Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2011 and ending 06-30-2012
BCheck if applicable:
CName of organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Doing Business As
SEE SCHEDULE O
 
Number and street (or P.O. box if mail is not delivered to street address)
1055 NORTH CURTIS ROAD
 
Room/suite
City or town, state or country, and ZIP + 4
BOISE, ID83706
D Employer identification number

82-0200895
E Telephone number

G Gross receipts $ 517,102,130
F Name and address of principal officer:
SALLY JEFFCOAT
1055 NORTH CURTIS ROAD
BOISE,ID83706
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SARMC.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:
 
L Year of formation: 1958
M State of legal domicile: ID
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: HEALTHCARE SERVICES
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 12
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 4,107
6 Total number of volunteers (estimate if necessary) .... 6 3,172
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 12,452
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,676,617 2,319,894
9 Program service revenue (Part VIII, line 2g) ......... 491,985,879 499,046,264
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 8,733,371 5,667,095
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 6,386,801 8,819,959
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 509,782,668 515,853,212
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 903,155 579,057
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) 228,588,769 216,875,695
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet1,079,319    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 269,003,649 266,202,018
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 498,495,573 483,656,770
19 Revenue less expenses. Subtract line 18 from line 12....... 11,287,095 32,196,442
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 588,441,049 631,742,977
21 Total liabilities (Part X, line 26)............. 271,096,178 295,262,732
22 Net assets or fund balances. Subtract line 21 from line 20..... 317,344,871 336,480,245
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: HEALTHCARE SERVICES - SEE LINE 4 AND SCHEDULE H FOR ADDITIONAL INFORMATION
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 419,590,268 including grants of $ 579,057 ) (Revenue $ 505,777,327 )
SAINT ALPHONSUS REGIONAL MEDICAL CENTER, A NOT-FOR-PROFIT CORPORATION, OWNS AND OPERATES AN ACUTE CARE HOSPITAL IN BOISE, IDAHO. THE HOSPITAL PROVIDES SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHIC REGION. THE HOSPITAL IS A MEMBER OF TRINITY HEALTH, AN INDIANA NOT-FOR-PROFIT CORPORATION SPONSORED BY CATHOLIC HEALTH MINISTRIES, A PUBLIC JURIDIC PERSON OF THE HOLY ROMAN CATHOLIC CHURCH. FOR MORE INFORMATION ON SPECIFIC SERVICES PROVIDED, PLEASE SEE SAINT ALPHONSUS REGIONAL MEDICAL CENTER'S WEBSITE AT WWW.SARMC.ORG. THE MISSION STATEMENT OF THE HOSPITAL IS AS FOLLOWS:WE SERVE TOGETHER IN TRINITY HEALTHIN THE SPIRIT OF THE GOSPEL
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
TO HEAL BODY, MIND, AND SPIRITTO IMPROVE THE HEALTH OF OUR COMMUNITIESAND TO STEWARD THE RESOURCES ENTRUSTED TO US.
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 419,590,268
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II......................... Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
620
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
4,107
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
14
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
OR
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
BRENT CHERNE CONTROLLER
1055 NORTH CURTIS ROAD
BOISE,ID83706
(208) 367-7192
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) SALLY JEFFCOAT
PRESIDENT & CEO
 15.00 X   X       0 688,536 92,426
(2) GEORGE JUETTEN
VICE CHAIR THROUGH 12/11; CHAIR
 1.00 X   X       0 0 0
(3) BRENT LLOYD
CHAIR THROUGH 12/11; TRUSTEE
 1.00 X   X       0 0 0
(4) J RICHARD O'CONNELL
TRUSTEE; TRIN EVP & COO HOSP NTWKS
 3.00 X           0 943,237 118,221
(5) KAYE O'RIORDAN
TRUSTEE
 1.00 X           0 0 0
(6) STEVE BROCATO
TRUSTEE THROUGH 11/11
 1.00 X           0 0 0
(7) SR SHARLET WAGNER CSC
TRUSTEE
 1.00 X           0 0 0
(8) SR SHARON FORD RSM
TRUSTEE
 1.00 X           0 0 0
(9) KENNETH HART
TRUSTEE
 1.00 X           0 0 0
(10) RONALD GRAVES
TRUSTEE
 1.00 X           0 0 0
(11) VICTOR YAMAMOTO
TRUSTEE
 1.00 X           0 0 0
(12) JON WAGNILD MD
TRUSTEE
 1.00 X           0 0 0
(13) LYNN HARRIS
TRUSTEE
 1.00 X           0 0 0
(14) MIKE REULING
TRUSTEE
 1.00 X           0 0 0
(15) MATT SHIRTCLIFF
TRUSTEE AS OF 1/12
 1.00 X           0 0 0
(16) STEPHANIE WESTERMEIER
SECRETARY; VP & GEN CNSL
 45.00     X       0 274,225 38,872
(17) BLAINE PETERSEN
TREASURER AND SYSTEM CFO
 5.00     X       0 415,490 40,858
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) JOSEPH SWEDISH
TRINITY HEALTH PRES & CEO
 2.00       X     0 5,186,660 576,202
(19) KEDRICK ADKINS
TRINITY HEALTH PRES INTEGRATED SVCS
 2.00       X     0 1,405,226 117,120
(20) MICHAEL MURPHY
TRINITY EVP, HLTH NTWKS THROUGH 4/12
 2.00       X     0 474,370 75,538
(21) RODNEY REIDER
COO
 41.00       X     0 384,532 44,250
(22) JANELLE G REILLY
CHIEF STRATEGY OFFICER THROUGH 2/12
 25.00       X     0 360,500 35,844
(23) JAMES POLK
SAHS, CHIEF QUALITY OFFICER
 25.00       X     0 345,649 51,765
(24) KENNETH FRY
CFO
 50.00       X     122,124 188,350 48,607
(25) JEAN BASOM
VP DEVELOPMENT
 50.00       X     0 198,425 78,378
(26) CHRISTIAN ZIMMERMAN MD
PHYSICIAN-NEUROSURGERY
 50.00         X   1,834,197 0 94,158
(27) MICHAEL COUGHLIN MD
PHYSICIAN-ORTHOPEDICS
 50.00         X   947,581 0 46,966
(28) STEPHEN JONES MD
PHYSICIAN-THORACIC SURGEON
 50.00         X   927,209 0 78,546
(29) STEPHEN FALL MD
PHYSICIAN-THORACIC SURGEON
 50.00         X   676,147 0 81,097
(30) MARK G PARENT MD
PHYSICIAN-CARDIOLOGY
 50.00         X   674,981 0 39,565
(31) MICHAEL SLUBOWSKI
FORMER KEY EMPLOYEE
 0.00           X 0 150,838 1,101
(32) KAREN HODGE
FORMER KEY EMPLOYEE
 0.00           X 0 224,028 137,187
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,182,239 11,240,066 1,796,701
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet238
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
REHABILITATION MANAGEMENT ASSOCIATES INC
901 N CURTIS 204
BOISE,ID83706 		REHABILITATION SERVICES 6,998,144
INTERMOUNTAIN MEDICAL IMAGING LLC
877 WEST MAIN ST STE 603
BOISE,ID83702 		RADIOLOGY SERVICES 3,490,409
BOISE ANESTHESIA PA
PO BOX 5641
PORTLAND,OR97228 		ANESTHESIA SERVICES 1,864,736
KREIZENBECK CONTRUCTORS
11724 WEST EXECUTIVE DRIVE
BOISE,ID83713 		CONSTRUCTION SERVICES 1,630,278
TREASURE VALLEY LABORATORY
PO BOX 2693
SPOKANE,WA99220 		LABORATORY SERVICES 1,608,577
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet102
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 469,042
d Related organizations...1d 170,439
e Government grants (contributions)1e 527,053
f All other contributions, gifts, grants, and
similar amounts not included above1f 		1,153,360
g Noncash contributions included in lines 1a-1f:$ 118,080
h Total. Add lines 1a-1f.......MediumBullet 2,319,894
Program Service Revenue Business Code
2a NET PATIENT SVC REV 900,099 497,665,818 497,665,818    
b INTERCO. ALLOCATION 900,099 1,380,446 1,380,446    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 499,046,264
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 3,536,399     3,536,399
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross rents 362,786  
b Less: rental expenses 0  
c Rental income or (loss) 362,786  
d Net rental income or (loss).......MediumBullet 362,786     362,786
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 2,801,220 108,624
b Less: cost or other basis and sales expenses 0 779,148
c Gain or (loss) 2,801,220 -670,524
d Net gain or (loss)..........MediumBullet 2,130,696     2,130,696
8a Gross income from fundraising events (not including
$ 469,042
of contributions reported on line 1c). See Part IV, line 18 ...
a 469,669
b Less: direct expenses ...b 469,670
c Net income or (loss) from fundraising events..MediumBullet -1   -1
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 11,822
b Less: direct expenses ...b 100
c Net income or (loss) from gaming activities...MediumBullet 11,722     11,722
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a MEDICARE/MEDICAID HIT 900,099 2,517,301 2,517,301    
b CAFETERIA REVENUE 900,099 1,701,937     1,701,937
c BIO-MEDICAL REPAIR 811,000 12,452   12,452  
d All other revenue .... 4,213,762 4,213,762    
e Total. Add lines 11a–11d ......MediumBullet 8,445,452
12 Total revenue. See Instructions....MediumBullet 515,853,212 505,777,327 12,452 7,743,539
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
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 21 538,052 538,052
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 41,005 41,005
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 3,330,528   3,330,528  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 304,987 55,786 249,201  
7 Other salaries and wages 179,352,848 175,924,869 3,102,455 325,524
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 9,859,096 9,798,148 42,820 18,128
9 Other employee benefits ....... 11,713,677 11,448,883 243,601 21,193
10 Payroll taxes ........... 12,314,559 11,141,233 1,150,424 22,902
11 Fees for services (non-employees):        
a Management ...... 1,295,212 1,295,212    
b Legal ......... 61,289 61,289    
c Accounting ........... 64,097 2,300 61,797  
d Lobbying ........... 61,390   61,390  
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 39,467,530 36,596,035 2,632,293 239,202
12 Advertising and promotion .... 1,493,446 691,384 745,921 56,141
13 Office expenses ....... 6,764,594 4,505,573 1,986,664 272,357
14 Information technology ...... 20,018,821 334,448 19,680,510 3,863
15 Royalties ..        
16 Occupancy ........... 9,576,325 9,395,016 178,931 2,378
17 Travel ............ 1,227,717 1,031,027 151,590 45,100
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 1,123 1,123    
20 Interest ........... 8,101,140 8,101,140    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 28,338,731 25,220,407 3,116,171 2,153
23 Insurance .............. 3,718,643 1,086,300 2,632,343  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a MEDICAL SUPPLIES 81,990,048 81,990,048    
b BAD DEBT 27,128,217 27,128,217    
c INTERCO. PURCHASED SVCS 22,850,663 21,283 22,829,380  
d HOSPITAL PROVIDER TAX 5,694,892 5,694,892    
e
f All other expenses 8,348,140 7,486,598 791,164 70,378
25 Total functional expenses. Add lines 1 through 24f 483,656,770 419,590,268 62,987,183 1,079,319
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 2,135,737 1 586,794
2 Savings and temporary cash investments ....... 3,579,548 2 3,600,401
3 Pledges and grants receivable, net ......... 389,843 3 238,049
4 Accounts receivable, net ......... 69,863,287 4 71,486,453
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 20,000 5 54,858
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 417,116 7 426,310
8 Inventories for sale or use .............. 5,830,294 8 6,530,940
9 Prepaid expenses and deferred charges ............ 941,931 9 1,316,268
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 463,414,966
b Less: accumulated depreciation. ..... 10b 202,302,722 263,322,195 10c 261,112,244
11 Investments—publicly traded securities .......... 112,223,910 11 112,677,102
12 Investments—other securities. See Part IV, line 11 ...... 95,472,730 12 133,912,202
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 34,244,458 15 39,801,356
16 Total assets. Add lines 1 through 15 (must equal line 34)... 588,441,049 16 631,742,977
Liabilities 17 Accounts payable and accrued expenses . 59,983,631 17 77,087,175
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 211,112,547 25 218,175,557
26 Total liabilities. Add lines 17 through 25..... 271,096,178 26 295,262,732
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 313,375,480 27 332,641,795
28 Temporarily restricted net assets ..... 3,969,391 28 3,838,450
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet 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 ..... 317,344,871 33 336,480,245
34 Total liabilities and net assets/fund balances ..... 588,441,049 34 631,742,977
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
515,853,212
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
483,656,770
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
32,196,442
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
317,344,871
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-13,061,068
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
336,480,245
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


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Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
  		Employer identification number

82-0200895
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




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
  		Employer identification number

82-0200895
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
  		Employer identification number

82-0200895
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		 (c)
Use 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		 (c)
Use 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		 (c)
Use 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		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


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SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2011

Schedule C (Form 990 or 990-EZ) 2011
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check expenses, and share of excess lobbying expenditures).
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(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? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes
No
(b)
Amount
1
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:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
48,879
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
66,390
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
4,785
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
120,054
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
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”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: LOBBYING ACTIVITIES PERFORMED BY SAINT ALPHONSUS REGIONAL MEDICAL CENTER (SARMC) INCLUDED THE RETENTION OF AN INDIVIDUAL WHO WAS PAID A RETAINER TO PERFORM THE FOLLOWING: 1. MONITOR AND REPORT ON ALL SIGNIFICANT DEVELOPMENTS IN IDAHO STATE LEGAL, LEGISLATIVE, POLICY AND REGULATORY MATTERS AFFECTING SARMC. 2. REGULARLY MEET IDAHO STATE OFFICIALS ON ISSUES OF CONTINUING CONCERN AND INTEREST TO SARMC AND REPORT THE RESULTS OF SUCH MEETINGS. 3. MONITOR ALL LEGISLATION INTRODUCED DURING EACH LEGISLATIVE SESSION, LOBBY AGAINST LEGISLATION DETERMINED TO BE ADVERSE TO SARMC AND LOBBY IN FAVOR OF ALL MATTERS OF INTEREST AND CONCERN TO SARMC DURING THE SAME LEGISLATIVE SESSION. SAINT ALPHONSUS REGIONAL MEDICAL CENTER ALSO PAYS DUES TO SEVERAL HEALTH ASSOCIATIONS WHO USE A PORTION OF THESE DUES FOR LOBBYING PURPOSES. THESE ORGANIZATIONS HAVE PROVIDED SARMC WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. THAT LOBBYING PORTION IS AS FOLLOWS: IDAHO HOSPITAL ASSOCIATION - $37,514; AMERICAN HOSPITAL ASSOCIATION - $5,838; CATHOLIC HOSPITAL ASSOCIATION - $5,527.
Schedule C (Form 990 or 990EZ) 2011

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
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 .......    
5
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? ............
6
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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
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 $  
2
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:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 12,908,822 10,237,747 8,914,610 11,601,314
b Contributions ........        
c Net investment earnings, gains, and losses ... 43,857 3,033,233 1,704,880 -2,363,278
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		507,725 362,158 381,743 323,426
f Administrative expenses ....        
g End of year balance ...... 12,444,954 12,908,822 10,237,747 8,914,610
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet100.000 %
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ................. 1,284,141 8,129,490 9,413,631
b Buildings ................   307,671,335 112,733,208 194,938,127
c Leasehold improvements ............        
d Equipment ................   126,674,814 89,569,514 37,105,300
e Other .................   19,655,186   19,655,186
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 261,112,244
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other 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    
(3)Other
(A) COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 		75,595,598 F

(B) EQUITY METHOD INVESTMENTS 		58,316,604 C







Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 133,912,202
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) INTERCOMPANY NOTES RECEIVABLES 810,835
(2) OTHER RECEIVABLES 3,082,484
(3) INTERCOMPANY OTHER LONG TERM ASSETS 24,993,844
(4) INTERCOMPANY RECEIVABLES 7,802,576
(5) INVESTMENT IN UNCONSOLIDATED AFFILIATES 3,111,617




Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 39,801,356
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes  
INTERCOMPANY ACCOUNTS PAYABLE 9,645,763
DEFERRED COMPENSATION LIABILITY 3,824,508
ASSET RETIREMENT OBLIGATION (FIN 47) 734,743
INTERCOMPANY NOTES PAYABLE 203,863,641
OTHER LONG TERM LIABILITIES 106,902




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 218,175,557
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8  
9 Total adjustments (net). Add lines 4 through 8 ......................... 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS ARE FOR: - PROJECTS DESIGNED TO ELEVATE THE QUALITY OF HEALTHCARE (INTERNAL GRANTS) - PROJECTS TO MEET IMMEDIATE NEEDS RELATED TO PATIENT CARE QUALITY (OPPORTUNITY GRANTS) - PROJECTS FOR HEALTH AND WELFARE-RELATED COMMUNITY BENEFIT PROJECTS THAT MEET THE NEEDS OF THE POOR AND UNDERSERVED.
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,or if the organization entered more than $15,000 on Form 990-EZ, line 6a.right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

FESTIVAL OF TREES
(event type) 		(b) Event #2

CHILDRENS CLASSIC RACE
(event type) 		(c) Other Events

6
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 800,900 62,097 75,714 938,711
2 Less: Charitable
contributions . . . 		378,243 33,957 56,842 469,042
3 Gross income (line 1
minus line 2) . . . 		422,657 28,140 18,872 469,669
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . . 3,432   311 3,743
6 Rent/facility costs . . 79,684     79,684
7 Food and beverages . . 70,768   6,902 77,670
8 Entertainment . . . 15,305     15,305
9 Other direct expenses . 253,468 28,140 11,660 293,268
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 469,670
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -1
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2011
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
 
No
c
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?...............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ...............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
and Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		1 7,305 10,762,943   10,762,943 2.360 %
b Medicaid (from Worksheet 3, column a) ..... 25 30,838 73,379,219 62,237,387 11,141,832 2.440 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .            
dTotal Financial Assistance and
Means-Tested Government Programs ..... 		26 38,143 84,142,162 62,237,387 21,904,775 4.800 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		10 73,064 1,809,221   1,809,221 0.400 %
f Health professions education
(from Worksheet 5) .. 		3 1,393 595,732   595,732 0.130 %
g Subsidized health services
(from Worksheet 6) .. 		8 3,832 2,199,407   2,199,407 0.480 %
h Research (from Worksheet 7) 1 1 413,899   413,899 0.090 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) .... 4 4,481 1,944,940   1,944,940 0.430 %
jTotal Other Benefits ... 26 82,771 6,963,199   6,963,199 1.530 %
kTotal. Add lines 7d and 7j. .. 52 120,914 91,105,361 62,237,387 28,867,974 6.330 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building 2 75 60,799   60,799 0.010 %
7 Community health improvement advocacy 2 26 77,579   77,579 0.020 %
8 Workforce development            
9 Other            
10 Total 4 101 138,378   138,378 0.030 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense........
2
11,571,241
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
1,735,686
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
77,386,473
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
80,071,853
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-2,685,380
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
11 MRI LIMITED PARTNERSHIP
  		MRI DIAGNOSTICS 14.170 % 0 % 65.720 %
22 MRI MOBILE LIMITED PARTNERSHIP
  		MRI DIAGNOSTICS 10.500 % 0 % 50.380 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 SAINT ALPHONSUS REGIONAL MEDICAL CENTER
1055 N CURTIS ROAD
BOISE,ID83706 		X X   X     X    
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 150.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?2
Name and address Type of Facility (describe)
1 ORTHO INST & BOISE HRT CARE
1070-1071 N CURTIS ROAD
BOISE,ID83706 		EMPLOYED PHYSICIANS
2 VIEWPOINTE CLINIC
1880 W JUDITH LANE
BOISE,ID83705 		EMPLOYED PHYSICIANS
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 6A: SAINT ALPHONSUS REGIONAL MEDICAL CENTER REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH IN ITS ANNUAL REPORT, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, SAINT ALPHONSUS REGIONAL MEDICAL CENTER INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE.
    PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM.
    PART I, L7 COL(F): THE FOLLOWING NUMBER, $27,128,217, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F).
    PART II: COMMUNITY BUILDING ACTIVITIES - SAINT ALPHONSUS REGIONAL MEDICAL CENTER STRIVES TO MAKE THE CITIZENS OF OUR COMMUNITY MORE PRODUCTIVE, HEALTHY MEMBERS OF SOCIETY. THROUGH OUR COMMUNITY NEEDS ASSESSMENT AND OTHER COMMUNITY DATA, WE LEARNED THAT SEVERAL AREAS CAN BENEFIT FROM OUR HEALTH CARE EXPERTISE AND MONETARY SUPPORT. THESE INCLUDE AGENCIES THAT SUPPORT ECONOMIC DEVELOPMENT AND JOB CREATION; SUPPORT THE UNINSURED; ADDRESS WELLNESS ISSUES IN THE WORKFORCE; IMPROVE END OF LIFE CARE; EDUCATE REFUGEES REGARDING CHILDBIRTH AND PARENTING; IMPROVE CHILD SAFETY, HEALTH AND EDUCATION; AND SUPPORT SUBSTANCE ABUSE DETOXIFICATION AND SOBERING SERVICES AND CRISIS MENTAL HEALTH.SPECIFIC EXAMPLES OF OUR COMMUNITY BUILDING ACTIVITIES ARE DESCRIBED BELOW:- PARTICIPATION IN LOCAL BOARDS & TASK FORCES: SAINT ALPHONSUS LEADERS AND ASSOCIATES PARTICIPATE IN A VARIETY OF LOCAL NONPROFIT BOARDS AND TASK FORCES AIMED AT IMPROVING THE HEALTH OF OUR COMMUNITIES AND MAKING OUR COMMUNITY A MORE LIVABLE PLACE. EXAMPLES OF BOARD PARTICIPATION INCLUDE: - FAMILY MEDICINE RESIDENCY OF IDAHO: THROUGH ACTIVE PARTICIPATION ON THE BOARD OF FAMILY MEDICINE RESIDENCY OF IDAHO, SAINT ALPHONSUS HAS BEEN ABLE TO HELP GUIDE THE CONTINUING DEVELOPMENT AND EXPANSION OF FAMILY MEDICINE RESIDENCY CAPACITY IN IDAHO - A CRITICAL NEED SINCE IDAHO RANKS 49TH NATIONWIDE IN TERMS OF PRIMARY CARE PHYSICIANS PER CAPITA. THROUGH THIS PARTNERSHIP, WE WERE ALSO ABLE TO DEVELOP A NEW PSYCHIATRIC RESIDENCY PROGRAM BASED IN BOISE, WHICH OVER TIME WILL EXPAND THE PIPELINE OF NEW PSYCHIATRISTS PRACTICING IN OUR REGION, WHICH IS A HEALTH PROVIDER SHORTAGE AREA FOR MENTAL HEALTH. - BOYS & GIRLS CLUBS OF ADA COUNTY: ENHANCEMENT OF BEFORE & AFTER-SCHOOL PROGRAMMING FOR LOCAL AT-RISK YOUTH, INCLUDING A NEW LOCATION IN MERIDIAN, IDAHO. SAINT ALPHONSUS' REPRESENTATIVE ON THE BOYS & GIRLS CLUB BOARD HAS CHAIRED SEVERAL IMPORTANT COMMITTEES, INCLUDING STRATEGIC PLANNING, PROGRAMS, AND THE ANNUAL FUNDRAISER AUCTION, WHICH BRINGS IN THE BULK OF ANNUAL OPERATING FUNDS FOR THE CLUBS. UNDER OUR GUIDANCE, OUR LOCAL CLUBS HAVE ALSO TAKEN ON A SIGNIFICANT ROLE IN PROVIDING MEALS FOR LOW INCOME CHILDREN IN ADA AND CANYON COUNTIES AND HAVE RECEIVED NATIONAL AWARDS FOR THEIR NUTRITION PROGRAMMING. - COMMUNITY MENTAL HEALTH MEETINGS: A SAINT ALPHONSUS REPRESENTATIVE PARTICIPATES IN DISCUSSIONS WITH MENTAL HEALTH PROVIDERS THROUGHOUT THE COMMUNITY, TO WORK THROUGH ISSUES AND IMPROVE COORDINATION OF SERVICES. -REFUGEE RESOURCE STEERING COMMITTEE: SAINT ALPHONSUS PARTICIPATES IN ONGOING COLLABORATION AND STRATEGIC PLANNING AMONG COMMUNITY LEADERS WITH THE PRIMARY GOAL OF STRENGTHENING SUPPORTS FOR REFUGEE RESETTLEMENT IN THE GREATER BOISE AREA. A SECONDARY GOAL OF THE PROCESS IS TO BETTER INFORM ALL PERSONS INVOLVED ABOUT THE PRINCIPLES AND PRACTICES OF REFUGEE RESETTLEMENT, ESPECIALLY AS THEY ARE APPLIED TO THE LARGER COMMUNITY OF BOISE. THE STEERING COMMITTEE IS MADE UP OF COMMUNITY LEADERS ADDRESSING NEEDS AND RESOURCES RELATED TO TRANSPORTATION, EDUCATION, HOUSING, EMPLOYMENT, HEALTH, AND SOCIAL INTEGRATION. THEY MEET TO BETTER DEFINE THE NEEDS AND TO RECOMMEND RESOURCES AND STRATEGIES FOR IMPROVING SERVICES AND OPPORTUNITIES FOR REFUGEES.HEALTH IMPROVEMENT ADVOCACY: SAINT ALPHONSUS HAS BEEN AN ACTIVE PARTICIPANT IN ADVOCACY SUPPORTING HEALTH IMPROVEMENT INITIATIVES SUCH AS: - HEALTH INSURANCE EXCHANGE:SAINT ALPHONSUS JOINED A COALITION OF BUSINESS AND HEALTH ORGANIZATIONS TO SUPPORT CREATION OF A STATE-BASED HEALTH INSURANCE EXCHANGE IN THE STATE OF IDAHO, TO HELP INCREASE THE NUMBER OF IDAHOANS WHO CAN ACCESS AFFORDABLE HEALTH INSURANCE. AS OF YET, IDAHO ELECTED OFFICIALS HAVE NOT DECIDED WHAT TYPE OF EXCHANGE IDAHO WILL HAVE. - TOBACCO PREVENTION:SAINT ALPHONSUS HAS COLLABORATED WITH PUBLIC HEALTH AND PROVIDER GROUPS TO ADVOCATE FOR RAISING THE TOBACCO TAX IN IDAHO, TO HELP DECREASE THE PERCENTAGE OF YOUTH WHO BEGIN SMOKING. OVER THE PAST COUPLE YEARS, LEGISLATION HAS BEEN DRAFTED AND TAKEN BEFORE THE LEGISLATURE, BUT NO LEGISLATION HAS BEEN PASSED YET. IN THE MEANWHILE, THIS COALITION HAS FOCUSED EFFORTS ON LOCAL CITY ORDINANCES AS A WAY TO IMPROVE SMOKE-FREE POLICIES AND DECREASE THE BURDEN OF TOBACCO-RELATED ILLNESS. - SUICIDE HOTLINE:IDAHO HAS THE 4TH HIGHEST SUICIDE RATE IN THE NATION, YET FOR THE PAST 5 YEARS HAS BEEN THE ONLY STATE WITHOUT ITS OWN SUICIDE HOTLINE. SAINT ALPHONSUS HELPED COORDINATE EFFORTS TO BRING TOGETHER PUBLIC AND PRIVATE PARTNERS TO ESTABLISH A HOTLINE IN IDAHO. THESE EFFORTS WERE SUCCESSFUL, WITH THE FIRST TWO YEARS OF OPERATING FUNDS BEING SUCCESSFULLY RAISED, AN OPERATOR BROUGHT ON BOARD, AND THE HOTLINE COMMENCED OPERATION IN NOVEMBER 2012.
    PART III, LINE 4: SAINT ALPHONSUS REGIONAL MEDICAL CENTER IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM THOSE STATEMENTS: "SUBSTANTIALLY ALL OF THE CORPORATION'S RECEIVABLES ARE RELATED TO PROVIDING HEALTHCARE SERVICES TO PATIENTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. THE CORPORATION'S ESTIMATE FOR ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS BY PAYOR."COSTING METHODOLOGY FOR LINES 2 AND 3: AMOUNTS ARE CALCULATED ON LINE 2 USING A COST TO CHARGE RATIO METHODOLOGY.ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS.THE AMOUNT ON LINE 3 IS AN ESTIMATE OF PATIENTS WHO WERE SENT TO COLLECTION AGENCIES BUT WOULD LIKELY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE IF THEY HAD PROVIDED DOCUMENTATION OF THEIR FINANCIAL SITUATION IN RESPONSE TO OUR COMMUNICATIONS.
    PART III, LINE 8: SAINT ALPHONSUS MEDICAL CENTER DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CHA RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTHCARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT.
    PART III, LINE 9B: SAINT ALPHONSUS REGIONAL MEDICAL CENTER'S COLLECTION POLICY CONTAINS THE CRITERIA FOR FINANCIAL ASSISTANCE, AND CONTAINS THE FOLLOWING VERBIAGE FOR ARRANGEMENTS WITH OUTSIDE COLLECTION AGENCIES: THE AGREEMENT MUST DEFINE THE STANDARDS AND SCOPE OF PRACTICES TO BE USED BY OUTSIDE COLLECTION AGENTS ACTING ON BEHALF OF SAINT ALPHONSUS HEALTH SYSTEM, ALL OF WHICH MUST BE IN COMPLIANCE WITH THIS POLICY.
SAINT ALPHONSUS REGIONAL MEDICAL CENTER   PART V, SECTION B, LINE 19D: PATIENTS WITH INCOME AT OR BELOW 150% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME ABOVE 150% BUT NOT EXCEEDING 400% RECEIVE A DISCOUNT ON MEDICALLY NECESSARY SERVICES, BASED ON A GRADUATED SCALE. A MINIMUM DISCOUNT OF 20% IS PROVIDED TO UNINSURED PATIENTS BETWEEN 300% TO 400% OF FPG. THIS DISCOUNT IS IN THE RANGE OF WHAT SAINT ALPHONSUS REGIONAL MEDICAL CENTER HAS NEGOTIATED WITH PAYERS WHO DO NOT HAVE AN EXCLUSIVE ARRANGEMENT WITH SAINT ALPHONSUS REGIONAL MEDICAL CENTER AND PROVIDE NO PATIENT INCENTIVES OR NO UTILIZATION MANAGEMENT.
    PART VI, LINE 2: NEEDS ASSESSMENT - SAINT ALPHONSUS REGIONAL MEDICAL CENTER ASSESSES THE HEALTH NEEDS OF THE COMMUNITY THROUGH COMMUNITY NEEDS ASSESSMENTS EVERY THREE YEARS. A COMMUNITY NEEDS ASSESSMENT IS A POINT-IN-TIME EFFORT TO MEASURE THE HEALTH AND WELL BEING OF THE COMMUNITY. IT SERVES AS THE BASIS FOR SAINT ALPHONSUS REGIONAL MEDICAL CENTER'S STRATEGIC AND SUBSEQUENT ACTION PLANNING TO DEVELOP HEALTH POLICY, ALLOCATE RESOURCES, IMPROVE OR EXPAND EXISTING SERVICES, IMPLEMENT NEW PROGRAMS AND COLLABORATE WITH OTHER COMMUNITY HEALTHCARE PROVIDERS. A COMMUNITY NEEDS ASSESSMENT ALSO SERVES AS A BENCHMARK FOR FUTURE ASSESSMENT OF RELATIVE PROGRESS TOWARD ESTABLISHED COMMUNITY HEALTH OBJECTIVES.THE SAINT ALPHONSUS COMMUNITY NEEDS ASSESSMENT PROVIDES THE OPPORTUNITY TO:- GAIN INSIGHTS INTO THE NEEDS AND ASSETS OF THE COMMUNITIES SERVED - IDENTIFY AND ADDRESS THE NEEDS OF VULNERABLE POPULATIONS WITHIN THE COMMUNITY- ENHANCE HOSPITAL/COMMUNITY RELATIONSHIPS AND THE OPPORTUNITY FOR COLLABORATIVE COMMUNITY ACTION, INCLUDING INVOLVEMENT WITH COALITIONS, PARTNERSHIPS, BOARDS, COMMITTEES, COMMISSIONS, ADVISORY GROUPS AND PANELS- PROVIDE THE INFORMATION REQUIRED FOR COMMUNITY OUTREACH PLANNINGTHE SAINT ALPHONSUS COMMUNITY NEEDS ASSESSMENT PROCESS INVOLVES THE GATHERING OF TWO TYPES OF DATA: QUANTITATIVE (DEMOGRAPHICS, HEALTH INDICATORS, ETC.) AND QUALITATIVE (PUBLIC SURVEYS, FORUMS, FOCUS GROUPS). THE DATA HELPS SUPPORT SHORT-TERM AND LONG-TERM DECISIONS ABOUT ALLOCATION OF COMMUNITY HUMAN AND CAPITAL RESOURCES. DURING FY12, SAINT ALPHONSUS PARTNERED WITH UNITED WAY OF TREASURE VALLEY, ST. LUKE'S HEALTH SYSTEM, ELKS REHABILITATION HOSPITAL, AND TREASURE VALLEY HEALTH PARTNERSHIP, TO CONDUCT A COMPREHENSIVE COMMUNITY NEEDS ASSESSMENT FOCUSING ON HEALTH, EDUCATION AND FINANCIAL INDEPENDENCE. ASSESSMENT WORK WAS THEN COMPLETED DURING FY12, AND THE PARTNERS HAVE PRIORITIZED AND CREATED AN IMPLEMENTATION PLAN. IMPLEMENTATION ACTIVITIES ARE ONGOING. BOISE STATE UNIVERSITY SERVED AS RESEARCH PARTNER, AND UTAH FOUNDATION HAS PROVIDED TECHNICAL ASSISTANCE TO THIS PROJECT.
    PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - SAINT ALPHONSUS IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTHCARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- IMPROVING IDENTIFICATION OF THOSE ELIGIBLE FOR FINANCIAL ASSISTANCE- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, SAINT ALPHONSUS HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSSAINT ALPHONSUS COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. SAINT ALPHONSUS HAS SIGNS POSTED IN ALL REGISTRATION AREAS AND PLASTIC TABLE TOP CARDS IN THE REGISTRATION WAITING ROOMS, NOTIFYING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. ALL SELF-PAY PATIENTS ARE OFFERED FINANCIAL ASSISTANCE FORMS. EACH PATIENT RECEIVES A BILLING BROCHURE THAT LISTS PAYMENT OPTIONS AND HOW TO APPLY FOR CHARITY CARE. PATIENTS ALSO ARE SCREENED FOR MEDICAID ELIGIBILITY, UTILIZING FINANCIAL ASSISTANCE FORMS. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY HELP THEM OBTAIN AND PAY FOR HEALTHCARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. HOWEVER, DETERMINATION FOR FINANCIAL SUPPORT CAN BE MADE DURING ANY STAGE OF THE PATIENT'S STAY AFTER STABILIZATION OR COLLECTION CYCLE.SAINT ALPHONSUS OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH SIGNS POSTED IN REGISTRATION AREAS, PLASTIC TABLE TOP CARDS IN REGISTRATION WAITING ROOMS AND PATIENT BROCHURES. SELF-PAY INPATIENTS AND SURGERY PATIENTS RECEIVE A VISIT FROM A PATIENT ADVOCATE WHO ASSISTS THEM IN COMPLETING FINANCIAL ASSISTANCE FORMS FOR COUNTY INDIGENT ASSISTANCE, MEDICAID, SOCIAL SECURITY AND HOSPITAL CHARITY CARE. SAINT ALPHONSUS ALSO ASSISTS PATIENTS WITH THE NEW PCIP (PRE-EXISTING INSURANCE) WHICH IS NEW WITH HEALTHCARE REFORM. STAFF HELP PATIENTS APPLY FOR PCIP, AS WELL AS ASSIST WITH THE PREMIUM IF NEED BE. SAINT ALPHONSUS HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. SAINT ALPHONSUS MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. THE MEDICAL CENTER EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES.
    PART VI, LINE 4: COMMUNITY INFORMATION - SAINT ALPHONSUS REGIONAL MEDICAL CENTER SERVES PATIENTS FROM THE PRIMARY, SECONDARY AND TERTIARY SERVICE AREAS LISTED BELOW:- PRIMARY SERVICE AREA (75% OF DISCHARGES): A FIVE-COUNTY REGION INCLUDING ADA, CANYON- SECONDARY SERVICE AREA (75-95% OF DISCHARGES): BOISE, GEM, MALHEUR, ELMORE, PAYETTE, OWYHEE, BAKER AND UNION COUNTIES - TERTIARY SERVICE AREA (90-95% OF DISCHARGES): TWIN FALLS, VALLEY, WASHINGTON, ADAMS, BLAINE, CASSIA, GOODING AND JEROME COUNTIESAREA HOSPITAL FACILITIES WITHIN SARMC'S PRIMARY SERVICE AREA INCLUDE ST. LUKE'S BOISE AND MERIDIAN, IDAHO ELKS REHABILITATION CENTER, TREASURE VALLEY HOSPITAL, SAINT ALPHONSUS MEDICAL CENTER-NAMPA, WEST VALLEY MEDICAL CENTER, SAINT ALPHONSUS MEDICAL CENTER-ONTARIO, SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY, GRANDE RONDE AND WALTER KNOX MEMORIAL HOSPITAL.SAINT ALPHONSUS' PRIMARY SERVICE AREA IS A MIX OF URBAN AND RURAL COMMUNITIES WITHIN THE TREASURE VALLEY, BORDERED BY RUGGED MOUNTAINOUS TERRAIN AND DESERT. THE REGION HAS EXPERIENCED RAPID POPULATION GROWTH OVER THE PAST DECADE (FROM 2000-2010), WITH DRAMATIC GROWTH RATES IN ADA & CANYON COUNTIES, THE TWO LARGEST COUNTIES IN THE SERVICE AREA:- ADA COUNTY POPULATION GREW 30.4% FROM 2000-2010. POPULATION IS EXPECTED TO GROW BY 9% FROM 2012-2017- CANYON COUNTY POPULATION GREW 43.7% FROM 2000-2010. POPULATION IS EXPECTED TO GROW BY 12% FROM 2012-2017.OTHER RELEVANT STATISTICS CHARACTERIZING SAINT ALPHONSUS' PRIMARY SERVICE AREA ARE INCLUDED BELOW:TOTAL POPULATION (2010):ADA COUNTY - 392,365CANYON COUNTY - 188,923ELMORE COUNTY - 27,038GEM COUNTY - 16,719MALHEUR COUNTY - 31,313PERCENT WHITE PERSONS NOT HISPANIC (2011):ADA COUNTY - 86.5%CANYON COUNTY - 71.9%ELMORE COUNTY - 74.6%GEM COUNTY - 88.7%MALHEUR COUNTY - 62.9%PERCENT HISPANIC/LATINO ORIGIN (2011):ADA COUNTY - 7.3%CANYON COUNTY - 24.1%ELMORE COUNTY - 15.7%GEM COUNTY - 8.2%MALHEUR COUNTY - 32.0%MEDIAN HOUSEHOLD INCOME (2007-2011):ADA COUNTY - $55,304CANYON COUNTY - $42,943ELMORE COUNTY - $43,691GEM COUNTY - $44,442MALHEUR COUNTY - $39,013PERSONS BELOW POVERTY LEVEL (2007-2011):ADA COUNTY - 11.2%CANYON COUNTY - 18.1%ELMORE COUNTY - 11.8%GEM COUNTY - 16.5%MALHEUR COUNTY - 22.6%APPROXIMATELY 18% OF NON-ELDERLY IDAHO RESIDENTS LACK HEALTH INSURANCE (KAISER HEALTH FACTS). MEDICALLY UNDERSERVED POPULATIONS AND HEALTH PROFESSIONAL SHORTAGE AREAS WITHIN OUR SERVICE AREA INCLUDE A SHORTAGE OF PRIMARY CARE AND MENTAL HEALTH SERVICES.THE LOCAL REFUGEE POPULATION HAS MORE THAN DOUBLED SINCE 2005. A LARGE MAJORITY OF REFUGEES ARRIVING IN IDAHO ARE WOMEN AND CHILDREN. SOME REFUGEES ARE HIGHLY EDUCATED WHILE OTHERS HAVE NEVER HAD THE OPPORTUNITY TO ATTEND SCHOOL. THE IDAHO REFUGEE ARRIVALS FOR 2001-2011 IS 5,341, WITH SEVERAL RESETTLEMENT AND ASSISTANCE AGENCIES HELPING LOCALLY AND THROUGHOUT THE STATE. IN 2011, 775 REFUGEES AND SPECIAL IMMIGRANTS ARRIVED IN IDAHO FROM 17 DIFFERENT COUNTRIES. THE TOP FIVE COUNTRIES OF ORIGIN FOR REFUGEES RESETTLED IN IDAHO IN 2011 ARE BHUTAN, BURMA, IRAQ, CONGO AND AFGHANISTAN. THE TOP FIVE LANGUAGES IN 2011 WERE NEPALI, KAREN, ARABIC, SWAHILI AND BURMESE. (IDAHO OFFICE FOR REFUGEES).THE REGION SEES A HIGH PREVALENCE OF MENTAL HEALTH & SUBSTANCE ABUSE ISSUES, WITH INADEQUATE PUBLIC BEHAVIORAL HEALTH SYSTEMS IN PLACE TO MEET THE EXISTING NEEDS FOR COMMUNITY-BASED AND INPATIENT SERVICES.ON REVIEW OF DEMOGRAPHIC AND SOCIO-ECONOMIC DATA AND TRENDS, SEVERAL FACTORS CLEARLY HAVE AN IMPACT ON THE HEALTH STATUS OF THE COMMUNITIES SERVED BY SAINT ALPHONSUS, WITH IMPLICATIONS FOR FUTURE PLANNING. POPULATION GROWTH, ESPECIALLY IN ADA AND CANYON COUNTIES, IS EXPECTED TO CONTINUE, WITH A GROWING HISPANIC POPULATION. THE GROWING REFUGEE POPULATION HAS GREATER LANGUAGE INTERPRETATION AND HEALTH EDUCATION NEEDS AS WELL.GROWTH IN IDAHO'S SENIOR POPULATION IS ALSO PROJECTED TO ACCELERATE, WHICH WILL REQUIRE INCREASED HEALTH CARE SPENDING. MAMMOGRAPHY RATES, THE RISING RATE OF LOW BIRTH WEIGHT BABIES, OVERWEIGHT AND OBESITY, TOBACCO USE, MENTAL HEALTH AND DRINKING/DRUG USE ARE ALSO OF GREAT CONCERN.
    PART VI, LINE 5: OTHER INFORMATION - CONSISTENT WITH ITS NONPROFIT STATUS, SAINT ALPHONSUS USES SURPLUS REVENUES TO REINVEST IN FACILITIES, TECHNOLOGY AND MEDICAL SERVICES FOR THE COMMUNITY, AND COLLABORATES WITH COMMUNITY PARTNERS AND INVESTS IN NEEDED COMMUNITY PROGRAMS SUCH AS FAMILY MEDICINE RESIDENCY OF IDAHO, ALLUMBAUGH HOUSE (SOBERING, DETOXIFICATION & CRISIS MENTAL HEALTH SERVICES), AND HEALTHTEACHER HEALTH LITERACY CURRICULUM FOR THE BOISE SCHOOL DISTRICT.SAINT ALPHONSUS ALSO COLLABORATES WITH UNITED WAY OF TREASURE VALLEY TO ADDRESS COMMUNITY NEEDS IN THE AREAS OF HEALTH, EDUCATION AND INCOME. SAINT ALPHONSUS IS REPRESENTED ON THE UNITED WAY BOARD OF DIRECTORS AND THE HEALTH VISION COUNCIL. IN ADDITION, SAINT ALPHONSUS HAS AN ANNUAL UNITED WAY WORKPLACE GIVING CAMPAIGN TO SUPPORT UNITED WAY INITIATIVES AND GRANTS TO LOCAL NONPROFITS PRODUCING MEASURABLE OUTCOMES IN ADDRESSING TOP COMMUNITY NEEDS.SAINT ALPHONSUS STRONGLY SUPPORTS HEALTHCARE WORKFORCE DEVELOPMENT EFFORTS, INCLUDING ANNUAL FINANCIAL SUPPORT TO THE FAMILY MEDICINE RESIDENCY OF IDAHO, PSYCHIATRIC RESIDENCY, ISU DENTAL RESIDENCY, AND THE BOISE STATE UNIVERSITY NURSING BUILDING FUND. IN ADDITION, SAINT ALPHONSUS SERVES AS A KEY CLINICAL TRAINING SITE FOR NEW PHYSICIANS, NURSES AND OTHER ALLIED HEALTH PROFESSIONALS.SAINT ALPHONSUS IS A LEVEL II TRAUMA CENTER AND TAKES A LEADERSHIP ROLE IN IMPROVING SYSTEMS OF CARE FOR TRAUMA PATIENTS. TRAUMA PREVENTION AND DISASTER PREPAREDNESS EFFORTS IN THE REGION ARE OFTEN LED BY STAFF AT SAINT ALPHONSUS, WHO HAVE CHAMPIONED TOUGHER SEAT BELT AND HELMET LAWS, COORDINATED DRUNK DRIVING PREVENTION EVENTS IN LOCAL HIGH SCHOOLS, AND LED IN RESPONSE PLANNING FOR EVENTS LIKE THE SPECIAL OLYMPICS WORLD WINTER GAMES. SAINT ALPHONSUS ALSO HOSTS AN ANNUAL SKI & MOUNTAIN TRAUMA CONFERENCE TO TRAIN FIRST RESPONDERS (EMS, FIRE, SKI PATROL, ETC.) THROUGHOUT THE NORTHWEST ON BEST PRACTICES FOR TRAUMA CARE IN THE PRE-HOSPITAL SETTING.SAINT ALPHONSUS COORDINATES A REGIONAL TELEMEDICINE NETWORK THROUGHOUT WESTERN & NORTHERN IDAHO AND EASTERN OREGON. SERVICES PROVIDED THROUGH THE NETWORK INCLUDE MUCH-NEEDED SERVICES SUCH AS TELEPSYCHIATRY, STROKE CARE, CLINICAL EDUCATION AND EMERGENCY MEDICINE CONSULTATIONS TO RURAL HOSPITALS IN REMOTE LOCATIONS, OFTEN PREVENTING UNNECESSARY TRANSPORTS AND ALLOWING PATIENTS TO BE CARED FOR CLOSER TO HOME.
    PART VI, LINE 6: SAINT ALPHONSUS REGIONAL MEDICAL CENTER IS A MEMBER ORGANIZATION OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE SYSTEMS IN THE COUNTRY. BASED IN LIVONIA, MICHIGAN, TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEVELOP, AND ARE HELD ACCOUNTABLE FOR ACHIEVING, COMMUNITY BENEFIT GOALS THAT INCLUDE DEVELOPING NEEDED SERVICES OR EXPANDING ACCESS TO SERVICES FOR LOW-INCOME INDIVIDUALS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITY THROUGH PROGRAMS TO SERVE THE POOR AND UNINSURED, MANAGE CHRONIC CONDITIONS LIKE DIABETES, HEALTH EDUCATION AND PROMOTION INITIATIVES, AND OUTREACH FOR THE ELDERLY. IN FISCAL YEAR 2012, THIS INCLUDED OVER $615 MILLION IN SUCH COMMUNITY BENEFITS. THEREFORE, TRINITY HEALTH TAKES A SYSTEM APPROACH IN ITS COMMUNITY BENEFIT PLANNING AND IMPLEMENTATION, AND IS CONSEQUENTLY ABLE TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ARE HELPING PROMOTE AND ADDRESS THE HEALTH NEEDS OF THEIR RESPECTIVE COMMUNITIES.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG
Schedule H (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number
82-0200895
Part I
General Information on Grants and Assistance
1
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? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) GENESIS WORLD MISSION INC215 W 35TH ST
GARDEN CITY,ID83714 		82-0505073 501(C)3 14,680       SPONSORSHIP
(2) DAVID A HINDSON MD EDUCATION FOUNDATION INC439 THATCHER ST
BOISE,ID83702 		80-0279825 501(C)3 25,000       SPONSORSHIP
(3) WOMEN'S AND CHILDREN'S ALLIANCE720 W WASHINGTON ST
BOISE,ID83702 		82-0204464 501(C)3 10,137       SPONSORSHIP
(4) BOISE METRO CHAMBER OF COMMERCE250 S 5TH STREET 300
BOISE,ID83702 		82-0100595 501(C)6 5,000       SPONSORSHIP
(5) BOYS AND GIRLS CLUB OF ADA COUNTY IDAHO INC610 E 42ND ST
GARDEN CITY,ID83714 		82-0481687 501(C)3 5,000 504 FMV XBOX AND KINECT BUNDLE GIFT BASKET SPONSORSHIP
(6) AMERICAN CANCER SOCIETY INC GREAT WEST DIVISION INC2120 FIRST AVENUE NORTH
SEATTLE,WA98109 		84-1316555 501(C)3 20,000       SPONSORSHIP
(7) AMERICAN HEART ASSOCIATION INC7272 GREENVILLE AVE
DALLAS,TX75231 		13-5613797 501(C)3 7,500       SPONSORSHIP
(8) FAMILY ADVOCACY CENTER & EDUC SVC417 S 6TH STREET
BOISE,ID83702 		20-4883532 501(C)3 15,000       SPONSORSHIP
(9) TREASURE VALLEY FAMILY YMCA1050 WEST STATE ST
BOISE,ID83702 		82-0200908 501(C)3 23,494       SPONSORSHIP
(10) MAIN STREET MILE INCPO BOX 6331
BOISE,ID83707 		11-3735163 501(C)3 15,000       SPONSORSHIP
(11) SUSAN G KOMEN BREAST CANCER FOUNDATION DBA SUSAN G KOMEN FOR THE CURE5005 LBJ FREEWAY
DALLAS,TX75244 		75-1835298 501(C)3 55,357       SPONSORSHIP
(12) ST PAULS BENEVOLENT INSTITUTE1181 SW 76TH AVE
MIAMI,FL33144 		22-6034713 501(C)3 50,000       PROJECT HAITI SPONSORSHIP
(13) MARCH OF DIMES FOUNDATION1275 MAMARONECK AVENUE
WHITE PLAINS,NY10605 		13-1846366 501(C)3 35,867       SPONSORSHIP
(14) BOISE STATE UNIVERSITY FOUNDATION INC2225 UNIVERSITY DRIVE
BOISE,ID83706 		82-6010706 501(C)3 131,100       SPONSORSHIP
(15) UNITED WAY OF TREASURE VALLEY INCPO BOX 7963
BOISE,ID83707 		82-0299013 501(C)3 10,000       SPONSORSHIP
(16) AMERICAN LUNG ASSOCIATION OF THE MOUNTAIN PACIFIC7420 SW BRIDGEPORT RD STE 200
TIGARD,OR97224 		93-0386887 501(C)3 12,000       SPONSORSHIP
(17) JOHN BUTLER LUNG FOUNDATION722 HARCOURT RD
BOISE,ID83702 		82-0467602 501(C)3 15,000       SPONSORSHIP
(18) CATHOLIC CHARITIES OF IDAHO INC1501 S FEDERAL WAY STE 450
BOISE,ID83705 		82-0524367 501(C)3 5,250       SPONSORSHIP
(19) IDAHO DIABETES YOUTH PROGRAMS INC1620 HARRISON BLVD
BOISE,ID83702 		31-1565651 501(C)3 6,000       SPONSORSHIP
(20) DUSTIN'S PAW IDAHO INC795 W TALLULAH
KUNA,ID83634 		20-8449841 501(C)3 6,993       SPONSORSHIP
(21) COLLEGE OF WESTERN IDAHO FOUNDATION INC6056 BIRCH LANE STE 200
NAMPA,ID83687 		27-1159705 501(C)3 9,975       SPONSORSHIP
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
20
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
1
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) SCHOLARSHIPS 6 15,000      
(2) UTILITIES ASSISTANCE 31 3,530      
(3) MEDICAL BILL AND PRESCRIPTION ASSISTANCE 30 1,975      
(4) TRANSPORTATION ASSISTANCE -TAXI 1 140      
(5) GIFT CARDS - GROCERIES, FOOD AND GAS 74 4,525      
(6) MEDICAL EQUIPMENT 2   1,785 COST WALKER, WHEELCHAIR LIFT AND INSTALLATION
(7) HOUSING ASSISTANCE 16 13,042      
(8) CELL PHONE ASSISTANCE 5 1,008      

Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: DONATIONS MADE BY SAINT ALPHONSUS REGIONAL MEDICAL CENTER TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE AND ARE CONSIDERED UNRESTRICTED WITH REGARD TO THE USE OF THE FUNDS. THE CONTRIBUTIONS COMMITTEE REVIEWS REQUESTS AND RECOMMENDS APPROVAL.
Schedule I (Form 990) 2011


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
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? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
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:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
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.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) SALLY JEFFCOAT (i)
(ii)		 0
471,288 		0
150,924 		0
66,324 		0
69,049 		0
23,377 		0
780,962 		0
0
(2) J RICHARD O'CONNELL (i)
(ii)		 0
571,942 		0
230,946 		0
140,349 		0
85,919 		0
32,302 		0
1,061,458 		0
0
(3) STEPHANIE WESTERMEIER (i)
(ii)		 0
273,314 		0
0 		0
911 		0
20,114 		0
18,758 		0
313,097 		0
0
(4) BLAINE PETERSEN (i)
(ii)		 0
318,198 		0
45,828 		0
51,464 		0
19,375 		0
21,483 		0
456,348 		0
0
(5) JOSEPH SWEDISH (i)
(ii)		 0
1,279,458 		0
677,642 		0
3,229,560 		0
548,602 		0
27,600 		0
5,762,862 		0
2,698,342
(6) KEDRICK ADKINS (i)
(ii)		 0
743,978 		0
316,652 		0
344,596 		0
103,857 		0
13,263 		0
1,522,346 		0
143,708
(7) MICHAEL MURPHY (i)
(ii)		 0
402,598 		0
0 		0
71,772 		0
48,365 		0
27,173 		0
549,908 		0
0
(8) RODNEY REIDER (i)
(ii)		 0
301,074 		0
49,174 		0
34,284 		0
20,273 		0
23,977 		0
428,782 		0
0
(9) JANELLE G REILLY (i)
(ii)		 0
296,481 		0
63,033 		0
986 		0
19,719 		0
16,125 		0
396,344 		0
0
(10) JAMES POLK (i)
(ii)		 0
284,924 		0
56,511 		0
4,214 		0
33,367 		0
18,398 		0
397,414 		0
0
(11) KENNETH FRY (i)
(ii)		 121,612
135,202 		0
51,910 		512
1,238 		0
30,513 		8,823
9,271 		130,947
228,134 		0
0
(12) JEAN BASOM (i)
(ii)		 0
159,839 		0
36,398 		0
2,188 		0
63,312 		0
15,066 		0
276,803 		0
0
(13) CHRISTIAN ZIMMERMAN MD (i)
(ii)		 1,197,328
0 		562,826
0 		74,043
0 		73,275
0 		20,883
0 		1,928,355
0 		0
0
(14) MICHAEL COUGHLIN MD (i)
(ii)		 868,936
0 		72,325
0 		6,320
0 		19,600
0 		27,366
0 		994,547
0 		0
0
(15) STEPHEN JONES MD (i)
(ii)		 820,446
0 		89,702
0 		17,061
0 		59,600
0 		18,946
0 		1,005,755
0 		0
0
(16) STEPHEN FALL MD (i)
(ii)		 668,567
0 		3,698
0 		3,882
0 		52,250
0 		28,847
0 		757,244
0 		0
0
(17) MARK G PARENT MD (i)
(ii)		 615,024
0 		55,275
0 		4,682
0 		19,600
0 		19,965
0 		714,546
0 		0
0
(18) MICHAEL SLUBOWSKI (i)
(ii)		 0
13,394 		0
0 		0
137,444 		0
500 		0
601 		0
151,939 		0
136,445
(19) KAREN HODGE (i)
(ii)		 0
54,068 		0
28,541 		0
141,419 		0
131,276 		0
5,911 		0
361,215 		0
0
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 3 SAINT ALPHONSUS REGIONAL MEDICAL CENTER IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. SAINT ALPHONSUS REGIONAL MEDICAL CENTER'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
  PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT IN CALENDAR 2011. THIS AMOUNT IS INCLUDED IN COLUMN B(III): KAREN HODGE - $122,988 IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES $54,662 OF SEVERANCE FOR KAREN HODGE WHICH WAS UNPAID AS OF 12/31/11. THE $54,662 WAS PAID AND INCLUDED IN KAREN HODGE'S TAXABLE INCOME IN 2012. PART I, LINE 4B: THE FOLLOWING ARE PARTICIPANTS IN THE TRINITY HEALTH PENSION RESTORATION PLAN, A NONQUALIFIED PLAN, WHICH PROVIDES RETIREMENT BENEFITS FOR CERTAIN ASSOCIATES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($245,000 FOR 2011). THE FOLLOWING ACCRUALS FOR 2011 FOR THIS PLAN ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: KEDRICK ADKINS - $91,607 SALLY JEFFCOAT - $48,910 MICHAEL MURPHY - $27,513 J. RICHARD O'CONNELL - $66,279 JOSEPH SWEDISH - $255,902 THE FOLLOWING IS A PARTICIPANT IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING SERP ACCRUAL FOR 2011 IS INCLUDED IN COLUMN C OF SCHEDULE J, PART II: JOSEPH SWEDISH - $265,000 PART II: THE FOLLOWING INDIVIDUALS BECAME VESTED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) DURING CALENDAR 2011. AS A RESULT, THE VESTED AMOUNTS WERE INCLUDED IN THEIR 2011 TAXABLE INCOMES. THE FOLLOWING VESTED SERP AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: KEDRICK ADKINS - $220,648 JOSEPH SWEDISH - $2,740,000 COLUMN F OF SCHEDULE J INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING INDIVIDUALS ARE PARTICIPANTS IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN UNDER SECTION 457(F). THE FOLLOWING DEFERRALS FOR CALENDAR 2011 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: MICHAEL COUGHLIN, MD - NONE STEPHEN FALL, MD - $40,000 STEPHEN JONES, MD - $40,000 MARK G. PARENT, MD - NONE CHRISTIAN ZIMMERMAN, MD - $50,000 THE FOLLOWING INDIVIDUAL BECAME VESTED IN A SECTION 457(F) DEFERRED COMPENSATION PLAN DURING CALENDAR 2011. AS A RESULT, THE VESTED AMOUNT WAS INCLUDED IN HIS 2011 TAXABLE INCOME. THE FOLLOWING VESTED 457(F) AMOUNT IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: CHRISTIAN ZIMMERMAN - $71,004
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
(1) STEPHEN JONES MD
  		  X 68,572 54,858   No   No Yes  
Total ...............Small Bullet $ 54,858
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2011
Schedule L (Form 990 or 990-EZ) 2011
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) BLUE CROSS OF IDAHO (BCI)
  		SALLY JEFFCOAT, PRESIDENT & CEO, ALSO SERVES ON THE BOARD OF BCI 73,629,412 PAYMENTS MADE BY BLUE CROSS OF IDAHO TO SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. FOR HEALTH CARE SERVICES PROVIDED TO BCI COVERED MEMBERS.   No
(2) ETHAN FRY FAMILY MEMBER OF KENNETH FRY, KEY EMPLOYEE 55,786 EMPLOYMENT ARRANGEMENT   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art .... X 1 2,700 COST
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 12,653 OPINION OF EXPERTS
5 Clothing and household
goods ....... 		X 65,759 OPINION OF EXPERTS
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles ..... X 1 5,990 FMV
19 Food inventory ... X 9 6,455 COST
20 Drugs and medical supplies . X 2 8,100 COST
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( ENTERTAINMENT ) X 13 8,010 COST
26 Other Right pointing arrow large image ( GIFT CERTIFICATES ) X 56 2,029 COST
27 Other Right pointing arrow large image ( PHOTO PROCESSING ) X 1 100 COST
28 Other Right pointing arrow large image ( ADVERTISING ) X 2 6,284 COST
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ............................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2011
Schedule M (Form 990) 2011
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33 and whether the organization is reporting in Part I, column (b) the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Identifier Return Reference Explanation
THIRD PARTY USE: PART I, LINE 32B: THE REPORTING ENTITY HAS USED THIRD PARTIES TO PROCESS OR SELL NON-CASH CONTRIBUTIONS WHEN SPECIFIC EXPERTISE IS WARRANTED. WHERE AN EXPERT APPRAISAL IS NECESSARY, A THIRD PARTY APPRAISER WILL BE ENGAGED. OCCASIONALLY THE SERVICES OF AN AGENT ARE ENGAGED TO SELL NON-CASH CONTRIBUTIONS THAT WILL NOT BE USED BY THE REPORTING ENTITY.
Schedule M (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
Identifier Return Reference Explanation
  FORM 990, PART VI, SECTION A, LINE 2 KAYE O'RIORDAN, TRUSTEE, AND BRENT LLOYD, TRUSTEE, HAVE A BUSINESS RELATIONSHIP.
  FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. IS SAINT ALPHONSUS HEALTH SYSTEM. SEE LINE 7 FOR ADDITIONAL INFORMATION.
  FORM 990, PART VI, SECTION A, LINE 7A SAINT ALPHONSUS HEALTH SYSTEM IS THE SOLE MEMBER OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. SAINT ALPHONSUS HEALTH SYSTEM HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF TRUSTEES OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC.
  FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER OF THE CORPORATION, SAINT ALPHONSUS HEALTH SYSTEM MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. SAINT ALPHONSUS HEALTH SYSTEM MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, A MATERIAL CHANGE IN MISSION, AND MODIFICATIONS TO GOVERNING DOCUMENTS.
  FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING, THE FORM 990 FOR SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE FINANCE COMMITTEE OF SAINT ALPHONSUS HEALTH SYSTEM. (SAINT ALPHONSUS HEALTH SYSTEM IS THE SOLE MEMBER OF THE CORPORATION.) THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
  FORM 990, PART VI, SECTION B, LINE 12C SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. HAS ADOPTED A CONFLICT OF INTEREST POLICY WHICH CONTAINS THE ELEMENTS IN THE MODEL CONFLICT OF INTEREST POLICY ISSUED BY THE IRS. IT APPLIES TO ALL INTERESTED PERSONS OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC., WHICH INCLUDES TRUSTEES, PRINCIPAL OFFICERS AND EXECUTIVES, AND MEMBERS OF COMMITTEES WITH BOARD DESIGNATED POWERS. INTERESTED PERSONS ARE REQUIRED TO ACT AT ALL TIMES IN A MANNER CONSISTENT WITH SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC.'S CHARITABLE PURPOSE AND SERVICE TO THE COMMUNITY AND TO AVOID CONFLICTS OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE BOARD OF TRUSTEES OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF TRANSACTIONS WITH INTERESTED PERSONS, INCLUDING DETERMINING THAT SUCH TRANSACTIONS ARE FAIR AND REASONABLE TO SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED WITH THE BOARD OF TRUSTEES OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. ON AN ANNUAL BASIS.
  FORM 990, PART VI, SECTION B, LINE 15 TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF SAINT ALPHONSUS REGIONAL MEDICAL CENTER, INC. ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS.
  FORM 990, PART VI, SECTION C, LINE 19 SAINT ALPHONSUS REGIONAL MEDICAL CENTER IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE ANNUAL REPORT (WHICH INCLUDES COMMUNITY BENEFIT MINISTRY INFORMATION) AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, SAINT ALPHONSUS REGIONAL MEDICAL CENTER INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE.
ESTIMATE OF THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: FORM 990, PART VII, SECTION A, LINE 1, COLUMN B THE HOURS LISTED IN COLUMN B OF PART VII, SECTION A, LINE 1 REFLECT ONLY THE INDIVIDUALS' AVERAGE WEEKLY HOURS SPENT DIRECTLY ON THE ACTIVITIES OF THE REPORTING ORGANIZATION. IN ADDITION, THESE ARE THE AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: KEDRICK ADKINS - 53 HOURS SALLY JEFFCOAT - 35 HOURS MICHAEL MURPHY - 53 HOURS J. RICHARD O'CONNELL - 52 HOURS BLAINE PETERSEN - 45 HOURS JAMES POLK - 25 HOURS RODNEY REIDER - 9 HOURS JANELLE REILLY - 25 HOURS JOSEPH SWEDISH - 53 HOURS STEPHANIE WESTERMEIER - 5 HOURS
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -8,577,830. EQUITY TRANSFERS TO AFFILIATES: -4,479,000. OTHER TRANSACTIONS: -4,238. TOTAL TO FORM 990, PART XI, LINE 5: -13,061,068.
  FORM 990, PART XII, LINE 2: SAINT ALPHONSUS REGIONAL MEDICAL CENTER'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY12 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.
  FORM 990, PAGE I, DOING BUSINESS AS: SAINT ALPHONSUS FOUNDATION, IDAHO NEUROLOGICAL INSTITUTE, IDAHO ORTHOPAEDIC INSTITUTE, IDAHO REHABILITATION AND PAIN CENTER, SAINT ALPHONSUS BREAST CARE CENTER, SAINT ALPHONSUS CANCER TREATMENT CENTER, SAINT ALPHONSUS CANCER CARE CENTER, SAINT ALPHONSUS SLEEP DISORDERS CENTER, SAINT ALPHONSUS PRIMARY STROKE CENTER, SAINT ALPHONSUS MEDICAL GROUP, SAINT ALPHONSUS EXPRESS CARE, ST. ALPHONSUS AMBULATORY REHABILITATION SERVICES, ST. ALPHONSUS HOME HEALTH, ST. ALPHONSUS BEHAVIORAL HEALTH, PROJECT HAITI, ST. ALPHONSUS CAPITAL CLASSIC, SAINT ALPHONSUS FESTIVAL OF TREES, ST. ALPHONSUS WOMEN'S HEALTH CARE FUND, NALEN FUND, WOMEN'S AND CHILDREN'S CENTER, CARE CLINIC, REFUGE CLINIC, EARLY LEARNING CENTER
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
 
Employer identification number

82-0200895
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP

245 STATE ST SE

GRAND RAPIDS,MI49503
27-2491974 		HEALTHCARE SERVICES MI 501(C)(3) 9 TRINITY HEALTH-MICHIGAN
 
 
No
(2) AMICARE HOSPICE SERVICES INC

20555 VICTOR PARKWAY

LIVONIA,MI48152
38-2949053 		PROVIDE HOSPICE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC
 
 
No
(3) AUXILIARY OF HOLY ROSARY HOSPITAL

351 SW 9TH STREET

ONTARIO,OR97914
94-3059469 		SUPPORTS SERVICES OF RELATED HOSPITAL OR 501(C)(3) 9 SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
 
 
No
(4) BAUM HARMON MERCY HOSPITAL

255 NORTH WELCH AVENUE

PRIMGHAR,IA51245
42-1500277 		ACUTE/AMBULATORY HEALTHCARE SERVICES IA 501(C)(3) 3 MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(5) BAUM HARMON MERCY HOSPITAL & CLINICS FOUNDATION

255 NORTH WELCH AVENUE

PRIMGHAR,IA51245
26-2973307 		SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) 11, TYPE I BAUM HARMON MERCY HOSPITAL
 
 
No
(6) CATHERINE MCAULEY HEALTH SERVICES CORP

PO BOX 995

ANN ARBOR,MI48106
38-2507173 		FURTHER TRINITY HEALTH ACTIVITIES, ORGANIZE AND DEVELOP MEDICAL SERVICES MI 501(C)(3) 11, TYPE II TRINITY HEALTH-MICHIGAN
 
 
No
(7) COMMUNITY HEALTH PARTNERS OF SOUTH BEND

PO BOX 3998

SOUTH BEND,IN46619
26-3051440 		HEALTHCARE SERVICES IN 501(C)(3) 3 SAINT JOSEPH REGIONAL MEDICAL CENTER INC
 
 
No
(8) CRANBROOK HOSPICE CARE

281 ENTERPRISE COURT

BLOOMFIELD HILLS,MI48302
38-3320699 		PROVIDE HOSPICE HEALTH SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC
 
 
No
(9) DILEY RIDGE MEDICAL CENTER

6150 EAST BROAD STREET

COLUMBUS,OH43213
34-2032340 		HOSPITAL CAMPUS IN FAIRFIELD COUNTY OHIO OH 501(C)(3) 3 MOUNT CARMEL HEALTH SYSTEM
 
 
No
(10) DUBUQUE MERCY HEALTH FOUNDATION INC

250 MERCY DRIVE

DUBUQUE,IA52001
26-2227941 		SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) 11, TYPE I MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(11) DYERSVILLE HEALTH FOUNDATION INC

1111 3RD STREET SW

DYERSVILLE,IA52040
20-5383271 		SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) 11, TYPE I MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(12) GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION

701 W NORTH AVE

MELROSE PARK,IL60160
36-3332852 		SUPPORT THE SERVICES OF RELATED HOSPITAL IL 501(C)(3) 9 GOTTLIEB MEMORIAL HOSPITAL
 
 
No
(13) GOTTLIEB MEMORIAL FOUNDATION

701 W NORTH AVE

MELROSE PARK,IL60160
74-3260011 		SUPPORT THE SERVICES OF RELATED HOSPITAL IL 501(C)(3) 11, TYPE III-FI N/A
 
No
(14) GOTTLIEB MEMORIAL HOSPITAL

701 W NORTH AVE

MELROSE PARK,IL60160
36-2379649 		HEALTHCARE SERVICES IL 501(C)(3) 3 LOYOLA UNIVERSITY HEALTH SYSTEM
 
 
No
(15) HACKLEY HOSPITAL

1700 CLINTON ST PO BOX 3302

MUSKEGON,MI494433302
38-1358196 		HEALTHCARE SERVICES MI 501(C)(3) 3 MERCY HEALTH PARTNERS
 
 
No
(16) HACKLEY HOSPITAL SELF INSURANCE PROFESSIONAL LIABILITY TRUST

PO BOX 3302

MUSKEGON,MI494433302
38-2299878 		SELF INSURANCE FOR GENERAL AND MALPRACTICE LIABILITY MI 501(C)(3) 11, TYPE III-FI MERCY HEALTH PARTNERS
 
 
No
(17) HACKLEY LIFE COUNSELING

1352 TERRACE ST

MUSKEGON,MI494423545
38-1386362 		COUNSELING, EDUCATION, AND SUPPORT MI 501(C)(3) 9 MERCY HEALTH PARTNERS
 
 
No
(18) HACKLEY VISITING NURSE SERVICES AND HOSPICE INC

888 TERRACE ST

MUSKEGON,MI49440
38-1359598 		PROVIDE HOME HEALTH CARE SERVICES MI 501(C)(3) 7 MERCY HEALTH PARTNERS
 
 
No
(19) HOLY CROSS CARENET INC

PO BOX 9184

FARMINGTON HILLS,MI48333
52-1945054 		LONG-TERM CARE AND REHABILITATION FOR THE ELDERLY MD 501(C)(3) 9 TRINITY CONTINUING CARE SERVICES
 
 
No
(20) HOLY CROSS HOSPITAL FOUNDATION INC

11801 TECH ROAD

SILVER SPRING,MD20904
20-8428450 		CHARITABLE FUNDRAISING MD 501(C)(3) 11, TYPE I HOLY CROSS HOSPITAL OF SILVER SPRING
 
 
No
(21) HOLY CROSS HOSPITAL OF SILVER SPRING INC

1500 FOREST GLEN RD

SILVER SPRING,MD209101484
52-0738041 		HEALTHCARE SERVICES MD 501(C)(3) 3 TRINITY HEALTH CORPORATION
 
 
No
(22) HOLY CROSS MEDICAL CENTER

20555 VICTOR PARKWAY

LIVONIA,MI48152
95-1985442 		HEALTHCARE SERVICES (FORMERLY) CA 501(C)(3) 3 TRINITY HEALTH CORPORATION
 
 
No
(23) HOSPICE OF NORTH IOWA

232 SECOND STREET SE

MASON CITY,IA504016208
42-1173708 		HOSPICE HEALTH CARE SERVICES IA 501(C)(3) 7 MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(24) HOSPICE OF WASHTENAW II

806 AIRPORT BLVD

ANN ARBOR,MI48108
38-3320707 		HOSPICE HEALTH CARE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN
 
 
No
(25) HPCN

1675 LEAHY STREET

MUSKEGON,MI49442
30-0207909 		HEALTHCARE SERVICES MI 501(C)(3) 11, TYPE II MERCY HEALTH PARTNERS
 
 
No
(26) IHA HEALTH SERVICES CORPORATION

24 FRANK LLOYD WRIGHT DR LOBBY J

ANN ARBOR,MI48106
38-3316559 		PROVIDES OFFICE-BASED MEDICAL CARE MI 501(C)(3) 9 TRINITY HEALTH-MICHIGAN
 
 
No
(27) LAKESHORE COMMUNITY HOSPITAL INC

72 S STATE STREET

SHELBY,MI494551228
38-2549295 		ACUTE HEALTHCARE SERVICES MI 501(C)(3) 3 MERCY HEALTH PARTNERS
 
 
No
(28) LOYOLA UNIVERSITY HEALTH SYSTEM

2160 SOUTH FIRST AVENUE

MAYWOOD,IL60153
36-3342448 		HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT IL 501(C)(3) 11, TYPE II TRINITY HEALTH CORPORATION
 
 
No
(29) LOYOLA UNIVERSITY MEDICAL CENTER

2160 SOUTH FIRST AVENUE

MAYWOOD,IL60153
36-4015560 		HEALTHCARE SERVICES IL 501(C)(3) 3 LOYOLA UNIVERSITY HEALTH SYSTEM
 
 
No
(30) MARIAN HOME HEALTHCARE

801 5TH STREET

SIOUX CITY,IA51101
38-3320705 		PROVIDE HOME HEALTH CARE SERVICES IA 501(C)(3) 11, TYPE I MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(31) MCAULEY CLINIC CORPORATION

PO BOX 992

ANN ARBOR,MI48106
38-2561013 		HEALTHCARE SERVICES (FORMERLY) MI 501(C)(3) 3 CATHERINE MCAULEY HEALTH SERVICES CORP
 
 
No
(32) MERCY AMICARE HOME HEALTHCARE OAKLAND

281 ENTERPRISE COURT

BLOOMFIELD HILLS,MI483020312
38-3320698 		PROVIDE HOME HEALTH CARE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC
 
 
No
(33) MERCY AMICARE HOME HEALTHCARE PORT HURON

505 HURON AVENUE

PORT HURON,MI48060
38-3320701 		PROVIDE HOME HEALTH CARE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC
 
 
No
(34) MERCY FOUNDATION INC

2525 SOUTH MICHIGAN AVENUE

CHICAGO,IL60616
36-3227350 		SUPPORTS THE SERVICES OF RELATED HEALTH CARE SYSTEM IL 501(C)(3) 11, TYPE I MERCY HEALTH SYSTEM OF CHICAGO
 
 
No
(35) MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE

684 HARVEY STREET

MUSKEGON,MI49442
38-3321856 		PROVIDE HOME HEALTH CARE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC
 
 
No
(36) MERCY HEALTH PARTNERS

1415 LEAHY STREET

MUSKEGON,MI49442
38-2589966 		HEALTHCARE SYSTEM SUPPORT MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN
 
 
No
(37) MERCY HEALTH SERVICES - IOWA CORP

1000 4TH STREET SW

MASON CITY,IA50401
31-1373080 		HEALTHCARE SERVICES DE 501(C)(3) 3 TRINITY HEALTH-MICHIGAN
 
 
No
(38) MERCY HEALTH SYSTEM OF CHICAGO

2525 SOUTH MICHIGAN AVENUE

CHICAGO,IL60616
36-3163327 		HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT IL 501(C)(3) 11, TYPE I TRINITY HEALTH CORPORATION
 
 
No
(39) MERCY HEALTH SYSTEM OF CHICAGO LIABILITY SELF INSURANCE TRUST

BK OF AMERICA 231 S LASALLE

CHICAGO,IL60697
91-2092113 		SELF INSURANCE FOR PROFESSIONAL AND COMPREHENSIVE LIABILITY IL 501(C)(3) 11, TYPE III-FI MERCY HEALTH SYSTEM OF CHICAGO
 
 
No
(40) MERCY HEALTHCARE FOUNDATION

1410 N 4TH ST

CLINTON,IA52732
42-1316126 		FUNDRAISING AND FINANCIAL ASSISTANCE FOR HOSPITAL CHARITABLE SERVICES IA 501(C)(3) 11, TYPE I MERCY MEDICAL CENTER-CLINTON
 
 
No
(41) MERCY HOSPITAL AND MEDICAL CENTER

2525 SOUTH MICHIGAN AVENUE

CHICAGO,IL60616
36-2170152 		HEALTHCARE SERVICES IL 501(C)(3) 3 MERCY HEALTH SYSTEM OF CHICAGO
 
 
No
(42) MERCY HOSPITAL CADILLAC FOUNDATION

400 HOBART

CADILLAC,MI496012331
20-3357131 		SUPPORT THE SERVICES OF RELATED HOSPITAL MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN
 
 
No
(43) MERCY HOSPITAL GIFT SHOP

2601 ELECTRIC AVE

PORT HURON,MI48060
38-1630480 		VOLUNTEER SERVICE AUXILIARY MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN
 
 
No
(44) MERCY MEDICAL CENTER - CLINTON INC

1410 NORTH 4TH ST

CLINTON,IA527322940
42-1336618 		TO PROVIDE QUALITY HEALTH CARE DE 501(C)(3) 3 MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(45) MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION

801 5TH STREET

SIOUX CITY,IA51102
14-1880022 		SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) 7 MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(46) MERCY MEDICAL CENTER FOUNDATION - NORTH IOWA

1000 4TH STREET SW

MASON CITY,IA504012800
42-1229151 		SUPPORT THE SERVICES OF RELATED HOSPITAL IA 501(C)(3) 11, TYPE III-FI MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(47) MERCY NORTH HOMECARE AND HOSPICE

7985 MACKINAW TRAIL

CADILLAC,MI49601
38-3313897 		HOME HEALTH AND HOSPICE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC
 
 
No
(48) MERCY PHYSICIAN GROUP INC

1512 12TH AVENUE ROAD

NAMPA,ID83686
20-8192593 		TO PROVIDE QUALITY HEALTH CARE ID 501(C)(3) 9 SAINT ALPHONSUS MEDICAL CENTER-NAMPA
 
 
No
(49) MERCY SERVICES FOR AGING NON-PROFIT HOUSING CORPORATION

PO BOX 9184

FARMINGTON HILLS,MI483339184
38-2719605 		PROVIDES LONG-TERM CARE FOR THE ELDERLY MI 501(C)(3) 11, TYPE II TRINITY CONTINUING CARE SERVICES INC
 
 
No
(50) MIDWEST MEDFLIGHT

1300 VICTORS WAY

ANN ARBOR,MI48108
38-2684671 		AEROMEDICAL TRANSPORT MI 501(C)(3) 9 TRINITY HEALTH-MICHIGAN
 
 
No
(51) MOUNT CARMEL CARE CONTINUUM SERVICES CORP

793 WEST STATE STREET

COLUMBUS,OH43222
31-1126211 		COOPERATIVE HOSPITAL SERVICE ORGANIZATION OH 501(C)(3) 3 MOUNT CARMEL HEALTH SYSTEM
 
 
No
(52) MOUNT CARMEL COLLEGE OF NURSING

6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1308555 		COLLEGE OF NURSING OH 501(C)(3) 2 MOUNT CARMEL HEALTH
 
 
No
(53) MOUNT CARMEL HEALTH

6150 EAST BROAD STREET

COLUMBUS,OH43213
31-4379602 		HEALTHCARE SERVICES OH 501(C)(3) 3 MOUNT CARMEL HEALTH SYSTEM
 
 
No
(54) MOUNT CARMEL HEALTH INSURANCE COMPANY

6150 EAST BROAD STREET

COLUMBUS,OH43213
25-1912781 		HEALTH INSURANCE OH 501(C)(4) N/A MOUNT CARMEL HEALTH SYSTEM
 
 
No
(55) MOUNT CARMEL HEALTH PLAN INC

6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1471229 		MEDICARE HMO FOR SENIORS OH 501(C)(4) N/A MOUNT CARMEL HEALTH SYSTEM
 
 
No
(56) MOUNT CARMEL HEALTH SYSTEM

6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1439334 		HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT OH 501(C)(3) 11, TYPE I TRINITY HEALTH CORPORATION
 
 
No
(57) MOUNT CARMEL HEALTH SYSTEM FOUNDATION

6150 EAST BROAD STREET

COLUMBUS,OH43213
31-1113966 		SUPPORT THE SERVICES OF RELATED HOSPITAL OH 501(C)(3) 11, TYPE I MOUNT CARMEL HEALTH SYSTEM
 
 
No
(58) MOUNT CARMEL HOME CARE LLC

1144 DUBLIN ROAD SUITE B

COLUMBUS,OH43215
26-2729300 		PROVIDE HOME HEALTH CARE SERVICES OH 501(C)(3) 9 TRINITY HOME HEALTH SERVICES INC
 
 
No
(59) MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL

7333 SMITHS MILL RD

NEW ALBANY,OH43054
87-0790288 		HEALTHCARE SERVICES OH 501(C)(3) 3 MOUNT CARMEL HEALTH SYSTEM
 
 
No
(60) MRI MOBILE SERVICES OF WEST MICHIGAN

1820 - 44TH STREET

KENTWOOD,MI49508
38-3073745 		OPERATE MAGNETIC IMAGING RESONANCE (FORMERLY) MI 501(C)(3) 9 TRINITY HEALTH-MICHIGAN
 
 
No
(61) MUSKEGON COMMUNITY HEALTH PROJECT

565 W WESTERN AVENUE

MUSKEGON,MI49440
91-1932918 		FACILITATE AND COORDINATE HEALTHCARE AND RELATED SERVICES MI 501(C)(3) 7 MERCY HEALTH PARTNERS
 
 
No
(62) OAKLAND MERCY HOSPITAL

601 EAST 2ND STREET

OAKLAND,NE68045
20-8072234 		HEALTHCARE SERVICES NE 501(C)(3) 3 MERCY HEALTH SERVICES-IOWA CORP
 
 
No
(63) OAKLAND MERCY HOSPITAL FOUNDATION

601 E 2ND STREET

OAKLAND,NE68045
31-1678345 		SUPPORTS SERVICES OF RELATED HOSPITAL NE 501(C)(3) 11, TYPE III-FI OAKLAND MERCY HOSPITAL
 
 
No
(64) PORT HURON MERCY FAMILY CARE INC

2601 ELECTRIC AVE

PORT HURON,MI48060
20-1855647 		HEALTHCARE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN
 
 
No
(65) PROFESSIONAL MED TEAM

965 FORK STREET

MUSKEGON,MI494423257
38-2638284 		MEDICAL CARE, TRANSPORTATION AND EDUCATION MI 501(C)(3) 9 TRINITY HEALTH-MICHIGAN
 
 
No
(66) PROFESSIONAL OFFICE CORPORATION

1303 EAST HERNDON AVE

FRESNO,CA93720
94-2839324 		HEALTHCARE SERVICES CA 501(C)(3) 11, TYPE I SAINT AGNES MEDICAL CENTER
 
 
No
(67) SAINT AGNES MEDICAL CENTER

1303 EAST HERNDON AVE

FRESNO,CA93720
94-1437713 		HEALTHCARE SERVICES CA 501(C)(3) 3 TRINITY HEALTH CORPORATION
 
 
No
(68) SAINT ALPHONSUS BUILDING COMPANY INC

1055 NORTH CURTIS RD

BOISE,ID83706
82-0401011 		SUPPORTS SERVICES OF RELATED HOSPITAL ID 501(C)(3) 11, TYPE I SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
 
Yes
 
(69) SAINT ALPHONSUS DIVERSIFIED CARE INC

1055 NORTH CURTIS RD

BOISE,ID83706
94-3028978 		SUPPORTS SERVICES OF RELATED HOSPITAL ID 501(C)(3) 11, TYPE I SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
 
Yes
 
(70) SAINT ALPHONSUS FOUNDATION-BAKER CITY INC

3325 POCAHONTAS ROAD

BAKER CITY,OR97814
94-3164869 		SUPPORT THE SERVICES OF RELATED HOSPITAL OR 501(C)(3) 7 SAINT ALPHONSUS MEDICAL CENTER - BAKER CITY
 
 
No
(71) SAINT ALPHONSUS FOUNDATION-ONTARIO INC

351 SW 9TH STREET

ONTARIO,OR97914
20-2683560 		SUPPORT THE SERVICES OF RELATED HOSPITAL OR 501(C)(3) 11, TYPE I SAINT ALPHONSUS MEDICAL CENTER-ONTARIO
 
 
No
(72) SAINT ALPHONSUS HEALTH SYSTEM INC

1055 N CURTIS ROAD

BOISE,ID83706
27-1929502 		HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT ID 501(C)(3) 11, TYPE I TRINITY HEALTH CORPORATION
 
 
No
(73) SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY

3325 POCAHONTAS ROAD

BAKER CITY,OR97814
27-1790052 		TO PROVIDE QUALITY HEALTH CARE OR 501(C)(3) 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
 
No
(74) SAINT ALPHONSUS MEDICAL CENTER-NAMPA

1512 12TH AVENUE ROAD

NAMPA,ID83686
82-0200896 		TO PROVIDE QUALITY HEALTH CARE ID 501(C)(3) 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
 
No
(75) SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION INC

1512 12TH AVENUE ROAD

NAMPA,ID83686
26-1737256 		SUPPORT THE SERVICES OF RELATED HOSPITAL ID 501(C)(3) 7 SAINT ALPHONSUS MEDICAL CENTER-NAMPA
 
 
No
(76) SAINT ALPHONSUS MEDICAL CENTER-ONTARIO

351 SW 9TH STREET

ONTARIO,OR97914
27-1789847 		TO PROVIDE QUALITY HEALTH CARE OR 501(C)(3) 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
 
No
(77) SAINT ALPHONSUS REGIONAL MEDICAL CENTER

1055 NORTH CURTIS RD

BOISE,ID83706
82-0200895 		HEALTHCARE SERVICES ID 501(C)(3) 3 SAINT ALPHONSUS HEALTH SYSTEM INC
 
Yes
 
(78) SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH CAMPUS INC

1915 LAKE AVENUE PO BOX 670

PLYMOUTH,IN46563
35-1142669 		HEALTHCARE SERVICES IN 501(C)(3) 3 SAINT JOSEPH REGIONAL MEDICAL CENTER INC
 
 
No
(79) SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND CAMPUS INC

PO BOX 1935

SOUTH BEND,IN466341935
35-0868157 		HEALTHCARE SERVICES IN 501(C)(3) 3 SAINT JOSEPH REGIONAL MEDICAL CENTER INC
 
 
No
(80) SAINT JOSEPH REGIONAL MEDICAL CENTER MISHAWAKA AUXILIARY INC

5215 HOLY CROSS PARKWAY

MISHAWAKA,IN46545
35-6033285 		HOSPITAL SERVICE AUXILIARY IN 501(C)(4) N/A SAINT JOSEPH REGIONAL MEDICAL CENTER-S BEND
 
 
No
(81) SAINT JOSEPH REGIONAL MEDICAL CENTER PLYMOUTH AUXILIARY INC

1915 LAKE AVENUE

PLYMOUTH,IN46563
35-6043563 		HOSPITAL SERVICE AUXILIARY IN 501(C)(3) 11, TYPE II SAINT JOSEPH REGIONAL MEDICAL CENTER-PLYMOUTH
 
 
No
(82) SAINT JOSEPH REGIONAL MEDICAL CENTER INC

801 EAST LASALLE AVE

SOUTH BEND,IN46617
35-1568821 		HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT IN 501(C)(3) 11, TYPE I TRINITY HEALTH CORPORATION
 
 
No
(83) SAINT JOSEPH'S TOWER INC

PO BOX 9184

FARMINGTON HILLS,MI483339184
31-1040468 		PROVIDES HOUSING FOR LOW INCOME ELDERLY INDIVIDUALS IN 501(C)(3) 9 TRINITY CONTINUING CARE SERVICES-INDIANA
 
 
No
(84) SAINT MARY'S AMICARE HOME HEALTHCARE

1430 MONROE NW

GRAND RAPIDS,MI49505
38-3320700 		PROVIDE HOME HEALTH CARE SERVICES MI 501(C)(3) 11, TYPE I TRINITY HOME HEALTH SERVICES INC
 
 
No
(85) SAINT MARY'S FOUNDATION (FKA SAINT MARY'S DORAN FOUNDATION)

200 JEFFERSON ST SE

GRAND RAPIDS,MI49503
38-1779602 		SUPPORTS SERVICES OF RELATED HOSPITAL MI 501(C)(3) 7 TRINITY HEALTH-MICHIGAN
 
 
No
(86) ST JOSEPH MERCY OAKLAND FOUNDATION

44405 WOODWARD AVE

PONTIAC,MI48341
35-2356789 		SUPPORTS SERVICES OF RELATED HOSPITAL MI 501(C)(3) 11, TYPE I TRINITY HEALTH-MICHIGAN
 
 
No
(87) ST ANN'S HOSPITAL

500 SOUTH CLEVELAND AVE

WESTERVILLE,OH43081
31-4412701 		HEALTHCARE SERVICES OH 501(C)(3) 3 MOUNT CARMEL HEALTH SYSTEM
 
 
No
(88) THE FOUNDATION OF SAINT JOSEPH REGIONAL MEDICAL CENTER

4215 EDISON LAKES PARKWAY

MISHAWAKA,IN46545
35-1654543 		SUPPORTS SERVICES OF RELATED HOSPITAL IN 501(C)(3) 11, TYPE I SAINT JOSEPH REGIONAL MEDICAL CENTER INC
 
 
No
(89) TRI-HOSPITAL MRI CENTER

4190 24TH AVENUE

FORT GRATIOT,MI48054
38-2884297 		MRI SERVICES MI 501(C)(3) 3 TRINITY HEALTH-MICHIGAN
 
 
No
(90) TRINITY CONTINUING CARE SERVICES

PO BOX 9184

FARMINGTON HILLS,MI483339184
38-2559656 		MANAGEMENT SERVICES FOR LONG TERM CARE AND SENIOR LIVING FACILITIES MI 501(C)(3) 11, TYPE I TRINITY HEALTH CORPORATION
 
 
No
(91) TRINITY CONTINUING CARE SERVICES - INDIANA INC

PO BOX 9184

FARMINGTON HILLS,MI483339184
93-0907047 		PROVIDES LONG-TERM CARE AND RESIDENTIAL HOUSING IN 501(C)(3) 9 TRINITY CONTINUING CARE SERVICES
 
 
No
(92) TRINITY HEALTH - MICHIGAN

20555 VICTOR PARKWAY

LIVONIA,MI48152
38-2113393 		HEALTHCARE SERVICES MI 501(C)(3) 3 TRINITY HEALTH CORPORATION
 
 
No
(93) TRINITY HEALTH CORPORATION

20555 VICTOR PARKWAY

LIVONIA,MI48152
35-1443425 		HEALTHCARE SYSTEM MANAGEMENT AND SUPPORT IN 501(C)(3) 11, TYPE I N/A
 
No
(94) TRINITY HEALTH INTERNATIONAL

20555 VICTOR PARKWAY

LIVONIA,MI48152
42-1253527 		HEALTHCARE TRAINING AND SUPPORT SERVICES MI 501(C)(3) 11, TYPE I TRINITY HEALTH CORPORATION
 
 
No
(95) TRINITY HEALTH WELFARE BENEFIT TRUST

20555 VICTOR PARKWAY

LIVONIA,MI48152
20-8151733 		RETIREE MEDICAL AND RETIREE LIFE INSURANCE COVERAGE MI 501(C)(9) N/A TRINITY HEALTH CORPORATION
 
 
No
(96) TRINITY HOME HEALTH SERVICES INC

17410 COLLEGE PARKWAY

LIVONIA,MI48152
38-2621935 		HOME HEALTH CARE SYSTEM MANAGEMENT SERVICES MI 501(C)(3) 11, TYPE I TRINITY HEALTH CORPORATION
 
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) ADVENT REHABILITATION LLC

607 DEWEY AVENUE SUITE 300
GRAND RAPIDS,MI49504
38-3306673 		REHABILITATION THERAPY SERVICES MI N/A
 N/A       No     No  
(2) BIG RUN MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
31-1608125 		MEDICAL OFFICE BUILDING RENTAL OH N/A
 N/A       No     No  
(3) CENTER FOR DIGESTIVE CARE LLC

5300 ELLIOTT DRIVE
YPSILANTI,MI48197
03-0447062 		PROVIDE GASTROINTESTINAL SERVICES MI N/A
 N/A       No     No  
(4) CENTRAL OHIO SLEEP MEDICINE LTD

6150 EAST BROAD STREET
COLUMBUS,OH43213
31-1701029 		SLEEP MEDICINE SERVICES OH N/A
 N/A       No     No  
(5) CLINTON IMAGING SERVICES LLC

615 VALLEY VIEW DR STE 202
MOLINE,IL61265
41-2044739 		MRI DIAGNOSTIC SERVICES IA N/A
 N/A       No     No  
(6) FOREST PARK IMAGING LLC

1000 4TH STREET SW
MASON CITY,IA50401
13-4365966 		X-RAY AND MAMMOGRAPHY SERVICES IA N/A
 N/A       No     No  
(7) FRANCES WARDE MEDICAL LABORATORY

300 WEST TEXTILE ROAD
ANN ARBOR,MI48104
38-2648446 		LABORATORY MI N/A
 N/A       No     No  
(8) FRESNO IMAGING CENTER

1303 E HERNDON AVE
FRESNO,CA93720
77-0363563 		DIAGNOSTIC IMAGING CA N/A
 N/A       No     No  
(9) HAWARDEN REGIONAL HEALTH CLINICS LLC

1122 AVENUE L
HAWARDEN,IA51023
20-1444339 		MEDICAL CLINIC IA N/A
 N/A       No     No  
(10) IDAHO GYNONCOLOGY SERVICES LLC

1055 N CURTIS RD
BOISE,ID83706
20-2975807 		PROVIDE GYN ONCOLOGY SERVICES ID SAINT ALPHONSUS REGIONAL MEDICAL CENTER
  		RELATED -107,173 34,671   No   Yes   50.000 %
(11) INTERMOUNTAIN MEDICAL IMAGING LLC

877 WEST MAIN ST STE 603
BOISE,ID83702
82-0514422 		PROVIDE IMAGING SERVICES ID N/A
 N/A       No     No  
(12) LOYOLA AMBULATORY SURGERY CENTER

1S224 SUMMIT AVE STE 201
OAKBROOK TERRACE,IL60181
36-4119522 		SURGICAL SERVICES IL N/A
 N/A       No     No  
(13) MAGNETIC RESONANCE SERVICES PARTNERSHIP

1416 SIXTH STREET SW
MASON CITY,IA50401
42-1328388 		MRI SERVICES IA N/A
 N/A       No     No  
(14) MASON CITY AMBULATORY SURGERY CENTER LLC

990 4TH STREET SW
MASON CITY,IA50401
20-1960348 		SURGERY-SAME DAY IA N/A
 N/A       No     No  
(15) MCE MOB IV LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
42-1544707 		MEDICAL OFFICE BUILDING RENTAL OH N/A
 N/A       No     No  
(16) MCMC POB III LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
31-1392994 		MEDICAL OFFICE BUILDING RENTAL OH N/A
 N/A       No     No  
(17) MEDILUCENT MOB I

793 W STATE STREET
COLUMBUS,OH43222
20-4911370 		MEDICAL OFFICE BUILDING RENTAL OH N/A
 N/A       No     No  
(18) MERCY ADVANCED MRI LLC

2525 SOUTH MICHIGAN AVE
CHICAGO,IL60616
26-2116721 		SUBLEASE MRI EQUIPMENT IL N/A
 N/A       No     No  
(19) MERCY HEART & VASCULAR LLC

2525 SOUTH MICHIGAN AVE
CHICAGO,IL60616
20-5272726 		SUBLEASE CT EQUIPMENT IL N/A
 N/A       No     No  
(20) MERCY HEART CTR OP SERVICES LLC

1000 4TH STREET SW
MASON CITY,IA50401
13-4237594 		CARDIOVASCULAR SERVICES IA N/A
 N/A       No     No  
(21) MERCY OUTPATIENT SURGERY CENTER LLC

1512 12TH AVENUE ROAD
NAMPA,ID83686
84-1380439 		OUTPATIENT SURGERY ID N/A
 N/A       No     No  
(22) MICHIANA HEALTH INFORMATION NETWORK LLC

215 WEST MADISON STREET
SOUTH BEND,IN46601
35-2050128 		COMMUNITY BASED CLINICAL INFO SYS & DATA DEPOSITORY IN N/A
 N/A       No     No  
(23) MOUNT CARMEL EAST POB III LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
31-1369473 		MEDICAL OFFICE BUILDING RENTAL OH N/A
 N/A       No     No  
(24) NEWCO AMBULATORY SURGERY CTR LLP

4190 24TH AVENUE
FORT GRATIOT,MI48059
30-0136708 		OUTPATIENT SURGERY CENTER MI N/A
 N/A       No     No  
(25) RIVERVIEW MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
31-1531135 		MEDICAL OFFICE BUILDING RENTAL OH N/A
 N/A       No     No  
(26) SARMED OUTPATIENT PHARMACY LLC

999 N CURTIS RD STE 102
BOISE,ID83706
51-0483218 		PHARMACY ID N/A
 N/A       No     No  
(27) SIXTY FOURTH STREET LLC

2373 64TH ST STE 2200
BYRON CENTER,MI49315
20-2443646 		PROVIDE OUTPATIENT SURGICAL CARE MI N/A
 N/A       No     No  
(28) ST ALPHONSUS CALDWELL CANCER CTR LLC

3123 MEDICAL DR
CALDWELL,ID83605
82-0526861 		RADIATION ONCOLOGY ID N/A
 N/A       No     No  
(29) ST ANN'S MEDICAL OFFICE BLDG II LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
31-1603660 		MEDICAL OFFICE BUILDING RENTAL OH N/A
 N/A       No     No  
(30) TAMARACK MEDICAL CLINIC LLC

610 VILLAGE DRIVE
DONNELLY,ID83615
20-1637921 		OUTPATIENT MEDICAL SERVICES ID N/A
 N/A       No     No  
(31) WESTAR MEDICAL OFFICE BUILDING LIMITED PARTNERSHIP

793 W STATE STREET
COLUMBUS,OH43222
31-1784409 		MEDICAL OFFICE BUILDING RENTAL OH N/A
 N/A       No     No  
(32) WOODLAND IMAGING CENTER LLC

5301 E HURON RIVER DR
ANN ARBOR,MI48106
76-0820959 		RADIOLOGY/IMAGING MI N/A
 N/A       No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) COMMUNITY HEALTH VENTURES INC
565 W WESTERN AVE
MUSKEGON,MI49440
38-3522260 		SOFTWARE MARKETING MI N/A
 C      
(2) GOTTLIEB MANAGEMENT SERVICES INC
701 W NORTH AVE
MELROSE PARK,IL60160
36-3330529 		MANAGEMENT SERVICES IL N/A
 C      
(3) HACKLEY HEALTH MANAGEMENT CENTER
1415 LEAHY ST
MUSKEGON,MI49442
38-2961814 		WEIGHT MANAGEMENT MI N/A
 C      
(4) HACKLEY HEALTH VENTURES INC
1415 LEAHY ST
MUSKEGON,MI49442
38-2589959 		OTHER MEDICAL SERVICES MI N/A
 C      
(5) HACKLEY HEALTHCARE EQUIPMENT
1415 LEAHY ST
MUSKEGON,MI49442
38-2578569 		HOME MEDICAL EQUIPMENT MI N/A
 C      
(6) HACKLEY PROFESSIONAL CENTER
1415 LEAHY ST
MUSKEGON,MI49442
38-3024797 		REAL ESTATE RENTAL MI N/A
 C      
(7) HACKLEY PROFESSIONAL PHARMACY
1415 LEAHY ST
MUSKEGON,MI49442
38-2447870 		PHARMACY MI N/A
 C      
(8) HEF INC
1415 LEAHY ST
MUSKEGON,MI49442
38-3086401 		OFFICE STAFFING MI N/A
 C      
(9) HOLY CROSS PRIVATE HOME SERVICES CORP
11801 TECH ROAD
SILVER SPRING,MD20904
52-1986562 		HOME CARE SERVICES MD N/A
 C      
(10) HPC CO-OWNERS ASSOCIATION
1700 CLINTON
MUSKEGON,MI49442
27-0734448 		CONDOMINIUM ASSOCIATION MI N/A
 C      
(11) HURON ARBOR CORPORATION
5301 EAST HURON RIVER DR PO BOX 992
ANN ARBOR,MI48106
38-2475644 		PROVIDES OFFICE RENTAL SPACE MI N/A
 C      
(12) IHA AFFILIATION CORPORATION
24 FRANK LLOYD WRIGHT DR LOBBY J
ANN ARBOR,MI48106
38-3188895 		MEDICAL MANAGEMENT MI N/A
 C      
(13) LOYOLA UNIVERSITY OF CHICAGO INSURANCE CO LTD
23 LIME TREE BAY AVENUE
GRAND CAYMAN    
CJ
PROVISION OF INSURANCE COVERAGE CJ N/A
 C      
(14) MARYLAND CARE GROUP INC
11801 TECH ROAD
SILVER SPRING,MD20904
52-1815313 		HEALTHCARE HOLDING MD N/A
 C      
(15) MEDNOW INC
1512 12TH AVENUE ROAD
NAMPA,ID83686
82-0389927 		OUTPATIENT PHARMACY ID N/A
 C      
(16) MERCY MEDICAL SERVICES
801 5TH STREET
SIOUX CITY,IA51101
42-1283849 		PRIMARY CARE PHYSICIANS IA N/A
 C      
(17) MERCY SERVICES CORPORATION
2525 SOUTH MICHIGAN AVENUE
CHICAGO,IL60616
36-3227348 		DORMANT IL N/A
 C      
(18) MICHIGAN ATHLETIC CLUB
2500 BURTON
GRAND RAPIDS,MI49546
38-2647304 		ATHLETIC CLUB MI N/A
 C      
(19) MOUNT CARMEL BEHAVIORAL HEALTHCARE SERVICES INC
6150 EAST BROAD STREET
COLUMBUS,OH43213
31-0971510 		BEHAVIORAL HEALTHCARE SERVICES OH N/A
 C      
(20) MOUNT CARMEL HEALTH PROVIDERS INC
6150 EAST BROAD STREET
COLUMBUS,OH43213
31-1382442 		MEDICAL SERVICES OH N/A
 C      
(21) NORTH IOWA MERCY MEDICAL SERVICES INC
1000 4TH ST SW
MASON CITY,IA50401
42-1382308 		MEDICAL SERVICES IA N/A
 C      
(22) PRIORITY PLUS OF CALIFORNIA
PO BOX 27230
FRESNO,CA93729
77-0395267 		FORMERLY HLTH MGMT NOW DISCONTINUED OPERATIONS CA N/A
 C      
(23) SAINT ALPHONSUS PHYSICIANS PA
1055 NORTH CURTIS ROAD
BOISE,ID837061370
33-1078261 		PHYSICIANS ID SAINT ALPHONSUS REGIONAL MEDICAL CENTER
  		C     100.000 %
(24) SAINT MARY'S HEALTH MANAGEMENT COMPANY
1640 EAST PARIS SE
GRAND RAPIDS,MI49546
38-3450733 		ATHLETIC CLUB MI N/A
 C      
(25) SURGERY CENTER FINANCING CORPORATION
6150 EAST BROAD STREET
COLUMBUS,OH43213
31-1531102 		FINANCE, INSURANCE AND REAL ESTATE OH N/A
 C      
(26) THRE SERVICES LLC
20555 VICTOR PARKWAY
LIVONIA,MI48152
45-2603654 		REAL ESTATE BROKERAGE SERVICES MI N/A
 C      
(27) TRINITY HEALTH EMPLOYEE BENEFIT TRUST
20555 VICTOR PARKWAY
LIVONIA,MI48152
38-3410377 		GRANTOR TRUST MI N/A
 T      
(28) VENZKE INSURANCE COMPANY LTD
PO BOX 1051 GRAND CAYMAN
GRAND CAYMAN    
CJ
98-0453602 		PROVISION OF INSURANCE COVERAGE CJ N/A
 C      
(29) WESTSHORE HEALTH NETWORK
1820 44TH STREET
KENTWOOD,MI49508
38-3280200 		PHYSICIAN HOSPITAL ORGANIZATION MI N/A
 C      
(30) WORKPLACE HEALTH OF GRAND HAVEN
1415 LEAHY ST
MUSKEGON,MI49442
38-3112035 		OCCUPATIONAL HEALTH MI N/A
 C      
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) MOUNT CARMEL HEALTH SYSTEM

 L 272,876 PER BOOKS
(2) ST ALPHONSUS CALDWELL CANCER CTR LLC

 K 499,743 PER BOOKS
(3) SAINT ALPHONSUS MEDICAL CENTER-ONTARIO

 K 1,623,967 PER BOOKS
(4) SAINT ALPHONSUS MEDICAL CENTER-ONTARIO

 L 497,954 PER BOOKS
(5) SAINT ALPHONSUS MEDICAL CENTER-ONTARIO

 P 618,551 PER BOOKS
(6) SAINT ALPHONSUS MEDICAL CENTER-ONTARIO

 A 31,423 PER BOOKS
(7) SAINT ALPHONSUS MEDICAL CENTER-NAMPA

 K 5,238,601 PER BOOKS
(8) SAINT ALPHONSUS MEDICAL CENTER-NAMPA

 L 120,175 PER BOOKS
(9) SAINT ALPHONSUS MEDICAL CENTER-NAMPA

 P 1,071,912 PER BOOKS
(10) SAINT ALPHONSUS MEDICAL CENTER-NAMPA

 J 156,226 PER BOOKS
(11) SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY

 K 722,081 PER BOOKS
(12) SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY

 P 334,978 PER BOOKS
(13) SAINT ALPHONSUS MEDICAL CENTER-BAKER CITY

 A 22,169 PER BOOKS
(14) SARMED OUTPATIENT PHARMACY LLC

 A 890 PER BOOKS
(15) SARMED OUTPATIENT PHARMACY LLC

 K 56,399 PER BOOKS
(16) TRINITY HEALTH CORPORATION

 E 5,477,000 PER BOOKS
(17) TRINITY HEALTH CORPORATION

 Q 9,370,958 PER BOOKS
(18) TRINITY HEALTH CORPORATION

 B 4,479,000 PER BOOKS
(19) TRINITY HEALTH CORPORATION

 L 44,113,112 PER BOOKS
(20) TRINITY HEALTH CORPORATION

 P 1,333,337 PER BOOKS
(21) TRINITY HEALTH CORPORATION

 O 15,435,008 PER BOOKS
(22) TRINITY HEALTH CORPORATION

 J 395,797 PER BOOKS
(23) SAINT ALPHONSUS HEALTH SYSTEM INC

 A 2,139 PER BOOKS
(24) SAINT ALPHONSUS HEALTH SYSTEM INC

 O 11,285,137 PER BOOKS
(25) SAINT ALPHONSUS MEDICAL CENTER-NAMPA HEALTH FOUNDATION

 A 86 PER BOOKS
(26) MEDNOW INC

 A 7,922 PER BOOKS
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(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 V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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