKLIN STREET DENVER,CO80218	X

Schedule H (Form 990) 2012

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Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	ST JOSEPH HOSPITAL
Name of hospital facility or facility reporting group

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

Yes

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The health needs of the community

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

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

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

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

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

Yes

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

Yes

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

Yes

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

Hospital facility’s website

Available upon request from the hospital facility

Other (describe in Part VI)

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

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

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

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

Prioritization of health needs in its community

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

Other (describe in Part VI)

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

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

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

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

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........	17		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Part VI)

Schedule H (Form 990) 2012

Page

Part VFacility Information (continued)

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

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Part VI)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

Yes

If “No,” indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Part VI)

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

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................

If “Yes,” explain in Part VI.

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

If “Yes,” explain in Part VI.

Schedule H (Form 990) 2012

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2012

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Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8	Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.

Identifier	ReturnReference	Explanation
COMMUNITY BENEFIT REPORT	PART I, LINE 6A	COMMUNITY BENEFITS OF ST JOSEPH HOSPITAL (ESJH) ARE INCLUDED IN A REPORT PREPARED BY EXEMPLA HEALTHCARE.
COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS	PART I, LINE 7G	THE ORGANIZATION DID NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS.
BAD DEBT EXPENSE	PART I, LINE 7G, COLUMN (F)	BAD DEBT EXPENSE INCLUDED ON PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSES IN SCHEDULE H PART I, LINE 7, COLUMN (H) IS $9,058,521.
COSTING METHODOLOGY	PART I, LINE 7	THE COST ACCOUNTING SYSTEM WAS USED AS THE BASIS TO CALCULATE THE AMOUNTS REPORTED AS CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. THE COST OF SUBSIDIZED SERVICES WAS CALCULATED AS THE NET LOSS OF THE RELEVANT DEPARTMENT USING THE DEPARTMENTAL EXPENSES AND ALLOCATED OVERHEAD EXPENSES, AND THE DEDUCTION RATIO PER THE COST ACCOUNTING SYSTEM. FOR SUBSIDIZED SERVICES, THE COST OF CHARITY, MEDICAID, AND SELF PAY PATIENTS WERE REMOVED IN THE CALCULATION.
COMMUNITY BUILDING ACTIVITIES	PART II	Community Resources Forum: ST JOSEPH HOSPITAL INITIATED AND HOSTS A COMMUNITY BUILDING ACTIVITY CALLED THE COMMUNITY RESOURCES FORUM. THE PRIMARY PURPOSE OF THE COMMUNITY RESOURCES FORUM IS TO IMPROVE HEALTH IN THE COMMUNITY. IT CREATES AND FOSTERS NETWORKS OF PARTNERSHIPS ACROSS AGENCIES WITH A SPECIAL EMPHASIS ON SERVING VULNERABLE POPULATIONS AND MAXIMIZING SUPPORT AND RESOURCES FOR THESE COMMUNITY MEMBERS. EACH MONTH BETWEEN SEVENTY-FIVE AND ONE HUNDRED REPRESENTATIVES FROM COMMUNITY AGENCIES, ORGANIZATIONS, GOVERNMENTAL SERVICE PROGRAMS, BUSINESSES AND HEALTH CARE PARTNERS MEET AT THE HOSPITAL TO NETWORK AND SHARE INFORMATION ABOUT HOW THEIR SERVICES BENEFIT THE COMMUNITY AND INDIVIDUALS. DURING THESE MEETINGS, FIVE AGENCIES PRESENT MORE DETAILED INFORMATION WITH TIME FOR QUESTIONS AND COMMENTS FROM THE AUDIENCE. THE COMMUNITY RESOURCES FORUM IS NOT DESIGNED TO PROVIDE ANY ADDITIONAL BENEFIT TO THE HOSPITAL AND WAS NOT CREATED AS A MARKETING ACTIVITY OR TO INCREASE REFERRALS OF PATIENTS. THE HOSPITAL PROVIDES THE MEETING ROOM LOCATION, CONTINENTAL BREAKFAST AND STAFF COORDINATION OF THE FORUM AS THE HOSTS OF A SERVICE TO THE GREATER DENVER METRO COMMUNITY. OVER 700 ORGANIZATIONS ARE LISTED IN THE COMMUNITY RESOURCE FORUM DATABASE AS HAVING MADE CONTACT WITH THE FORUM. THE DATABASE IS NOT USED FOR ANY PURPOSE OTHER THAN NOTIFICATION OF UPCOMING COMMUNITY RESOURCE FORUM MEETINGS AND EVENTS. Arrupe Jesuit High School Corporate Work-Study Program: Arrupe Jesuit High School is a non-profit, Roman Catholic, co-educational, college preparatory school sponsored by the Jesuits of the Missouri Province. Arrupe Jesuit serves economically disadvantaged students from Denver's inner-city neighborhoods. The school model seeks to end generational poverty by providing entry-level work experiences for the students who simultaneously earn financial support for their tuition. Saint Joseph Hospital was one of the original corporate partners and annually supports a team of low-income students with mentoring and job skills training at the hospital in departments such as human resources, laboratory, pre-operative services and business services. Each student is placed at the hospital one day per week throughout the school year, developing job skills and leadership abilities in addition to experiencing future career opportunities in health care.
BAD DEBT EXPENSE COSTING METHODOLOGY AND OTHER INFO	PART III, LINE 4	A COST TO CHARGE RATIO IS USED AS THE METHODOLOGY FOR DETERMINING THE AMOUNTS REPORTED AS COST OF BAD DEBT EXPENSE. FOR ALL SELF-PAY ACCOUNTS, A STANDARD 40% DISCOUNT IS FIRST APPLIED TO CHARGES AS A DEDUCTION OF REVENUE. BAD DEBT EXPENSE IS REFLECTED NET OF DISCOUNTS APPLIED AND PAYMENTS RECEIVED. THE ORGANIZATION DOES NOT INCLUDE IN BAD DEBT EXPENSE ANY AMOUNT THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. THE FOLLOWING ARE THE RELEVANT PORTIONS OF THE COMPANY'S FOOTNOTE TO THE FINANCIAL STATEMENTS RELATED TO BAD DEBT: INCLUDED IN NET RECEIVABLES IS THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS AND TAKES INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE ASSESSMENTS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE.
COSTING METHODOLOGY FOR MEDICARE COSTS	PART III, LINE 8	INPATIENT AND OUTPATIENT MEDICARE COSTS ARE CALCULATED ON THE COST REPORT. INPATIENT COSTS ARE A PRODUCT OF ROUTINE SERVICE COSTS BASED ON PER DIEMS AND ANCILLARY COSTS BASED ON INPATIENT MEDICARE CHARGES FACTORED BY INPATIENT COST TO CHARGE RATIOS. OUTPATIENT COSTS ARE BASED ON MEDICARE OUTPATIENT CHARGES FACTORED BY OUTPATIENT COST TO CHARGE RATIOS. ST JOSEPH HOSPITAL DOES NOT RECOGNIZE THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. DEBT COLLECTION POLICY PART III, LINE 9B AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST, AND TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. ST JOSEPH HOSPITAL NOTIFIES PATIENTS OF ITS FINANCIAL ASSISTANCE POLICY UPON ADMISSION, DISCHARGE AND IN COMMUNICATION REGARDING PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED.
PUBLICIZING THE FINANCIAL ASSISTANCE POLICY	PART V, LINE 14G	ST JOSEPH HOPSITAL TREATS PATIENTS WITH RESPECT AND DIGNITY REGARDLESS OF THEIR ABILITY TO PAY. ST JOSEPH HOSPITAL HAS A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINS ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE AT VARIOUS LEVELS, INCLUDING A 100% DISCOUNT, AND IS BASED ON FEDERAL POVERTY GUIDELINES. WE WORK WITH PATIENTS TO HELP THEM UNDERSTAND THEIR FINANCIAL RESPONSIBILITY FOR CARE RECEIVED, FINANCIAL ASSISTANCE AVAILABLE TO THEM, AND TO ESTABLISH PAYMENT PROGRAMS IN DEMONSTRATION OF OUR CORE VALUE OF RESPECT. AS PART OF OUR RESPONSIBILITY TO EDUCATE, WE INFORM OUR PATIENTS AND THEIR FAMILIES OF THE AVAILABILITY OF ASSISTANCE, INCLUDING GOVERNMENT PROGRAMS. WE COMMUNICATE THIS IN A VARIETY OF WAYS TO ENSURE THAT MESSAGES REACH MULTIPLE AUDIENCES. BEFORE, DURING AND/OR AFTER ADMISSION, WE ENCOURAGE OUR SELF PAY PATIENTS TO VISIT WITH A FINANCIAL COUNSELOR TO DISCUSS QUALIFICATIONS FOR FINANCIAL ASSISTANCE. WE POST FINANCIAL ASSISTANCE INFORMATION IN THE FORM OF A FINANCIAL ASSISTANCE BROCHURE IN EMERGENCY AND ADMISSIONS AREAS, ON BILLINGS INVOICES, IN VARIOUS AREAS AROUND THE HOSPITAL AND CLINIC SITES AND ON THE HOSPITAL WEBSITE. THE BROCHURE EXPLAINS OUR FINANCIAL ASSISTANCE POLICY AND HOW IT IS ADMINISTERED. THIS COVERS ELIGIBILITY, STEPS TO FOLLOW TO DETERMINE IF A PATIENT QUALIFIES FOR ASSISTANCE, TYPICAL CHARGES A PATIENT MAY EXPECT FOR ROUTINE PROCEDURES, AND ASSISTANCE AVAILABLE BASED ON A PATIENT'S INCOME LEVEL. WE PROVIDE THESE MATERIALS AND EDUCATION WHEN PATIENTS ARE DISCHARGED, AND INCLUDE INFORMATION IN BILLING STATEMENTS, INCLUDING PHONE NUMBERS AND OTHER METHODS TO CONTACT US WITH QUESTIONS. WE ENSURE THAT OUR FINANCIAL COUNSELORS, ADMISSION EMPLOYEES, SOCIAL WORKERS AND OTHER EMPLOYEES UNDERSTAND OUR POLICIES TO BE ABLE TO ASSIST PATIENTS IN THE MOST APPROPRIATE WAY. WE ALSO PROVIDE THE DETAILED FINANCIAL ASSISTANCE POLICY TO INDIVIDUALS UPON REQUEST AND POST THE POLICY TO OUR WEBSITE TO ENSURE THE ENTIRE COMMUNITY HAS ACCESS TO SUCH INFORMATION. AMOUNTS BILLED TO UNINSURED INDIVIDUALS PART V, LINE 20D THE FACILITY AUTOMATICALLY APPLIES A 40% DISCOUNT FOR ANY PATIENT WITHOUT INSURANCE. IF AN INDIVIDUAL QUALIFIES FOR FINANCIAL ASSISTANCE AND HAS INCOME BELOWW 200% OF THE FEDERAL POVERTY GUIDELINES, THE FULL ACCOUNT BALANCE IS ADJUSTED TO ZERO. IF INCOME IS BETWEEN 200% AND 400% OF THE FEDERAL POVERTY GUIDELINES OR IS DETERMINED TO BE MEDICALLY INDIGENT EVEN IF THEIR INCOME IS ABOVE 400% OF THE FEDERAL POVERTY GUIDELINES, A MODEST PATIENT FINANCIAL RESPONSIBILITY IS DETERMINED FOLLOWING A COPAY GRID. THE GRID TAKES INTO CONSIDERATION INCOME AND FAMILY SIZE, AND IS DESIGNED TO RESULT IN AN AMOUNT THAT IS LOWER THAN THE LOWEST COMMERCIAL PAYER RATES.
NEEDS ASSESSMENT	PART VI, LINE 3	EXEMPLA St. Joseph Hospital has REGULARLY PARTICIPATED IN NEEDS ASSESSMENTS TO IDENTIFY THE ONGOING AND CHANGING NEEDS OF THE COMMUNITY. The most recent Community Health Needs Assessment was conducted and approved by the Board of Directors in 2012. The CHNA process began with the engagement of senior executive leaders at Exempla Saint Joseph Hospital and Exempla Healthcare. A discussion of the Patient Protection and Affordable Care Act requirements led to the outline of a planning process to meet the standards. The opportunity to use the CHNA process to enhance the organization's strategic planning and community benefit programming was also recognized. The CHNA has a two-fold purpose: to meet the regulatory requirements and to improve internal hospital planning. This CHNA will be used to plan ESJH community benefit programs, allocate resources and strengthen community partnerships in the pursuit of community health improvement. The scope of the CHNA is Denver County with its particularly vulnerable population. For 2012, the process included two other hospitals, Exempla Good Samaritan Medical Center and Exempla Lutheran Medical Center, both located in the Denver metropolitan area. After the purpose and scope was determined, Exempla Saint Joseph Hospital retained the services of the Center for Health Administration at the University of Colorado Denver to conduct data collection for the 2012 CHNA for Exempla per Internal Revenue Code requirements. As part of the Affordable Care Act of 2010 (ACA), each freestanding non-profit (501(c)3) hospital is required to conduct a CHNA every three years. This report is the first CHNA on behalf of Exempla that comply with the IRS mandate. This CHNA describes the health status of each hospital's community and is to be used by the hospital and other collaborators when it develops an implementation plan that addresses the identified community needs. Data for the CHNA was predominantly collected from the Colorado Department of Public Health and Environment (CDPHE). CDPHE publishes health indicator data according to a health equity model in order to facilitate the identification of community health needs. The health equity model incorporates factors that influence health such as social determinants of health, health behaviors and conditions, and population health outcomes. The CDPHE database includes many health, environmental and social topics and is generally organized at the state and/or county level. This facilitates obtaining data for Denver County, the geographic location selected for the ESJH assessment. Health professionals and the public have become increasingly aware of the role of such lifestyle factors as cigarette smoking, overweight, sedentary lifestyle, and the nonuse of seat belts in contributing to injury, illness and death. To measure such factors in adults, the Colorado Behavioral Risk Factor Surveillance System Survey (BRFSS) was used. BRFSS is a system of telephone surveys sponsored by the Centers for Disease Control (CDC). Since 1981, CDC has been using the Behavioral Risk Factor Surveillance System as a method of estimating the prevalence of high risk behaviors and lifestyle factors that contribute to death and disease. Colorado specific data was obtained via the CDPHE website and can be accessed at http://www.chd.dphe.state.co.us/topics.aspx?q=Adult_Health_Data . To measure risk factors in youth, the national Youth Risk Behavior Survey was included to determine behaviors that impact the health of students in 9th through 12th grades. The survey is conducted by select school systems across the nation and reported back to CDC. The CDC's Youth Risk Behavior Surveillance System (YRBSS) monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, including unintentional injuries and violence, alcohol and other drug use, tobacco use, dietary behaviors, and inadequate physical activity. YRBSS also measures the prevalence of obesity and asthma among youth and young adults. Colorado specific data was obtained via the CDC website and can be accessed at http://apps.nccd.cdc.gov/youthonline/App/Results.aspx?LID=CO . The Exempla CHNA mirrors applicable parts of the CDPHE's 2012 Colorado's 10 Winnable Battles which identifies key health issues where progress can be made in the next five years. By aligning with the CDPHE, Exempla joins forces with an ally in efforts to make an impact on improving the health of its hospitals' communities. Through this process, Exempla also meets stipulations set by the ACA that requires hospitals to collaborate with their Public Health Departments to improve their communities' health. To ensure alignment with publically available CDPHE data, Exempla leaders decided that Colorado counties would make up the geographic area for the 2012 CHNA. Individual Exempla hospital facilities then examined their primary market areas and identified Colorado counties in which at least 10% of their patient population resided. The counties identified by each facility comprise the Primary"" Service Area usedinthedatareports.Whencountydatawasunavailable,"" Health Statistic Region data was substituted. The health indicators that were chosen for this report were selected based on publically available CDPHE data, and many were also identified as part of Colorado's 10 Winnable Battles. The health indicators are as follows: Overall Health Status; Access; Cancer; Diabetes; Heart Disease and Cerebrovascular Disease; HIV/AIDS; Communicable Disease; Injury; Mental Health; Obesity, Nutrition and Physical Activity; Oral Health; Sexual Health; Substance Abuse; and Tobacco. A complete CHNA process must include representatives from the broad interests of the community served by the hospital, especially those who can provide input regarding underserved populations and their health needs. ESJH identified several community organizations, including current and potential community outreach partners, and reached out to them for participation in the CHNA process: Community Resources Forum: One of the current community benefit activities for ESJH is hosting the Community Resources Forum, a monthly learning and networking opportunity for nonprofits in the Denver community. For over five years, approximately seventy local or state agencies attend the monthly Forum to share information about their organizations, client needs and upcoming events. Representatives at each Forum come from many different types of agencies including senior services, home health, child welfare, the arts, and many others. The attendees of the June 2012 Community Resources Forum were asked to complete a community health needs questionnaire to rank their perception of the severity of health issues. The top five health issues with the highest ranking of severity by this group of thirty-seven respondents were access to health services and insurance coverage, obesity, mental health, nutrition and diet, and cancer. Kaiser Permanente Colorado: ESJH and Kaiser Permanente Colorado (KP) have been business partners for over forty years. KP is an integrated nonprofit health care delivery system, and the majority of patients served by ESJH for acute, inpatient health care are KP members. KP is the largest nonprofit health plan in Colorado and has a significant community benefit program that emphasizes access to care, health knowledge and environmental health improvement efforts with a particular focus on healthy eating and active living. KP and ESJH defined shared community benefit goals in 2012 related to access to care, the provision of charity care and advancement of graduate medical education. Denver Urban Ministries (DenUM): This agency is located several blocks from ESJH and provides emergency assistance, job search assistance and other support services such as legal aid, food pantry and utility support for low-income people. Health care issues for DenUM clients include access to a regular source of health care other than a hospital emergency department, diabetes, heart disease, and proper food and nutrition. DenUM used to provide a monthly blood pressure screening clinic, however there are no resources available at this time to support a screening clinic on a regular basis. Inner City Health Center: Inner City Health Center is a community-based, primary care and dental clinic serving uninsured and low-income persons. Located near ESJH, the health center also offers individual and family counseling for their patients. Outreach efforts at Inner City focus on cardiovascular disease with education, screening, and the promotion of an active lifestyle. They are one of the few resources in the city of Denver for emergency dental and oral health needs for the uninsured. The main community health concern for this organization is overall lifestyle and well-being issues with key components of violence prevention and mental health support. *Civic Canopy: This organization foc
PATIENT EDUCATION OF ELIGIBILITY ASSISTANCE	PART VI, LINE 4	ST JOSEPH HOSPITAL TREATS PATIENTS WITH RESPECT AND DIGNITY REGARDLESS OF THEIR ABILITY TO PAY. ST JOSEPH HOSPITAL HAS A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINS ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE AT VARIOUS LEVELS, INCLUDING A 100% DISCOUNT, AND IS BASED ON FEDERAL POVERTY GUIDELINES. WE WORK WITH PATIENTS TO HELP THEM UNDERSTAND THEIR FINANCIAL RESPONSIBILITY FOR CARE RECEIVED, FINANCIAL ASSISTANCE AVAILABLE TO THEM, AND TO ESTABLISH PAYMENT PROGRAMS IN DEMONSTRATION OF OUR CORE VALUE OF RESPECT. AS PART OF OUR RESPONSIBILITY TO EDUCATE, WE INFORM OUR PATIENTS AND THEIR FAMILIES OF THE AVAILABILITY OF ASSISTANCE, INCLUDING GOVERNMENT PROGRAMS. WE COMMUNICATE THIS IN A VARIETY OF WAYS TO ENSURE THAT MESSAGES REACH MULTIPLE AUDIENCES. BEFORE, DURING AND/OR AFTER ADMISSION, WE ENCOURAGE OUR SELF PAY PATIENTS TO VISIT WITH A FINANCIAL COUNSELOR TO DISCUSS QUALIFICATIONS FOR FINANCIAL ASSISTANCE. THE FINANCIAL COUNSELOR WORKS WITH THE PATIENT TO COMPLETE A FINANCIAL ASSISTANCE FORM TO DETERMINE THE LEVEL OF DISCOUNT FOR WHICH THE PATIENT MAY BE ELIGIBLE. WE POST FINANCIAL ASSISTANCE INFORMATION IN EMERGENCY AND ADMISSIONS AREAS, ON BILLINGS INVOICES, IN VARIOUS AREAS AROUND THE HOSPITAL AND CLINIC SITES AND ON THE HOSPITAL WEBSITE. WE PROVIDE WRITTEN MATERIALS TO PATIENTS THAT DETAIL OUR FINANCIAL ASSISTANCE POLICY AND HOW IT IS ADMINISTERED. THIS COVERS ELIGIBILITY, STEPS TO FOLLOW TO DETERMINE IF A PATIENT QUALIFIES FOR ASSISTANCE, TYPICAL CHARGES A PATIENT MAY EXPECT FOR ROUTINE PROCEDURES, AND ASSISTANCE AVAILABLE BASED ON A PATIENT'S INCOME LEVEL. WE PROVIDE MATERIALS AND EDUCATION WHEN PATIENTS ARE DISCHARGED, AND INCLUDE INFORMATION IN BILLING STATEMENTS, INCLUDING PHONE NUMBERS AND OTHER METHODS TO CONTACT US WITH QUESTIONS. WE ENSURE THAT OUR FINANCIAL COUNSELORS, ADMISSION EMPLOYEES, SOCIAL WORKERS AND OTHER EMPLOYEES UNDERSTAND OUR POLICIES TO BE ABLE TO ASSIST PATIENTS IN THE MOST APPROPRIATE WAY. WE ALSO PROVIDE PAYMENT PLAN OPTIONS TO OUR PATIENTS. THIS HELPS PATIENTS MEET THEIR FINANCIAL OBLIGATIONS IN A REASONABLE AND DIGNIFIED MANNER BASED ON THEIR ABILITY TO PAY, AND ALLOWS THEM TO CONTINUE TO ENSURE THE ONGOING WELFARE OF THEIR FAMILIES. THIS IS DONE IN ACCORDANCE WITH OUR CORE VALUE OF RESPECT. Saint Joseph services a broad primary service area encompassing multiple communities across the Denver metropolitan area. The hospital's close alignment with Kaiser Permanente contributes to it having a large catchment area. The primary service area is defined as the geographic area of contiguous zip codes from which the hospital draws approximately 75% of its inpatient discharges. This primary service area is represented by 54 standard zip codes in the counties of Denver (25 zip codes), Arapahoe (14 zip codes), Jefferson (11 zip codes) and Adams (4 zip codes). The combined primary and secondary service area is based on the geographic area of contiguous zip codes from which the hospital draws approximately 90% of its inpatient discharges. The secondary service area is represented by 27 zip codes and extends across Adams, Arapahoe, Broomfield, Denver, Douglas, Gilpin and Jefferson Counties. The care site fulfills the role of a tertiary referral center for the metropolitan area. Within its large primary service area, Saint Joseph services the third most patient discharges after University Hospital and Denver Health treating about 11% of the inpatients originating from that area. The community from which Saint Joseph treats the highest concentration of patients includes central Denver, northern Aurora, Commerce City and eastern Lakewood. Patient origin from these communities comprises 50% of Saint Joseph's inpatient discharges. The primary service area is serviced by 13 acute care hospitals, including Saint Joseph and Exempla Lutheran Medical Center, another SCL Health System affiliate hospital. Of the 13 hospitals in the primary service area, 10 are members of one of the local health systems. Four are affiliates of Centura Health (not-for-profit), four are affiliates of HealthONE (for-profit) and two are affiliates of SCL Health System (not-for-profit). There is also Denver Health (publically owned) which serves are the area's safety net facility, the pulmonary specialty hospital of National Jewish Health (not-for-profit) and the Veteran's Administration's VA Eastern Colorado Healthcare facility (government owned). In Saint Joseph's secondary service area there are five more hospitals, two Centura Health facilities (not-for-profit), two HealthONE facilities (for-profit) and one not-for-profit independent hospital. Additionally, the University of Colorado Hospital (government owned) and the Children's Hospital Colorado (not-for-profit) both have a significant presence in Saint Joseph's service areas and are located just outside of the primary service area. While the hospital's primary service area is defined by discharged patients' zip codes, executive leadership decided to focus the CHNA on a more geographically proximate area. The hospital selected Denver County as the defined community for the CHNA in order to focus resources and planning on the most local geographic area. Denver County is also the second most populous county in Colorado with the second highest growth rate, and has a highly vulnerable population and severe health needs. According to the 2012 CHNA, THE POPULATION OF Denver County is OVER 600,000 PEOPLE. THE POPULATION OF PEOPLE OVER 65 YEARS OF AGE IS 10.4% AND THE POPULATION OF CHILDREN UNDER AGE 18 IS 22.3%. The median household income in Denver county is $46,693 which is lower than the state average of $55,735. Denver County had the highest poverty level at 18.8% of the residents living below the poverty level compared to that state average of 12.6%. There is also a lower educational level within Denver County and greater racial and ethnic diversity. This diversity includes the largest population of Latino residents in the State at 31.8%, and the largest percentage of residents of Black race at 10.2%. Denver County is also 68.9% White and 3.4% Asian. Denver County also has the highest incidence of a language other than English spoken at home at 28.7% compared to the state average of 16.6%. Regarding health care and access to care, 19.6% of Denver County residents are uninsured. Throughout the state of Colorado, 38.9% of residents whose annual household income is less than $25,000 are uninsured. Forum come from many different types of agencies including senior services, home health, child welfare, the arts, and many others. The attendees of the June 2012 Community Resources Forum were asked to complete a community health needs questionnaire to rank their perception of the severity of health issues. The top five health issues with the highest ranking of severity by this group of thirty-seven respondents were access to health services and insurance coverage, obesity, mental health, nutrition and diet, and cancer. Kaiser Permanente Colorado: ESJH and Kaiser Permanente Colorado (KP) have been business partners for over forty years. KP is an integrated nonprofit health care delivery system, and the majority of patients served by ESJH for acute, inpatient health care are KP members. KP is the largest nonprofit health plan in Colorado and has a significant community benefit program that emphasizes access to care, health knowledge and environmental health improvement efforts with a particular focus on healthy eating and active living. KP and ESJH defined shared community benefit goals in 2012 related to access to care, the provision of charity care and advancement of graduate medical education. Denver Urban Ministries (DenUM): This agency is located several blocks from ESJH and provides emergency assistance, job search assistance and other support services such as legal aid, food pantry and utility support for low-income people. Health care issues for DenUM clients include access to a regular source of health care other than a hospital emergency department, diabetes, heart disease, and proper food and nutrition. DenUM used to provide a monthly blood pressure screening clinic, however there are no resources available at this time to support a screening clinic on a regular basis. Inner City Health Center: Inner City Health Center is a community-based, primary care and dental clinic serving uninsured and low-income persons. Located near ESJH, the health center also offers individual and family counseling for their patients. Outreach efforts at Inner City focus on cardiovascular disease with education, screening, and the promotion of an active lifestyle. They are one of the few resources in the city of Denver for emergency dental and oral health needs for the uninsured. The main community health concern for this organization is overall lifestyle and well-being issues with key components of violence prevention and mental health support. Civic Canopy: This organization focuses on community impr
COMMUNITY INFORMATION	PART VI, LINE 5	Exempla Saint Joseph Hospital (SaintJoseph"")islocatedincentral"" Denver, Colorado, adjacent to the east of the downtown business/residential district. Founded by a small group of Sisters of Charity of Leavenworth in 1873, it began in response to the invitation from the local Bishop to meet the needs of the sick and injured who did not have access to health care in the frontier town. Immigrant laborers worked in the Colorado mines and had very few options for health services. Diseases such as typhoid and cholera took their toll on people who had no means to pay for medicines or care, and so the Sisters provided a welcoming place for all people regardless of race, creed or ability to pay. Throughout its 140 year history, the hospital has remained committed to the city and its residents, and is located in uptown Denver, less than three miles from the downtown business district. The hospital has grown and adapted programs and services to meet the needs of the community. Today the hospital has 371 beds, caring for 20,000 inpatient admissions, 146,000 outpatient visits, and 50,000 Emergency Department visits on an annual basis. The community of Denver and the history of serving the needs of the central city are important to ESJH. In light of failing infrastructure of the current facility, the hospital and its parent company considered other locations to rebuild given the space requirements for a modern hospital facility, but when the opportunity for land adjacent to its current location became available, the commitment to the central core of Denver was solidified. ESJH is currently building a $623 million dollar replacement hospital on property that is contiguous to its existing location in the heart of the city. The immediate area around the care site is a medical campus housing a competing hospital, HealthONE's Presbyterian/St. Luke's Medical Center, a large ambulatory care complex operated by Kaiser Permanente, and numerous other healthcare providers such as physician offices. Saint Joseph services a broad primary service area encompassing multiple communities across the Denver metropolitan area. The hospital's close alignment with Kaiser Permanente contributes to it having a large catchment area. The primary service area is defined as the geographic area of contiguous zip codes from which the hospital draws approximately 75% of its inpatient discharges. This primary service area is represented by 54 standard zip codes in the counties of Denver (25 zip codes), Arapahoe (14 zip codes), Jefferson (11 zip codes) and Adams (4 zip codes). The combined primary and secondary service area is based on the geographic area of contiguous zip codes from which the hospital draws approximately 90% of its inpatient discharges. The secondary service area is represented by 27 zip codes and extends across Adams, Arapahoe, Broomfield, Denver, Douglas, Gilpin and Jefferson Counties. The care site fulfills the role of a tertiary referral center for the metropolitan area. Within its large primary service area, Saint Joseph services the third most patient discharges after University Hospital and Denver Health treating about 11% of the inpatients originating from that area. The community from which Saint Joseph treats the highest concentration of patients includes central Denver, northern Aurora, Commerce City and eastern Lakewood. Patient origin from these communities comprises 50% of Saint Joseph's inpatient discharges. The primary service area is serviced by 13 acute care hospitals, including Saint Joseph and Exempla Lutheran Medical Center, another SCL Health System affiliate hospital. Of the 13 hospitals in the primary service area, 10 are members of one of the local health systems. Four are affiliates of Centura Health (not-for-profit), four are affiliates of HealthONE (for-profit) and two are affiliates of SCL Health System (not-for-profit). There is also Denver Health (publically owned) which serves are the area's safety net facility, the pulmonary specialty hospital of National Jewish Health (not-for-profit) and the Veteran's Administration's VA Eastern Colorado Healthcare facility (government owned). In Saint Joseph's secondary service area there are five more hospitals, two Centura Health facilities (not-for-profit), two HealthONE facilities (for-profit) and one not-for-profit independent hospital. Additionally, the University of Colorado Hospital (government owned) and the Children's Hospital Colorado (not-for-profit) both have a significant presence in Saint Joseph's service areas and are located just outside of the primary service area. While the hospital's primary service area is defined by discharged patients' zip codes, executive leadership decided to focus the CHNA on a more geographically proximate area. The hospital selected Denver County as the defined community for the CHNA in order to focus resources and planning on the most local geographic area. Denver County is also the second most populous county in Colorado with the second highest growth rate, and has a highly vulnerable population and severe health needs. According to the 2012 CHNA, THE POPULATION OF Denver County is OVER 600,000 PEOPLE. THE POPULATION OF PEOPLE OVER 65 YEARS OF AGE IS 10.4% AND THE POPULATION OF CHILDREN UNDER AGE 18 IS 22.3%. The median household income in Denver county is $46,693 which is lower than the state average of $55,735. Denver County had the highest poverty level at 18.8% of the residents living below the poverty level compared to that state average of 12.6%. There is also a lower educational level within Denver County and greater racial and ethnic diversity. This diversity includes the largest population of Latino residents in the State at 31.8%, and the largest percentage of residents of Black race at 10.2%. Denver County is also 68.9% White and 3.4% Asian. Denver County also has the highest incidence of a language other than English spoken at home at 28.7% compared to the state average of 16.6%. Regarding health care and access to care, 19.6% of Denver County residents are uninsured. Throughout the state of Colorado, 38.9% of residents whose annual household income is less than $25,000 are uninsured.
PROMOTION OF COMMUNITY HEALTH	PART VI, LINE 6	WE EXTEND OUR CARE BEYOND OUR HOSPITAL'S WALLS IN ORDER TO IMPROVE THE HEALTH OF OUR COMMUNITY. OUR COMMUNITY ACTIVITIES DEMONSTRATE THIS COMMITMENT. IN 2012, WE PROVIDED COMMUNITY BENEFIT TOTALING $54,030,484, INCLUDING TRADITIONAL CHARITY CARE AND THE UNPAID COST OF MEDICAID. DURING THIS YEAR, OUR COMMUNITY HEALTH ACTIVITIES INCLUDED HEALTH EDUCATION WITH A PARTICULAR EMPHASIS ON PRENATAL CARE FOR POOR AND VULNERABLE POPULATIONS INCLUDING THE BABY BOUTIQUE PROGRAM, Boot Camp for New Dads, TEEN CHILDBIRTH EDUCATION AND TEEN BREASTFEEDING CLASSES. THESE OUTREACH EFFORTS ARE FOCUSED ON DECREASING THE OCCURRENCE OF LOW-BIRTH WEIGHT INFANTS BY INCREASING HEALTHY BEHAVIORS AND PROMOTING HEALTH LITERACY. ST JOSEPH HOSPITAL (ESJH) ALSO SERVES THE ENTIRE COMMUNITY THROUGH THE CONSUMER LIBRARY AND PROVIDES PACKETS OF INFORMATION ON HEALTH CONDITIONS RESEARCHED BY MEDICAL LIBRARIANS TO ANYONE AT NO CHARGE. Saint Joseph Hospital is the city of Denver's oldest, private teaching hospital, and has invested in medical professional training since 1893. Currently, Saint Joseph Hospital has four medical residency programs - Internal Medicine, Family Medicine, Obstetrics & Gynecology, and General Surgery. We also support health professions education for students from multiple disciplines including nursing, advanced nursing, pharmacy, and radiology. We ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS, FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS. OUR BOARD OF DIRECTORS REPRESENTS MEDICAL AND BUSINESS PROFESSIONALS, AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE INVOLVED IN OUR NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT PEOPLE KNOW ABOUT SERVICES AVAILABLE TO THEM THROUGH OUR HOSPITAL. WHEN ST JOSEPH HOSPITAL HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE WE'LL BE HERE TO CARE FOR FUTURE GENERATIONS. WE ALSO SUPPORT OUR EMPLOYEES IN VOLUNTEERING FOR COMMUNITY ORGANIZATIONS, INCLUDING SERVING ON COMMUNITY BOARDS, AND PROVIDE OPPORTUNITIES FOR THEM TO SUPPORT CAUSES THROUGH HOSPITAL EVENTS SUCH AS FOOD DRIVES FOR LOCAL FOOD BANKS, SCHOOL SUPPLY DRIVES FOR LOCAL SCHOOLS, AMERICAN HEART WALK AND KOMEN RACE FOR THE CURE. WE ARE GOOD CITIZENS AND PARTNER WITH OTHER ORGANIZATIONS AND AGENCIES TO SUPPORT A THRIVING COMMUNITY. WE ARE MEMBERS OF THE DENVER CHAMBER OF COMMERCE, CAPITOL HILL UNITED NEIGHBORHOODS, INC., AND CAPITOL HILL UNITED MINISTRIES. WE PROVIDE FOCUSED OPERATIONAL AND STRATEGIC SUPPORT FOR BRUNER FAMILY MEDICINE CENTER, CARITAS CLINIC, SETON WOMEN'S CENTER AND A CERTIFIED NUrSE MIDWIVES CLINIC. THESE CLINICS SERVE THE HEALTH NEEDS FOR THE UNINSURED. WE WORK CLOSELY TOGETHER TO PROVIDE INTEGRATED CARE FOR THOSE WHO COME TO EITHER THE HOSPITAL FACILITY OR THE OUTPATIENT CLINICS FOR THEIR HEALTH NEEDS. BRUNER FAMILY MEDICINE CENTER, CARITAS CLINIC, SETON WOMEN'S CENTER AND THE CERTIFIED NURSE MIDWIVES CLINIC PROVIDE QUALITY PRIMARY HEALTH CARE SERVICES FOR UNINSURED, LOW-INCOME PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE CLINICS ARE COMMITTED TO PROVIDING ACCESS TO COMPASSIONATE AND TRUSTWORTHY CARE FOR THE UNINSURED POOR. SERVICES THE CLINIC PROVIDES INCLUDE PRIMARY CARE, ONGOING MANAGEMENT OF CHRONIC DISEASES, coordination and financial support for specialist and subspecialist care, AND MEDICATION ASSISTANCE. COMMUNITY BENEFITS PROVIDED IN 2012 THROUGHOUT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) TOTALED $252 MILLION. AS PART OF SCLHS, WE PROMOTE THE SHARED MISSION THAT WEWILL,INTHESPIRITOFTHESISTERS"" OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE. WEARECOMMITTEDTOLIVINGANDDEMONSTRATINGOURCOREVALUES"" OF EXCELLENCE, RESPECT, RESPONSE TO NEED, STEWARDSHIP AND WHOLENESS. SCLHS SUPPORTS ITS HOSPITALS BY PROVIDING GUIDANCE, OVERSIGHT, AND RESOURCES TO HELP THEM ACCOMPLISH INITIATIVES THAT IMPROVE HEALTH IN ALL OUR COMMUNITIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. OTHER WAYS SCLHS BENEFITS ITS HOSPITALS INCLUDE QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE IT IMPLEMENTATION AND INFRASTRUCTURE; STRATEGic AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; BENEFITS ADMINISTRATION (INCLUDING A WELLNESS PROGRAM FREE TO EMPLOYEES THAT PROMOTES THEIR HEALTH AND WELL-BEING); RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE. BY SHARING THE WORK ACROSS OUR SYSTEM WE ARE ABLE TO LIGHTEN THE BURDEN FOR ALL IN ORDER TO FULFILL OUR MISSION OF IMPROVING HEALTH IN OUR COMMUNITIES. SCLHS IMPROVES OVERALL HEALTH IN OUR COMMUNITIES BY PROVIDING INFRASTRUCTURE TO SUPPORT AND SUSTAIN FOUR CLINICS FOR THE UNINSURED IN KANSAS AND COLORADO. THE SCLHS CLINICS FOR THE UNINSURED ARE OFTEN THE ONLY SAFETY NET CLINIC IN THEIR COMMUNITY AND PROVIDE VALUABLE SERVICES FOR THOSE WHO ARE MOST VULNERABLE. EACH HOSPITAL IS SUPPORTED BY A FOUNDATION TO ACCESS AND OPTIMIZE LOCAL PHILANTHROPIC ORGANIZATIONS AND INDIVIDUALS. THESE FOUNDATIONS RAISE FUNDS THROUGH OUTREACH, SPECIAL EVENTS, AND BUILDING DONOR RELATIONS THROUGHOUT THEIR COMMUNITY TO SUPPORT THE NEEDS OF THE HOSPITAL. 18.8% of the residents living below the poverty level compared to that state average of 12.6%. There is also a lower educational level within Denver County and greater racial and ethnic diversity. This diversity includes the largest population of Latino residents in the State at 31.8%, and the largest percentage of residents of Black race at 10.2%. Denver County is also 68.9% White and 3.4% Asian. Denver County also has the highest incidence of a language other than English spoken at home at 28.7% compared to the state average of 16.6%. Regarding health care and access to care, 19.6% of Denver County residents are uninsured. Throughout the state of Colorado, 38.9% of residents whose annual household income is less than $25,000 are uninsured.
AFFILIATED HEALTH CARE SYSTEM	PART VI, LINE 7	ST JOSEPH HOSPITAL IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION TOREVEALGOD'SHEALINGLOVE"" BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE. STJOSEPHHOSPITAL"" PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. SCLHS SUPPORTS THE EFFORTS OF THE HOSPITAL THROUGH STRATEGIC DIRECTION AND OPERATING OVERSIGHT. SCLHS SUPPLIES OVERHEAD SUPPORT SERVICES TO ST JOSEPH HOSPITAL, INCLUDING INFORMATION TECHNOLOGY SERVICES, CENTRAL CASH MANAGEMENT AND INVESTMENT, RISK MANAGEMENT AND INSURANCE AND QUALITY IMPROVEMENT LEADERSHIP. HEALTH CONDITIONS RESEARCHED BY MEDICAL LIBRARIANS TO ANYONE AT NO CHARGE. Saint Joseph Hospital is the city of Denver's oldest, private teaching hospital, and has invested in medical professional training since 1893. Currently, Saint Joseph Hospital has four medical residency programs - Internal Medicine, Family Medicine, Obstetrics & Gynecology, and General Surgery. We also support health professions education for students from multiple disciplines including nursing, advanced nursing, pharmacy, and radiology. We ARE AN IMPORTANT PART OF OUR COMMUNITY AND SERVE IN MANY WAYS, FROM DELIVERING CORE HEALTH CARE TO PREVENTIVE CARE TO SUPPORT OF OTHER CIVIC GROUPS. OUR BOARD OF DIRECTORS REPRESENTS MEDICAL AND BUSINESS PROFESSIONALS, AND ALL PROVIDE HOURS OF SERVICE IN SUPPORT OF OUR HOSPITAL. THEY ARE INVOLVED IN OUR NEEDS ASSESSMENT PROCESS, BUILDING PROGRAMS AND SERVICES, AND COMMUNITY OUTREACH TO ENSURE THAT PEOPLE KNOW ABOUT SERVICES AVAILABLE TO THEM THROUGH OUR HOSPITAL. WHEN ST JOSEPH HOSPITAL HAS EXCESS REVENUE OVER OPERATING EXPENSES, WE USE THOSE FUNDS TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION AND RESEARCH, AND TO EXPAND ACCESS TO POINTS OF CARE. THESE INVESTMENTS ENSURE WE'LL BE HERE TO CARE FOR FUTURE GENERATIONS. WE ALSO SUPPORT OUR EMPLOYEES IN VOLUNTEERING FOR COMMUNITY ORGANIZATIONS, INCLUDING SERVING ON COMMUNITY BOARDS, AND PROVIDE OPPORTUNITIES FOR THEM TO SUPPORT CAUSES THROUGH HOSPITAL EVENTS SUCH AS FOOD DRIVES FOR LOCAL FOOD BANKS, SCHOOL SUPPLY DRIVES FOR LOCAL SCHOOLS, AMERICAN HEART WALK AND KOMEN RACE FOR THE CURE. WE ARE GOOD CITIZENS AND PARTNER WITH OTHER ORGANIZATIONS AND AGENCIES TO SUPPORT A THRIVING COMMUNITY. WE ARE MEMBERS OF THE DENVER CHAMBER OF COMMERCE, CAPITOL HILL UNITED NEIGHBORHOODS, INC., AND CAPITOL HILL UNITED MINISTRIES. WE PROVIDE FOCUSED OPERATIONAL AND STRATEGIC SUPPORT FOR BRUNER FAMILY MEDICINE CENTER, CARITAS CLINIC, SETON WOMEN'S CENTER AND A CERTIFIED NUrSE MIDWIVES CLINIC. THESE CLINICS SERVE THE HEALTH NEEDS FOR THE UNINSURED. WE WORK CLOSELY TOGETHER TO PROVIDE INTEGRATED CARE FOR THOSE WHO COME TO EITHER THE HOSPITAL FACILITY OR THE OUTPATIENT CLINICS FOR THEIR HEALTH NEEDS. BRUNER FAMILY MEDICINE CENTER, CARITAS CLINIC, SETON WOMEN'S CENTER AND THE CERTIFIED NURSE MIDWIVES CLINIC PROVIDE QUALITY PRIMARY HEALTH CARE SERVICES FOR UNINSURED, LOW-INCOME PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE CLINICS ARE COMMITTED TO PROVIDING ACCESS TO COMPASSIONATE AND TRUSTWORTHY CARE FOR THE UNINSURED POOR. SERVICES THE CLINIC PROVIDES INCLUDE PRIMARY CARE, ONGOING MANAGEMENT OF CHRONIC DISEASES, coordination and financial support for specialist and subspecialist care, AND MEDICATION ASSISTANCE. COMMUNITY BENEFITS PROVIDED IN 2012 THROUGHOUT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) TOTALED $252 MILLION. AS PART OF SCLHS, WE PROMOTE THE SHARED MISSION THAT WEWILL,INTHESPIRITOFTHESISTERS"" OF CHARITY, REVEAL GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE. WEARECOMMITTEDTOLIVINGANDDEMONSTRATINGOURCOREVALUES"" OF EXCELLENCE, RESPECT, RESPONSE TO NEED, STEWARDSHIP AND WHOLENESS. SCLHS SUPPORTS ITS HOSPITALS BY PROVIDING GUIDANCE, OVERSIGHT, AND RESOURCES TO HELP THEM ACCOMPLISH INITIATIVES THAT IMPROVE HEALTH IN ALL OUR COMMUNITIES. THIS INCLUDES COORDINATING COMMUNITY BENEFIT PROCESSES, PROVIDING GUIDANCE WITH COMMUNITY NEEDS ASSESSMENTS, AND ESTABLISHING CONSISTENT FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES AND PROCEDURES. OTHER WAYS SCLHS BENEFITS ITS HOSPITALS INCLUDE QUALITY IMPROVEMENT AND PERFORMANCE EXCELLENCE INITIATIVES; SYSTEM-WIDE IT IMPLEMENTATION AND INFRASTRUCTURE; STRATEGic AND OPERATIONS DIRECTION AND OVERSIGHT; SUPPLY CHAIN MANAGEMENT AND PURCHASING; BENEFITS ADMINISTRATION (INCLUDING A WELLNESS PROGRAM FREE TO EMPLOYEES THAT PROMOTES THEIR HEALTH AND WELL-BEING); RISK MANAGEMENT; DISASTER PLANNING AND CRISIS ASSISTANCE. BY SHARING THE WORK ACROSS OUR SYSTEM WE ARE ABLE TO LIGHTEN THE BURDEN FOR ALL IN ORDER TO FULFILL OUR MISSION OF IMPROVING HEALTH IN OUR COMMUNITIES. SCLHS IMPROVES OVERALL HEALTH IN OUR COMMUNITIES BY PROVIDING INFRASTRUCTURE TO SUPPORT AND SUSTAIN FOUR CLINICS FOR THE UNINSURED IN KANSAS AND COLORADO. THE SCLHS CLINICS FOR THE UNINSURED ARE OFTEN THE ONLY SAFETY NET CLINIC IN THEIR COMMUNITY AND PROVIDE VALUABLE SERVICES FOR THOSE WHO ARE MOST VULNERABLE. EACH HOSPITAL IS SUPPORTED BY A FOUNDATION TO ACCESS AND OPTIMIZE LOCAL PHILANTHROPIC ORGANIZATIONS AND INDIVIDUALS. THESE FOUNDATIONS RAISE FUNDS THROUGH OUTREACH, SPECIAL EVENTS, AND BUILDING DONOR RELATIONS THROUGHOUT THEIR COMMUNITY TO SUPPORT THE NEEDS OF THE HOSPITAL.
STATE FILING OF COMMUNITY BENEFIT REPORT	PART VI, LINE 7	THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM FILES A COMMUNITY BENEFIT REPORT IN FOUR STATES: CALIFORNIA, COLORADO, KANSAS AND MONTANA.
STATE FILING OF COMMUNITY BENEFIT REPORT		THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM FILES A COMMUNITY BENEFIT REPORT IN FOUR STATES: CALIFORNIA, COLORADO, KANSAS AND MONTANA.
AMOUNTS BILLED TO UNINSURED INDIVIDUALS	PART V, LINE 20D	THE FACILITY AUTOMATICALLY APPLIES A 40% DISCOUNT FOR ANY PATIENT WITHOUT INSURANCE. IF AN INDIVIDUAL QUALIFIES FOR FINANCIAL ASSISTANCE AND HAS INCOME BELOW 200% OF THE FEDERAL POVERTY GUIDELINES, THE FULL ACCOUNT BALANCE IS ADJUSTED TO ZERO. IF INCOME IS BETWEEN 200% AND 400% OF THE FEDERAL POVERTY GUIDELINES, A MODEST PATIENT FINANCIAL RESPONSIBILITY IS DETERMINED FOLLOWING A COPAY GRID. THE GRID TAKES INTO CONSIDERATION INCOME AND FAMILY SIZE, AND IS DESIGNED TO RESULT IN AN AMOUNT THAT IS LOWER THAN THE LOWEST COMMERCIAL PAYER RATES.

Schedule H (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
SAINT JOSEPH HOSPITAL

Employer identification number
84-0417134

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) SUSAN G KOMEN BREAST CANCER FOUNDATION 1835 FRANKLIN ST DENVER,CO80218	84-1199858	501(c)(3)	10,000	PINK TIE AFFAIR SPONSORSHIP
(2) ARRUPE CORPORATE WORK STUDY PROGRAM 4343 UTICA ST DENVER,CO80212	46-0508814	501(c)(3)	24,250	SUPPORT FOR WORK STUDY PROGRAM OF ARRUPE JESUIT HIGH SCHOOL
(3) HISTORY COLORADO 1200 BROADWAY DENVER,CO80203	84-6000482	501(c)(3)	100,000

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2012

Page 2

Part III

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

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information.

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

Identifier	Return Reference	Explanation
DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS	SCHEDULE I, PART I	- THE ORGANIZATION KEEPS RECORDS TO SUPPORT THE AMOUNTS PROVIDED OR REASON FOR SUCH SUPPORT. SUPPORT IS NOT CONSIDERED GRANTS, BUT RATHER MISCELLANEOUS DONATIONS AND SPONSORSHIPS. ELIGIBILITY FOR FUNDING IS DETERMINED ON AN INDIVIDUAL BASIS, CONSIDERING THE USE OF THE FUNDS AND HOW THE USE RELATES TO THE ORGANIZATION'S MISSION.

Schedule I (Form 990) 2012

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

SAINT JOSEPH HOSPITAL

Employer identification number

84-0417134

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

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

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)ROBERT GIBBONSASSOC DIR-PHYSICIAN GME	(i) (ii)	304,564 0	10,474 0	11,510 0	18,000 0	11,738 0	356,286 0	0 0
(2)CHRISTINE RUTH GIESINGPHYSICIAN-GME FACULTY	(i) (ii)	247,472 0	0 0	0 0	17,759 0	15,953 0	281,184 0	0 0
(3)BRADLEY KEITH LUDFORDVP-FINANCE (ESJH)	(i) (ii)	0 211,559	0 37,570	0 1,216	0 22,986	0 16,029	0 289,360	0 0
(4)MARY E SHEPLERVP-CHIEF NURSING OFFICER	(i) (ii)	0 192,401	0 33,381	0 2,353	0 34,176	0 16,395	0 278,706	0 0
(5)BARBARA A JAHNCHIEF OPRTG OFCR-ESJH	(i) (ii)	0 239,764	0 41,725	0 1,585	0 39,101	0 11,978	0 334,153	0 0
(6)BAIN FARRISPRESIDENT & CEO-ESJH	(i) (ii)	0 441,578	0 141,476	0 35,360	0 199,364	0 12,465	0 830,243	0 0
(7)ROBERT LADENBURGERPRESIDENT&CEO-EXEMPLA	(i) (ii)	0 660,676	0 203,467	0 511,903	0 94,171	0 12,465	0 1,482,682	0 0
(8)MICHAEL A SLUBOWSKICHAIR, SYSTEM PRESIDENT & CEO	(i) (ii)	0 993,061	0 398,970	0 121,672	0 24,119	0 12,465	0 1,550,287	0 0
(9)ALWIN F STEINMANNCHIEF ACADEMIC MEDICINE	(i) (ii)	0 290,053	0 53,781	0 2,293	0 47,870	0 17,330	0 411,327	0 0
(10)G EDWARD KIMM JRPHYSICIAN-GME FACULTY	(i) (ii)	234,392 0	0 0	0 0	16,599 0	11,861 0	262,852 0	0 0
(11)SHAWN P DUFFORDVP-MED AFFIARS & CMO	(i) (ii)	386,794 0	35,421 0	2,222 0	46,846 0	16,393 0	487,676 0	0 0
(12)STEVE COBB MDPresident EPN	(i) (ii)	0 238,645	0 24,557	0 8,994	0 46,845	0 13,594	0 332,635	0 0
(13)LYDIA JUMONVILLESVP Finance & CFO	(i) (ii)	0 499,288	0 152,073	0 13,890	0 73,035	0 16,546	0 754,832	0 0
(14)RICK LOPES MDSVP HEALTH NETWORKS	(i) (ii)	0 507,612	0 96,853	0 313,140	0 43,290	0 12,465	0 973,360	0 0
(15)JOHN M BREENPROG DIR- PHYSICIAN GME	(i) (ii)	359,596 0	0 0	0 0	14,220 0	16,927 0	390,743 0	0 0
(16)MARSHALL R GOTTESFELDPHYSICIAN- GME FACULTY	(i) (ii)	227,787 0	0 0	5,000 0	16,680 0	1,492 0	250,959 0	0 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

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

Identifier	Return Reference	Explanation
TAX INDEMNIFICATION AND GROSS UP PAYMENTS	SCH J, PART I, QUESTION 1A	16 INDIVIDUALS RECEIVED GROSS UP PAYMENTS FOR GIFTS OR OTHER ITEMS THAT WERE TAXABLE TO THE INDIVIDUAL IN THEIR W-2'S. THESE TOTALED $484 IN THE AGGREGATE.
COMPENSATION OF THE ORGANIZATION'S CEO	SCHEDULE J, PART I, QUESTION 3	THE ORGANIZATION'S CEO IS COMPENSATED BY SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS), A RELATED ORGANIZATION. SCLHS USED ALL OF THE METHODS DESCRIBED IN SCHEDULE J, PART I TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO.
SEVERANCE AND CHANGE OF CONTROL PAYMENTS	SCHEDULE J, PART I, QUESTION 4A	A CHANGE OF CONTROL PAYMENT WAS MADE TO KATHRYN BALLINGER IN THE AMOUNT OF $314,537 IN 2012. SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) PERIODICALLY INCURS SEVERANCE PAYMENTS RELATED TO FORMER EMPLOYEES.
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS	SCHEDULE J, PART I, QUESTION 4B	OTHER REPORTABLE COMPENSATION SHOWN IN SCHEDULE J PART II COLUMN (B) (III) CONTAINS AN ANNUAL REPORTING ADJUSTMENT FOR CERTAIN EMPLOYEES WHO PARTICIPATE IN THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. SCLHS PROVIDES NONQUALIFIED RETIREMENT PLANS FOR EXECUTIVES TO COMPENSATE FOR IRS IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT FOR PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. ON THE ADVICE OF COUNSEL, SCLHS HAS DETERMINED THAT THESE BENEFITS SHOULD BE SUBJECT TO TAXATION AS THEY ARE EARNED AND VESTED RATHER THAN WHEN THEY ARE RECEIVED. AS A RESULT, THE TOTAL NONQUALIFIED RETIREMENT PLAN BENEFITS, WHICH WERE ACCRUED AND VESTED IN THE CURRENT YEAR, ARE NOW CONSIDERED TAXABLE AND THUS WERE TAXED TO THE PARTICIPANTS.
INCENTIVE PLANS	SCHEDULE J, PART I, QUESTION 7	THE MANAGEMENT INCENTIVE PLANS ARE BASED ON A COMBINATION OF MEASURES. MANAGEMENT AND SENIOR LEADERSHIP ARE ELIGIBLE FOR THE INCENTIVE COMPENSATION. PERFORMANCE CATEGORIES ARE MADE UP OF A COMBINATION OF CLINICAL QUALITY MEASURES AND OPERATING INCOME. THE OPERATING INCOME CATEGORY IS GENERALLY RELATED TO THE NET EARNINGS OF THE DIVISION IN WHICH THE INDIVIDUAL WORKS, OR IN THE CASE OF SYSTEM SERVICES SENIOR MANAGEMENT, THE NET EARNINGS OF THE COMPANY.
COMPENSATION OF BOARD MEMBER	SCHEDULE J, PART II	SCLHS CONSISTS OF ELEVEN HOSPITALS AND THREE CLINICS (AFFILIATES) IN FOUR STATES INCLUDING ST. JOSEPH HOSPITAL. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. MICHAEL A. SLUBOWSKI IS PRESIDENT & CHIEF EXECUTIVE OFFICER FOR SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS). HE ALSO SERVES AS A MEMBER OF THE EXEMPLA, INC.'S (EXEMPLA) BOARD AND AS CHAIRMAN. THE COMPENSATION REFLECTED IS THAT OF MR. SLUBOWSKI'S POSITION AS AN SCLHS EXECUTIVE AND NOT AS A MEMBER OF EXEMPLA'S BOARD. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE.

Schedule J (Form 990) 2012

Additional Data

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

SAINT JOSEPH HOSPITAL

Employer identification number

84-0417134

Part I

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

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

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

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

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

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






Total ...... $

Part III

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2012

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) MIDTOWN INPATIENT MEDICINE	PARTNER / EXEMPLA OFFICER	4,533,049	HOSPITALIST SVCS AGREEMENT		No
(2) HOSPITAL SHARED SERVICES	BOD / EXEMPLA KEY EMP	2,010,605	CONTRACTED SERVICES		No

Part V

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

Identifier	Return Reference	Explanation
BUSINESS TRANSACTION RELATIONSHIPS	PART IV	LISA KETTERING, AN OFFICER, IS A GREATER THAN 5% PARTNER IN MIDTOWN INPATIENT MEDICINE. BRADLEY LUDFORD, A KEY EMPLOYEE, SERVES ON THE BOARD OF DIRECTORS OF HOSPITAL SHARED SERVICES.

Schedule L (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

SAINT JOSEPH HOSPITAL

Employer identification number

84-0417134

Identifier	Return Reference	Explanation
EXEMPT PURPOSE ACHIEVEMENTS	FORM 990, PART III, LINES 4A - 4D	ST JOSEPH HOSPITAL (ESJH) IS OWNED BY SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS). EXEMPLA HEALTHCARE (EXEMPLA) IS A HEALTH CARE DELIVERY SYSTEM FORMED ON JANUARY 1, 1998, BY A JOINT OPERATING AGREEMENT AMONG SCLHS, ESJH, LMC COMMUNITY FOUNDATION (CURRENTLY COMMUNITY FIRST FOUNDATION) AND EXEMPLA, INC. (EXEMPLA). EXEMPLA OPERATES EXEMPLA LUTHERAN MEDICAL CENTER, EXEMPLA GOOD SAMARITAN MEDICAL CENTER AND OTHER AFFILIATED MEDICAL SERVICES INCLUDING THE EXEMPLA PHYSICIAN NETWORK. THE SYSTEM'S COLLECTIVE PROGRAM SERVICES ACCOMPLISHMENTS INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING: THE MEDICAL SERVICES ARE PROVIDED TO ALL WHO SEEK SERVICE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS CRITICAL FOR THE OPERATION AND STABILITY OF EXEMPLA AND ESJH, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH EXEMPLA'S AND ESJH'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE WILL BE CONSIDERED AND PROVIDED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY EXIST. IN ADDITION, EXEMPLA AND ESJH RECOGNIZE THE ESSENTIAL NEED TO BE EXCEPTIONAL STEWARDS OF MEDICARE, MEDICAID AND COMMUNITY/PRIVATE FUNDING DOLLARS. FOR 2012, ESJH PROVIDED BENEFIT TO THE COMMUNITY AT A COST OF $56.0 MILLION, INCLUDING CHARITY CARE, UNREIMBURSED MEDICAID, OTHER SUBSIDIZED HEALTH SERVICES AND EDUCATION. EXEMPLA AND ESJH ALSO RECOGNIZE THE ESSENTIAL NEED TO ENHANCE AND IMPROVE MEDICAL OUTCOMES, QUALITY, AND SERVICES. IN RESPONSE, A BEST IN THE NATION STRATEGY AND PROGRAM WAS IMPLEMENTED. THE OBJECTIVES OF THE PROGRAM ARE TO BE THE BEST IN THE NATION ON PREDEFINED QUALITIES, SERVICE AND COST INDICATORS. THE QUALITY INDICATORS ARE IN ALIGNMENT WITH MAJOR PUBLICLY COMPARABLE DATABASES INCLUDING THE COLORADO HEALTH AND HOSPITAL ASSOCIATION AND CENTERS FOR MEDICARE AND MEDICAID SERVICES. CURRENTLY, THE PROGRAM IS IN THE NINTH YEAR OF THIS INITIATIVE.
WITH ITS 565 LICENSED BEDS, ESJH SERVED THE COMMUNITY WITH 18,514	INPATIENT ADMISSIONS, 177,450 OUTPATIENT VISITS AND 51,934 EMERGENCY ROOM	VISITS. SERVICES - COMPREHENSIVE MEDICAL SERVICES INCLUDE, BUT ARE NOT LIMITED TO, CARDIOLOGY, ONCOLOGY, ORTHOPEDIC, WOMEN AND FAMILY, EMERGENCY, NEONATAL INTENSIVE CARE, NEUROLOGY, OB/GYN AND GENERAL SURGICAL AND MEDICAL. - ESJH IS A LEADING HEART HOSPITAL IN DENVER PERFORMING APPROXIMATELY 400 OPEN-HEART SURGERIES ANNUALLY, MORE THAT ANY OTHER COLORADO HOSPITAL. - ESJH DELIVERS MORE BABIES THAT ANY OTHER COLORADO HOSPITAL WITH 3,773 BIRTHS IN 2012. ALONG WITH NORMAL DELIVERIES, THE HOSPITAL ALSO CARES FOR CRITICALLY ILL NEWBORNS AND HIGH-RISK MOTHERS. - ESJH IS AMONG THE TOP THREE COLORADO HOSPITALS FOR NEWLY DIAGNOSED CANCER CASES. IN ORDER TO MEET THE SPECIAL NEEDS OF THESE PATIENTS, THE COMPREHENSIVE CANCER CENTER BRINGS TOGETHER IN ONE PLACE THE ESJH BREAST CARE CENTER, CANCER PSYCHOSOCIAL SERVICES, MEDICAL AND SURGICAL ONCOLOGY, A LABORATORY, A RESEARCH DEPARTMENT, A NEW CANCER PHARMACY AND THE INFUSION CENTER. THIS MEANS THAT THE PROFESSIONALS FROM ONCOLOGISTS TO LAB TECHNICIANS TO PSYCHOTHERAPISTS TO INFUSION SPECIALISTS, PHARMACIST AND RADIOLOGISTS -HAVE ACCESS TO LEADING-EDGE TECHNOLOGY AND CAN BETTER INTERACT WITH ONE ANOTHER TO PROVIDE FULLY COORDINATED CARE TO EACH OF OUR PATIENTS. - THE HIGHLY TRAINED PHYSICIANS, NURSES AND SUPPORT STAFF IN THE EMERGENCY DEPARTMENT TREAT MORE THAN 142 PATIENTS PER DAY FOR A WIDE RANGE OF EMERGENCY MEDICAL CONDITIONS. PROGRAMS STRONG COMMITMENT TO THE HEALTH OF THE COMMUNITY IS FURTHER EXEMPLIFIED, BUT NOT LIMITED TO, THE FOLLOWING PROGRAMS: - THE GRADUATE MEDICAL EDUCATION PROGRAM TRAINS 104 MEDICAL RESIDENTS EACH YEAR IN THE FIELDS OF FAMILY Medicine, INTERNAL MEDICINE, OBSTETRICS/GYNECOLOGY AND GENERAL SURGERY. IN 2010, THE INTERNAL MEDICINE RECEIVED THE HIGHEST LEVEL OF ACCREDITATION FOR FIVE YEARS BY THE AMERICAN COLLEGE OF GRADUATE MEDICAL EDUCATION. ALL FOUR PROGRAMS CONTINUED TO ENHANCE MEDICAL KNOWLEDGE THROUGH ADVANCED SCHOLARSHIP INCLUDING OVER TWENTY PUBLISHED PAPERS AND SEVERAL NATIONAL PRESENTATIONS. - THE CARITAS CLINIC, SISTER JOANNA BRUNER FAMILY MEDICINE CENTER, AND SETON WOMEN'S CENTER PROVIDE A CONTINUUM OF CARE FROM PREVENTIVE THROUGH ACUTE CARE TO MEDICALLY UNDERSERVED INDIVIDUALS IN A PHYSICIAN OFFICE SETTING. THE THREE ON-CAMPUS CLINICS PROVIDE MORE THAN 40,000 PATIENT VISITS EACH YEAR AND OFFER PAYMENT FOR SERVICES VIA A SLIDING FEE PROGRAM. NO PATIENT IS DENIED SERVICE DUE TO AN INABILITY TO PAY. - BOOT CAMP FOR NEW DADS IS AN INNOVATIVE PROGRAM DESIGNED TO BUILD CONFIDENCE AND PREPARE FIRST-TIME DADS FOR THE CHALLENGES OF PARENTHOOD. VETERAN DADS AND THEIR NEWBORNS ORIENT ROOKIE DADS. IT SERVED APPROXIMATELY 1,043 EXPECTANT FATHERS IN 2012. - THE BABY BOUTIQUE IS AN AWARD-WINNING INCENTIVE PROGRAM THAT ENCOURAGES PRENATAL CARE AMONG EXPECTANT FAMILIES. BY FOLLOWING APPROPRIATE PRENATAL CARE AND REGULAR OFFICE VISIT SCHEDULES AND ATTENDING PRENATAL EDUCATIONAL CLASSES, EXPECTANT FAMILIES EARN COUPONS FOR NECESSARY BABY SUPPLIES, CLOTHES AND EQUIPMENT. IN 2012, APPROXIMATELY 755 FAMILIES WERE SERVED, WITH MOST FAMILIES RETURNING REGULARLY TO THE BABY BOUTIQUE AS THE COURSE OF PREGNANCY PROCEEDED. INCIDENCE OF LOW BIRTH WEIGHT WAS LESS IN PARTICIPATING FAMILIES THAN IN NON-PARTICIPATING FAMILIES. - THE ST JOSEPH HOSPITAL FOUNDATION RAISES AND MANAGES FUNDS FOR THE BENEFIT OF THE HOSPITAL AND ITS COMMUNITY PROGRAMS. FUNDS RAISED BY THE FOUNDATION ENABLE THE HOSPITAL TO OFFER A VARIETY OF HEALTH CARE PROGRAMS TO THE COMMUNITY, PARTICULARLY THE MEDICALLY UNDERSERVED. - ESJH MOBILE MAMMOGRAPHY - THROUGH SUPPORT FROM THE DENVER AFFILIATE OF THE KOMEN FOUNDATION, ESJH PROVIDES DIAGNOSTIC CARE FOR MEDICALLY UNDERSERVED, AT RISK WOMEN. INTRODUCED IN SEPTEMBER 2005, THE MOBILE MAMMOGRAPHY UNIT SERVES SOME 2,000 COLORADO WOMEN ANNUALLY. - THE WILLIAM V. GERVASINI MEMORIAL LIBRARY IS A HEALTH INFORMATION RESOURCE FOR PATIENTS, THEIR FAMILIES, AND THE COMMUNITY. THE LIBRARY COLLECTION FOCUSES ON UNDERSTANDABLE, OBJECTIVE INFORMATION ABOUT MEDICAL ISSUES AND CONDITIONS. MAILING SERVICES ARE AVAILABLE FOR THOSE WHO ARE UNABLE TO VISIT THE LIBRARY. - THE SCHOOL AT WORK PROGRAM, WHICH IS PART OF ESJH'S WORKFORCE DEVELOPMENT INITIATIVE, OFFERS PROFESSIONAL DEVELOPMENT OPPORTUNITIES TO HIGH PERFORMING EMPLOYEES WHO WISH TO ENHANCE THEIR COMPUTER SKILLS AND HEALTH CARE KNOWLEDGE FOR ENTRY INTO HEALTH CARE CAREERS. THE STUDENTS TAKE CLASSES AT THE HOSPITAL FOR SEVERAL HOURS A WEEK FOR EIGHT MONTHS. THEY ARE PROVIDED WITH TEXT BOOKS AND MATERIALS AND ARE EXPECTED TO COMPLETE SEVERAL HOURS OF HOMEWORK ON-LINE. - THE WOMEN'S PAVILION OFFERS COMMUNITY HEALTH EDUCATION FOCUSED ON PRENATAL CARE, PARENTING AND WOMEN'S HEALTH. IN 2012, THE WOMEN'S PAVILION PROVIDED HEALTH EDUCATION TO OVER 5,130 WOMEN AND THEIR SPOUSES AND SUPPORT PERSONS. DELEGATION OF BOARD AUTHORITY TO AN EXECUTIVE COMMITTEE PART VI, QUESTION 1A PURSUANT TO THE BYLAWS, THE EXECUTIVE COMMITTEE OF THE ORGANIZATION HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE ORGANIZATION DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD, PROVIDED THAT ANY ACTION TAKEN BY THE EXECUTIVE COMMITTEE DOES NOT CONFLICT WITH THE ARTICLES OF INCORPORATION, THE BYLAWS OR THE POLICIES OR EXPRESSED WISHES OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL REPORT ALL MATTERS ACTED UPON TO THE BOARD AT THE BOARD'S NEXT MEETING. THE EXECUTIVE COMMITTEE CONSISTS OF AT LEAST THREE MEMBERS, ALL OF WHOM SHALL BE MEMBERS OF THE BOARD OF DIRECTORS, AND INCLUDE THE CHAIRPERSON OF THE BOARD, THE PRESIDENT/CEO AND OTHERS AS DESIGNATED BY THE CHAIRPERSON.
FORM W-3	FORM 990, PART V, LINE 2A	ALL FORMS W-2 ARE ISSUED BY EXEMPLA, INC., A RELATED TAX-EXEMPT ORGANIZATION. DELEGATION OF CONTROL OVER MANAGEMENT DUTIES FORM 990, PART VI, QUESTION 3 IN JUNE 2008, EXEMPLA, INC., AS MANAGER OF ST JOSEPH HOSPITAL (ESJH), ENTERED INTO A MANAGEMENT AGREEMENT WITH INSIGHT ONCOLOGY FOR THE MANAGEMENT OF THE HOSPITAL'S COMPREHENSIVE CANCER CENTER SERVICES. EXEMPLA, INC. MANAGES AND GOVERNS ST JOSEPH HOSPITAL UNDER A JOINT OPERATING AGREEMENT. IN JULY 2009, ESJH CONTRACTED WITH INSIGHT ONCOLOGY TO MANAGE A BREAST CENTER, SURGICAL SERVICES, RADIATION ONCOLOGY, OUTPATIENT INFUSION SERVICES, A PHARMACY, INPATIENT SERVICES, AND OTHER SPECIALIZED CARE TO PATIENTS WITH ONCOLOGY DISEASES AND DISORDERS. CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, QUESTION 4 EFFECTIVE OCTOBER 1, 2012, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS) AND COMMUNITY FIRST FOUNDATION AGREED TO AMEND AND RESTATE THE BYLAWS OF EXEMPLA. UNDER THE AMENDMENTS, COMMUNITY FIRST FOUNDATION'S INTEREST IN THE JOINT OPERATING AGREEMENT AND OTHER RIGHTS OF COMMUNITY FIRST FOUNDATION RELATED TO EXEMPLA WERE TERMINATED. IN RETURN, SCLHS COMMITTED TO PROVIDE $275 MILLION TO COMMUNITY FIRST FOUNDATION OVER A PERIOD OF 20 YEARS. THE BOARD OF DIRECTORS OF EXEMPLA WILL CONTINUE TO CONSIST OF 10 MEMBERS, 9 OF WHICH ARE APPOINTED BY SCLHS AND 1 OF WHICH IS APPOINTED BY COMMUNITY FIRST FOUNDATION.
MEMBERS OR STOCKHOLDERS	FORM 990, PART VI, QUESTION 6	ST JOSEPH HOSPITAL HAS ONE MEMBER, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM. ST JOSEPH HOSPITAL IS MANAGED AND GOVERNED BY EXEMPLA, INC. EXEMPLA, INC. HAS TWO MEMBERS: COMMUNITY FIRST FOUNDATION (CFF) AND SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM (SCLHS).
ELECTION OF MEMBERS OF GOVERNING BODY	FORM 990, PART VI, QUESTION 7A	SISTERS OF CHARITY LEAVENWORTH HEALTH SYSTEMS, THE SOLE MEMBER OF SAINT JOSEPH HOSPITAL APPOINTS MEMBERS OF THE SAINT JOSEPH HOSPITAL BOARD OF DIRECTORS. SAINT JOSEPH HOSPITAL IS MANAGED AND GOVERNED BY EXEMPLA, INC. EXEMPLA, INC HAS TWO MEMBERS, SISTERS OF CHARITY LEAVENWORTH HEALTH SYSTEMS AND COMMUNITY FIRST FOUNDATION. CFF APPOINTS 1 OF THE DIRECTORS AND SCLHS APPOINTS 9 OF THE DIRECTORS.
DECISIONS OF GOVERNING BODY SUBJECT TO APPROVAL	FORM 990, PART VI, QUESTION 7B	BOTH MEMBERS (COMMUNITY FIRST FOUNDATION AND SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, SCLHS) HAVE CERTAIN RESERVE POWERS TO APPROVE CHANGES TO THE BYLAWS REGARDING APPOINTMENT OF BOARD MEMBERS. SCLHS ALSO HAS EXTENSIVE RESERVE POWERS OVER ANY CHANGE IN MISSION, CHANGES TO THE ARTICLES OF INCORPORATION OR BYLAWS, ACQUISITION OF ASSETS, INCURRENCE OF DEBT, MERGER OR DISSOLUTION, APPROVAL OF STRATEGIC PLANS AND BUDGETS, AND APPOINTMENT OF AUDITORS.
990 REVIEW PROCESS	FORM 990, PART VI, QUESTION 11b	ALL 990 REPORTING WAS REVIEWED INTERNALLY WITH SENIOR MANAGEMENT. ALL QUESTIONS AND CHANGES PROPOSED WERE ADDRESSED PRIOR TO FILING FORM 990. A DRAFT 990 WAS PROVIDED TO THE MEMBERS OF THE FINANCE COMMITTEE AND OF THE BOARD FOR REVIEW. A COMPLETE COPY OF THE FINAL FORM 990 WAS THEN PROVIDED ELECTRONICALLY TO EACH VOTING MEMBER OF THE EXEMPLA BOARD OF DIRECTORS PRIOR TO ITS SUBMISSION TO THE INTERNAL REVENUE SERVICE.
MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY	FORM 990, PART VI, QUESTION 12C	THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY PROVIDING EDUCATION AND TRAINING FOR EACH OF ITS EMPLOYEES, STAFF, OFFICERS AND DIRECTORS, AS WELL AS HAVING EACH OF THESE INDIVIDUALS COMPLETE A CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS TO DISCLOSE ANY POTENTIAL CONFLICT ISSUES. THESE STATEMENTS ARE CAREFULLY REVIEWED BY THE LEGAL DEPARTMENT. WHEN A CONFLICT IS IDENTIFIED, THE LEGAL DEPARTMENT COMPILES ALL REPORTED CONFLICTS, AND EVALUATES THE DISCLOSURES FOR ACTUAL CONFLICTS. A REPORT IS PROVIDED TO ORGANIZATION'S PRESIDENT/CEO REGARDING EMPLOYEES AND OFFICERS, AND TO THE CHAIR OF THE BOARD AND CHAIR OF THE GOVERNANCE COMMITTEE REGARDING BOARD MEMBERS. THOSE WITH IDENTIFIED CONFLICTS OF INTEREST MUST RECUSE THEMSELVES FROM ANY MEETING DURING THE DISCUSSION AND VOTE THEREOF.
PROCESS FOR DETERMINING COMPENSATION OF CEO, OFFICERS, OR KEY EMPLOYEES	FORM 990, PART VI, QUESTION 15A & 15B	COMPENSATION FOR THE CEO IS PAID BY SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, A RELATED NON-PROFIT ORGANIZATION. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS PAID BY EITHER EXEMPLA, INC. OR SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, BOTH OF WHICH ARE RELATED NON-PROFIT ORGANIZATIONS. WHEN REVIEWING AND SETTING COMPENSATION FOR 'DISQUALIFIED PERSONS', EXEMPLA'S PROCESS INCLUDES: THE COMPENSATION COMMITTEE OF THE BOARD IS CHARGED WITH THE RESPONSIBILITY FOR SETTING THE OVERALL COMPENSATION PHILOSOPHY AND FOR EVALUATING THE TOTAL COMPENSATION PROGRAMS FOR DISQUALIFIED PERSONS. THE BOARD MEMBERS ARE INDEPENDENT MEMBERS AND IN THESE DISCUSSIONS THE CEO RECUSES HIMSELF FROM THE DISCUSSIONS AROUND HIS OWN COMPENSATION. THE COMMITTEE OBTAINS VALID, COMPARABLE MARKET DATA (FROM INDEPENDENTLY PUBLISHED SOURCES) FOR COMPARABLE POSITIONS AND FROM FORM 990 FILINGS. THIS COMMITTEE ENGAGES THE SERVICES OF AN INDEPENDENT EXPERT IN EXECUTIVE COMPENSATION TO REVIEW THE MARKET DATA AND PROVIDE AN OPINION AS TO THE REASONABLENESS OF THE TOTAL COMPENSATION PROGRAM. FOR THE PAST SEVERAL YEARS, THE INDEPENDENT FIRM HAS BEEN WATSON WYATT. WATSON WYATT VALIDATES THE PROCESS USED BY MANAGEMENT FOR IDENTIFYING 'DISQUALIFIED PERSONS' AND THEN CONDUCTS A COMPARABILITY STUDY/ANALYSIS OF PAY AT SIMILAR TYPES AND SIZES OF ORGANIZATIONS AND REVIEWS BASE SALARY, INCENTIVE (OR OVER-BASE PROGRAMS), BENEFITS, RETIREMENT PLANS AND PERQUISITES. WATSON WYATT REVIEWS THE FINDINGS WITH THE BOARD COMMITTEE AND MINUTES ARE PREPARED AND SHARED WITH ALL THE VOTING BOARD MEMBERS EACH YEAR THAT DOCUMENTS THE DISCUSSION AND ANY ACTIONS THAT MAY HAVE BEEN TAKEN. A COPY OF A FORMAL OPINION LETTER PREPARED BY WATSON WYATT FOLLOWING THE DISCUSSION WITH THE COMPENSATION COMMITTEE IS PROVIDED TO THE BOARD CHAIR AND SHARED WITH THE FULL BOARD. THIS PROCESS IS UNDERTAKEN EACH YEAR. SCLHS EMPLOYS THE EXECUTIVE TEAM AT EACH OF ITS HOSPITAL AFFILIATES, INCLUDING EXEMPLA. AS PART OF ITS ANNUAL REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF THOSE IN THESE POSITIONS: 1) COMPENSATION COMMITTEE, 2) INDEPENDENT COMPENSATION CONSULTANT, 3) FORM 990 OF OTHER ORGANIZATIONS, 4) WRITTEN EMPLOYMENT CONTRACTS, 5) COMPENSATION SURVEYS AND STUDIES, 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS' EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED IN SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS.
AVAILABILITY OF GOVERNING DOCS, CONFLICT OF INTEREST POLICY, FINANCIALS	FORM 990, PART VI, QUESTION 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND RELATED DOCUMENTATION ARE PROVIDED UPON REQUEST AS DEEMED APPROPRIATE.
INDEPENDENT CONTRACTORS	PART V, QUESTION 1A AND PART VII, SECTION B, QUESTION 2	NO VENDOR PAYMENTS ARE PAID BY ST JOSEPH HOSPITAL. THEY ARE ALL PAID BY EXEMPLA, INC. AND THE NUMBER OF INDEPENDENT CONTRACTORS PAID OVER $100,000 ARE REFLECTED IN THE EXEMPLA, INC. FORM 990 AS THE TOTAL PAID FOR ALL ENTITIES OWNED/MANAGED BY EXEMPLA, INC.
OTHER CHANGES IN NET ASSETS	PART XI, LINE 5	REFLECTED AS OTHER CHANGES IN NET ASSETS ARE CONTRIBUTIONS OF TEMPORARILY RESTRICTED NET ASSETS OF $7,966.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

SAINT JOSEPH HOSPITAL

Employer identification number

84-0417134

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) SISTERS OF CHARITY LEAVENWORTH HLTH SYST 2420 W 26TH AVE SUITE 100D DENVER,CO80211 23-7379161	SUPPORT MMBRS	KS	501(c)(3)	11B-TYPE II	NA		No
(2) CARITAS CLINICS INC 818 NORTH 7TH STREET LEAVENWORTH,KS66048 48-1009910	CLINIC SVCS	KS	501(c)(3)	3	SCLHS	Yes
(3) MARIAN CLINIC INC 1001 SW GARFIELD TOPEKA,KS66604 48-1046905	CLINIC SVCS	KS	501(c)(3)	3	SCLHS	Yes
(4) MARILLAC CLINIC INC 2333 N 6TH STREET GRAND JUNCTION,CO81501 84-1085822	CLINIC SVCS	CO	501(c)(3)	3	SCLHS	Yes
(5) PROVIDENCE MEDICAL CENTER 8929 PARALLEL PARKWAY KANSAS CITY,KS66112 48-0784446	HEALTHCARE	KS	501(c)(3)	3	SCLHS	Yes
(6) ST JOHN HOSPITAL INC 3500 SOUTH FOURTH STREET LEAVENWORTH,KS66048 48-0543768	HEALTHCARE	KS	501(c)(3)	3	PMC	Yes
(7) BETHANY COMMUNITY PLAZA INC 15 NORTH 12TH STREET KANSAS CITY,KS66102 48-1207407	HEALTHCARE	KS	501(c)(3)	3	PMC	Yes
(8) PROVIDENCEST JOHN FOUNDATION INC 8929 PARALLEL PARKWAY KANSAS CITY,KS66112 48-0925688	SUPPORT 501C3	KS	501(c)(3)	7	PMC	Yes
(9) ST FRANCIS HEALTH CENTER INC 1700 SW 7TH STREET TOPEKA,KS66606 48-0547719	HEALTHCARE	KS	501(c)(3)	3	SCLHS	Yes
(10) ST FRANCIS HEALTH CENTER FOUNDATION 1700 SW 7TH STREET TOPEKA,KS66606 48-1092520	SUPPORT 501C3	KS	501(c)(3)	11A-TYPE I	SFHC	Yes
(11) ST MARYS HOSPITAL & MEDICAL CENTER INC 2635 N 7TH STREET GRAND JUNCTION,CO81502 84-0425720	HEALTHCARE	CO	501(c)(3)	3	SCLHS	Yes
(12) ST MARYS HOSPITAL DEVELOPMENT FOUNDATION 2635 N 7TH STREET GRAND JUNCTION,CO81502 23-7001007	SUPPORT 501C3	CO	501(c)(3)	11A-TYPE I	SMHMC	Yes
(13) SAINT JOSEPH HOSPITAL FOUNDATION 1835 FRANKLIN STREET DENVER,CO80218 84-0735096	SUPPORT 501C3	CO	501(c)(3)	11A-TYPE I	SJH	Yes
(14) HOLY ROSARY HEALTHCARE 2600 WILSON MILES CITY,MT59301 81-0231792	HEALTHCARE	MT	501(c)(3)	3	SCLHS	Yes
(15) HOLY ROSARY HEALTHCARE FOUNDATION INC 2600 WILSON MILES CITY,MT59301 20-2270238	SUPPORT 501C3	MT	501(c)(3)	11A-TYPE I	HRHC	Yes
(16) ST VINCENT HEALTHCARE 1233 NORTH 30TH BILLINGS,MT59101 81-0232124	HEALTHCARE	MT	501(c)(3)	3	SCLHS	Yes
(17) ST VINCENT HEALTHCARE FOUNDATION PO BOX 35200 BILLINGS,MT59107 81-0468034	SUPPORT 501C3	MT	501(c)(3)	7	SVHC	Yes
(18) NORTHWEST RESEARCH & EDUCATION INSTITUTE 315 NORTH 25TH STREET BILLINGS,MT59101 20-1343024	COMM HLTH RES	MT	501(c)(3)	9	SVHC	Yes
(19) ST JAMES HEALTHCARE 400 SOUTH CLARK STREET BUTTE,MT59701 81-0231785	HEALTHCARE	MT	501(c)(3)	3	SCLHS	Yes
(20) ST JAMES HEALTHCARE FOUNDATION 400 SOUTH CLARK STREET BUTTE,MT59701 65-1202190	SUPPORT 501C3	MT	501(c)(3)	11A-TYPE I	SJHC	Yes
(21) SAINT JOHNS HEALTH CENTER 2121 SANTA MONICA BLVD SANTA MONICA,CA90404 95-1684082	HEALTHCARE	CA	501(c)(3)	3	SCLHS	Yes
(22) JOHN WAYNE CANCER INSTITUTE 2000 SANTA MONICA BLVD SANTA MONICA,CA90404 95-4291515	CANCER R&D	CA	501(c)(3)	4	SJHC	Yes
(23) SAINT JOHNS HOSPITAL & HLTH CENTER FNDTN 2121 SANTA MONICA BLVD SANTA MONICA,CA90404 95-6100079	SUPPORT 501C3	CA	501(c)(3)	11A-TYPE I	SJHC	Yes
(24) EXEMPLA INC FKA LUTHERAN HOSPITAL 2420 W 26TH AVE SUITE 100D DENVER,CO80211 84-1103606	HEALTHCARE	CO	501(c)(3)	3	SCLHS	Yes
(25) EXEMPLA LUTHERAN MEDICAL CENTER FNDTN 2480 W 26TH AVESUITE 360B DENVER,CO80211 20-8846152	SUPPORT 501C3	CO	501(c)(3)	7	EXEMPLA INC	Yes
(26) EXEMPLA GOOD SAMARITAN MEDICAL CTR FNDTN 200 EXEMPLA CIRCLE LAFAYETTE,CO80026 84-1649162	SUPPORT 501C3	CO	501(c)(3)	7	EXEMPLA INC	Yes
(27) LUTH MED CNTR PRO&GEN LIAB SELF-INS TRST 2480 W 26TH AVESUITE 360B DENVER,CO80211 74-2571584	INSURANCE	CO	501(c)(3)	11A-TYPE I	EXEMPLA INC	Yes
(28) MOUNT ST VINCENT HOME INC 4159 LOWELL BOULEVARD DENVER,CO80211 84-0405260	RESIDENT CARE	CO	501(c)(3)	11A-TYPE I	SCLHS	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) PAVILION IMAGING LLC 750 WELLINGTON GRAND JUNCTION,CO81501 03-0516198	RADIOLOGY	CO	NA	N/A				No	0
(2) GRAND VALLEY SURGICAL CENTER LLC 710 WELLINGTON GRAND JUNCTION,CO81501 84-1505075	OP SURGERY	CO	NA	N/A				No	0
(3) SAN JUAN CANCER CENTER LLC 600 SOUTH 5TH STREET MONTROSE,CO81401 20-2856331	OP CANCER	CO	NA	N/A				No	0
(4) BILLINGS MRI CENTER LLC 1041 NORTH 29TH STREET BILLINGS,MT59101 81-0450943	MRI-PET SCAN	MT	NA	N/A				No	0
(5) LUTHERAN CAMPUS ASC LLC 3455 LUTHRN PKW SUITE 150 WHEATRIDGE,CO800336028 02-0749532	OP SURGERY	CO	NA	N/A				No	0
(6) COLORADO SURGICAL VENTURES LLC 30 S WACKER DR SUITE 2302 CHICAGO,IL60605 20-8038915	OP SURGERY	CO	ST JOSEPH HOSP	N/A	-642,193	3,627,401		No	0			85.000 %
(7) COLORADO SURGICAL HOSPITAL LLC 30 S WACKER DR SUITE 2302 CHICAGO,IL60605 20-8038977	OP SURGERY	CO	CO SURG VENTURE	N/A	518,553	18,685		No	0			51.000 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) CARITAS INC AND SUBSIDIARIES 9801 RENNER BOULEVARD SUITE 100 LENEXA,KS66219 48-0941069	OTHER MEDICAL	KS		C CORP
(2) LEAVEN INSURANCE COMPANY LTD 23 LIME TREE BAY AVE PO BOX 1051 GEORGETOWN,GRAND CAYMANKY1-1102 CJ 98-0370522	INSURANCE	CJ

Schedule R (Form 990) 2012

Page 3

Part V

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

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

Yes

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

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

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

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

Yes

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

Yes

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

Yes

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

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

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

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

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

s 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-s)	(c) Amount involved	(d) Method of determining amount involved
(1) EXEMPLA INC FKA LUTHERAN HOSPITAL	N	174,552,345	ACCRUAL
(2) EXEMPLA INC FKA LUTHERAN HOSPITAL	M	5,623,048	ACCRUAL
(3) EXEMPLA INC FKA LUTHERAN HOSPITAL	L	44,167,683	ACCRUAL
(4) EXEMPLA INC FKA LUTHERAN HOSPITAL	Q	1,801,555	ACCRUAL
(5) EXEMPLA INC FKA LUTHERAN HOSPITAL	D	60,000,000	AMT LOANED
(6) EXEMPLA INC FKA LUTHERAN HOSPITAL	O	151,700,629	ACCRUAL
(7) SAINT JOSEPH HOSPITAL FOUNDATION	C	1,648,633	ACCRUAL
(8) EXEMPLA INC FKA LUTHERAN HOSPITAL	E	12,250,785	ACCRUAL
(9) EXEMPLA INC FKA LUTHERAN HOSPITAL	P	19,706	ACCRUAL

Schedule R (Form 990) 2012

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2012

Page 5

Part VII

Supplemental Information

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

Identifier	Return Reference	Explanation
METHOD TO DETERMINE VALUE OF SCHEDULE R TRANSACTIONS	SCHEDULE R, PART V, LINE 2 COLUMN D	THE ORGANIZATION USED THE AMOUNT RECOGNIZED ON THE BOOKS AND RECORDS OF THE ORGANIZATION OF CASH RECEIVED OR PROVIDED, ADJUSTED TO THE ACCRUAL BASIS, TO DETERMINE THE VALUE OF SCHEDULE R TRANSACTIONS, WHICH APPROXIMATES FAIR MARKET VALUE.

Additional Data

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Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE JOINT MISSION OF EXEMPLA AND ST JOSEPH HOSPITAL IS TO FOSTER HEALING AND HEALTH FOR THE GREATER DENVER COLORADO METROPOLITAN SERVICE AREA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	5
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	2,827
6	Total number of volunteers (estimate if necessary) .............	6	350
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	537,747
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	255,363

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	902,306	1,225,010
9	Program service revenue (Part VIII, line 2g) .........	444,377,719	460,733,649
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	5,090,490	8,092,240
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-1,534,411	-1,772,124
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	448,836,104	468,278,775
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	79,324	185,482
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)	196,755,615	174,552,345
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–24e)....	219,789,321	240,219,507
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	416,624,260	414,957,334
19	Revenue less expenses. Subtract line 18 from line 12.......	32,211,844	53,321,441
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	489,755,294	527,883,841
21	Total liabilities (Part X, line 26).............	98,287,851	83,086,990
22	Net assets or fund balances. Subtract line 21 from line 20.....	391,467,443	444,796,851

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 291,058,108 including grants of $ 0 ) (Revenue $ 360,954,208 )
	Provision of hospital based healthcare services, including charity care and unreimbursed Medicaid - see description in Schedule O.

4b	(Code: ) (Expenses $ 16,196,972 including grants of $ 0 ) (Revenue $ 12,679,315 )
	Health professions education - See detailed descriptions in Schedule O.

4c	(Code: ) (Expenses $ 15,422,224 including grants of $ 0 ) (Revenue $ 84,667,606 )
	COMPREHENSIVE CANCER CENTER - See detailed descriptions in Schedule O.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 1,296,431 including grants of $ 185,482 ) (Revenue $ 2,432,520 )
4e	Total program service expenses323,973,735

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,825,232	6,470,896	971,157

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) ROBERT GIBBONS........................................................................ ASSOC DIR-PHYSICIAN GME	40.0 .......................0.0	X	326,548	0	29,738
(19) CHRISTINE RUTH GIESING........................................................................ PHYSICIAN-GME FACULTY	40.0 .......................0.0	X	247,472	0	33,712
(20) G EDWARD KIMM JR........................................................................ PHYSICIAN-GME FACULTY	40.0 .......................0.0	X	234,392	0	28,460
(21) JOHN M BREEN........................................................................ PROG DIR- PHYSICIAN GME	40.0 .......................0.0	X	359,596	0	31,147
(22) MARSHALL R GOTTESFELD........................................................................ PHYSICIAN- GME FACULTY	40.0 .......................0.0	X	232,787	0	18,172

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





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

				(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		1,225,010
e	Government grants (contributions)1e

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

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			1,225,010
			Business Code
2a	NET PATIENT REV.		621500	446,869,693	446,869,693	537,747
b	EDUCATION & OTHER		611600	9,202,208	9,202,208
c	ADMIN MISC INCOME		900003	2,067,562	2,067,562
d	MEANINGFUL USE INCENTIVE		621500	2,594,186	2,594,186
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			460,733,649
3	Investment income (including dividends, interest, and other similar amounts).......			8,102,356			8,102,356
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	4,034,277
b	Less: rental expenses	4,708,958
c	Rental income or (loss)	-674,681	0
d	Net rental income or (loss).......			-674,681			-674,681
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses		10,116
c	Gain or (loss)		-10,116
d	Net gain or (loss)..........			-10,116			-10,116
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		1,519,195
b	Less: cost of goods sold ..b		2,616,638
c	Net income or (loss) from sales of inventory..			-1,097,443	-1,097,443
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			468,278,775	459,636,206	537,747	7,417,559


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			2,365,144	1	3,584,937
2	Savings and temporary cash investments .........			10,792,526	2	1,046,041
3	Pledges and grants receivable, net ...........			0	3	0
4	Accounts receivable, net .............			50,169,401	4	25,052,778
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			60,000,000	7	60,000,000
8	Inventories for sale or use ..............			5,273,610	8	6,232,292
9	Prepaid expenses and deferred charges ..........			1,521,771	9	3,387,994
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	671,995,412
b	Less: accumulated depreciation .....	10b	340,172,163	241,934,230	10c	331,823,249
11	Investments—publicly traded securities ..........			55,740,467	11	36,700,594
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			34,968,252	13	29,345,204
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			26,989,893	15	30,710,752
16	Total assets. Add lines 1 through 15 (must equal line 34)......			489,755,294	16	527,883,841
17	Accounts payable and accrued expenses .........			27,887,243	17	28,440,977
18	Grants payable .................			0	18	0
19	Deferred revenue ................			4,266	19	2,873
20	Tax-exempt bond liabilities .............			0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			70,396,342	25	54,643,140
26	Total liabilities. Add lines 17 through 25.........			98,287,851	26	83,086,990
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			391,282,077	27	444,603,517
28	Temporarily restricted net assets ...........			185,366	28	193,334
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			391,467,443	33	444,796,851
34	Total liabilities and net assets/fund balances ........			489,755,294	34	527,883,841