TY 2013 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) JOHN SNYDER MD........................................................................ CHAIRMAN	1.00 .......................0	X	X	0	0	0
(2) ROBERT BAXTER........................................................................ MARKET PRESIDENT & CEO, SRHP	40.00 .......................3.00	X	X	417,449	0	61,812
(3) STEVE WALTER........................................................................ VICE CHAIRMAN	1.00 .......................1.00	X	X	0	0	0
(4) BARRY CLARK........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(5) DANIEL CLIFFORD........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(6) GEORGE RICKS........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(7) HECTOR BUCH MD........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(8) JAMES MAY........................................................................ Board Member, CHP EVP & COO	1.00 .......................42.70	X		0	1,794,878	45,028
(9) JAYE E MCCAIN........................................................................ BOARD MEMBER	1.00 .......................1.00	X		0	0	0
(10) JOAN NIESE........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(11) KIRK GRIFFITH MD........................................................................ BOARD MEMBER	1.00 .......................0	X		10,688	0	0
(12) SR DOROTHY THUM RSM........................................................................ BOARD MEMBER	.50 .......................4.00	X		0	0	0
(13) SR MARIE MOORE RSM........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(14) TRACEY RIEPENHOFF........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(15) WILLIAM SCHERGER MD........................................................................ BOARD MEMBER	1.00 .......................0	X		0	0	0
(16) DIANA PICKARD........................................................................ ADMIN COORDINATOR, SECRETARY	40.00 .......................0		X	81,624	0	10,186
(17) JOHN RENNER........................................................................ TREASURER, MARKET CFO	40.00 .......................0		X	310,529	0	-99,800

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) TIMOTHY RIEGER........................................................................ TREASURER, MARKET CFO	40.00 .......................0	X				204,958	0	-22,883
(19) CHRISTINE PROVAZNIK........................................................................ VICE PRESIDENT	40.00 .......................0		X			235,463	0	-11,004
(20) DAVID MURPHY........................................................................ EXECUTIVE DIRECTOR, SRPS	40.00 .......................0		X			242,500	0	29,756
(21) HERBERT SCHUMM MD........................................................................ VP - MEDICAL AFFAIRS	40.00 .......................0		X			432,349	0	29,553
(22) JODI PAHL........................................................................ Chief Nurse Executive	40.00 .......................0		X			187,427	0	31,550
(23) JOHN MEYER........................................................................ SVP - REGIONAL CARE SYSTEMS	40.00 .......................0		X			271,074	0	16,262
(24) KAY WELLMAN........................................................................ SVP - CHIEF NURSE EXECUTIVE	40.00 .......................0		X			295,979	0	-49,926
(25) MARK SKAJA........................................................................ VP - MISSION SERVICES	40.00 .......................0		X			194,779	0	16,058
(26) MIKE BISSEGGER........................................................................ VP & GENERAL COUNSEL	40.00 .......................0		X			220,062	0	16,831
(27) RONDA LEHMAN........................................................................ COO	40.00 .......................1.00		X			209,503	0	15,231
(28) WILBERT CASON........................................................................ VP - HUMAN RESOURCES	40.00 .......................0		X			252,426	0	29,923
(29) DR BEKELE AYELE........................................................................ Cardiologist	40.00 .......................0			X		857,637	0	12,680
(30) DR CRAIG A NICHOLSON........................................................................ UROLOGIST	40.00 .......................0			X		801,740	0	31,218
(31) DR JASON BOWERSTOCK........................................................................ GENERAL SURGEON	.......................0			X		845,349	0	30,568
(32) DR JULIUS KATO........................................................................ CARDIOLOGIST	40.00 .......................0			X		1,066,916	0	28,826
(33) DR ZOHEIR ABDELBAKI........................................................................ CARDIOLOGIST	40.00 .......................0			X		1,630,500	0	31,052
(34) BRIAN SMITH........................................................................ FORMER KEY EMPLOYEE	37.00 .......................15.50				X	594,776	396,518	-51,781

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	1,522,298	1,522,298
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	30,000	30,000
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	3,459,359	2,940,455	518,904
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	142,156,027	120,832,623	21,323,404
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	8,838,462	7,512,693	1,325,769
9	Other employee benefits .......	24,774,612	21,058,420	3,716,192
10	Payroll taxes ...........	11,172,865	9,496,935	1,675,930
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	58,219		58,219
c	Accounting ...........	495,775		495,775
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	83,462,335	73,262,663	10,199,672	0
12	Advertising and promotion ....	643,669	547,119	96,550
13	Office expenses .......	935,379	795,075	140,304
14	Information technology ......	63,579	54,042	9,537
15	Royalties ..	0
16	Occupancy ...........	15,831,227	13,456,543	2,374,684
17	Travel ............	945,033	803,278	141,755
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	6,510,844	5,534,217	976,627
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	20,144,607	17,122,916	3,021,691
23	Insurance ..............	1,920,515	1,632,438	288,077
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	STATE ASSESSMENTS	4,535,943	4,535,943
b	MEMBERSHIP DUES	2,056,980	1,748,433	308,547
c	MEDICAL SUPPLIES	61,517,425	61,517,425
d	TAXES	395,192	335,913	59,279
e	All other expenses	0	0	0	0
25	Total functional expenses. Add lines 1 through 24e	391,470,345	344,739,429	46,730,916	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).	0

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	6,519,111	1
2	Savings and temporary cash investments .........		2
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	64,285,322	4
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	186,247	7
8	Inventories for sale or use ..............	8,133,909	8
9	Prepaid expenses and deferred charges ..........	-410,369	9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation .....	10b	0	256,690,988	10c	0
11	Investments—publicly traded securities ..........	243,191,576	11
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............	8,254,445	14
15	Other assets. See Part IV, line 11 ...........	10,289,699	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)......	597,140,928	16	0
	17	Accounts payable and accrued expenses .........	26,394,120	17
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	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..		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....................	171,449,339	25	0
26	Total liabilities. Add lines 17 through 25.........	197,843,459	26	0
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	399,297,469	27
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	399,297,469	33	0
34	Total liabilities and net assets/fund balances ........	597,140,928	34	0

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SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

See separate instructions.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

ST RITA'S MEDICAL CENTER

Employer identification number

34-1105619

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

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

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

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

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

Yes

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

11g(i)

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

11g(ii)

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

11g(iii)

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

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

17a

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2013

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(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) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2012. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

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

Schedule A (Form 990 or 990-EZ) 2013

Page 4

Part IV

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

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

See separate instructions. SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

ST RITA'S MEDICAL CENTER

Employer identification number

34-1105619

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2013

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2013

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

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

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

Yes

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

Yes

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

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

Yes

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

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

Yes

18,057

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

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

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

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

18,057

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
Schedule C, Part II-B, Line 1, Description of the activities reported on Lines 1a through 1i	LOBBYING ACTIVITIES PERFORMED INCLUDE BOTH THE USE OF VOLUNTEERS ENCOURAGED TO WRITE LETTERS TO PUBLIC OFFICIALS ON ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE TO PROVIDE HEALTH SERVICES TO THE COMMUNITIES SERVED, AND THE USE OF PAID STAFF MEMBERS AND MANAGEMENT PERSONNEL. PAID MANAGEMENT PERSONNEL REGULARLY ISSUE MAILINGS TO LEGISLATORS ATTEMPTING TO INFLUENCE LEGISLATIVE MATTERS AND REFERENDUM, AND ORGANIZE AND HOST MEETINGS AMONG HOSPITAL EXECUTIVES AND THEIR LEGISLATORS REGARDING ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE PROVIDING HEALTHCARE SERVICES TO ITS PATIENTS AND TO CONTINUE IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. PAID STAFF MEMBERS HAVE, ON LIMITED OCCASIONS, WRITTEN TO LEGISLATORS ON SUCH ISSUES. THE PRIMARY PURPOSE FOR LOBBYING ACTIVITIES IS TO ENHANCE THE ORGANIZATION'S PUBLIC POSITION ON LEGISLATIVE AND REGULATORY ISSUES THAT IMPACT PATIENT CARE THROUGHOUT OUR SYSTEM. THE ORGANIZATION FOCUSES ON PUBLIC POLICY ISSUES THAT EXTEND OUR HEALING MINISTRY TO THOSE WHO ARE POOR AND UNDERSERVED IN THE COMMUNITIES WE SERVE. TO CARRY OUT THESE EFFORTS, THE ORGANIZATION PARTNERS WITH EXPERT CONSULTANTS AND PROFESSIONAL TRADE ASSOCIATIONS TO BUILD AWARENESS AND EXECUTE SPECIFIC STRATEGIES THAT WILL YIELD A FAVORABLE OUTCOME FOR PATIENT CARE IN THE ORGANIZATION'S FACILITIES WHERE THEY ARE TREATED.

Return Reference

Explanation

Schedule C, Part II-B, Line 1, Description of the activities reported on Lines 1a through 1i

LOBBYING ACTIVITIES PERFORMED INCLUDE BOTH THE USE OF VOLUNTEERS ENCOURAGED TO WRITE LETTERS TO PUBLIC OFFICIALS ON ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE TO PROVIDE HEALTH SERVICES TO THE COMMUNITIES SERVED, AND THE USE OF PAID STAFF MEMBERS AND MANAGEMENT PERSONNEL. PAID MANAGEMENT PERSONNEL REGULARLY ISSUE MAILINGS TO LEGISLATORS ATTEMPTING TO INFLUENCE LEGISLATIVE MATTERS AND REFERENDUM, AND ORGANIZE AND HOST MEETINGS AMONG HOSPITAL EXECUTIVES AND THEIR LEGISLATORS REGARDING ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE PROVIDING HEALTHCARE SERVICES TO ITS PATIENTS AND TO CONTINUE IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. PAID STAFF MEMBERS HAVE, ON LIMITED OCCASIONS, WRITTEN TO LEGISLATORS ON SUCH ISSUES. THE PRIMARY PURPOSE FOR LOBBYING ACTIVITIES IS TO ENHANCE THE ORGANIZATION'S PUBLIC POSITION ON LEGISLATIVE AND REGULATORY ISSUES THAT IMPACT PATIENT CARE THROUGHOUT OUR SYSTEM. THE ORGANIZATION FOCUSES ON PUBLIC POLICY ISSUES THAT EXTEND OUR HEALING MINISTRY TO THOSE WHO ARE POOR AND UNDERSERVED IN THE COMMUNITIES WE SERVE. TO CARRY OUT THESE EFFORTS, THE ORGANIZATION PARTNERS WITH EXPERT CONSULTANTS AND PROFESSIONAL TRADE ASSOCIATIONS TO BUILD AWARENESS AND EXECUTE SPECIFIC STRATEGIES THAT WILL YIELD A FAVORABLE OUTCOME FOR PATIENT CARE IN THE ORGANIZATION'S FACILITIES WHERE THEY ARE TREATED.

Schedule C (Form 990 or 990EZ) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990. SchDMd Bullet

See separate instructions. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST RITA'S MEDICAL CENTER

Employer identification number

34-1105619

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

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


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

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

Yes No

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

Part V

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

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

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. 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 .................				0
b	Buildings ................				0
c	Leasehold improvements ............				0
d	Equipment ................				0
e	Other .................				0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......					0

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

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








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

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

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









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

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value









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

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0









Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		0
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................

Schedule D (Form 990) 2013

Page 4

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

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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

Return Reference	Explanation
Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote	THE COMPANY [CATHOLIC HEALTH PARTNERS AND AFFILIATED ENTITIES] COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT DECEMBER 31, 2013 AND 2012, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2013 OR 2012.

Schedule D (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST RITA'S MEDICAL CENTER

Employer identification number

34-1105619

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(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) ..		34,766	17,870,731	3,882,540	13,988,191	3.590 %
b	Medicaid (from Worksheet 3, column a) ....		68,192	47,385,302	32,397,909	14,987,393	3.840 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs .	0	102,958	65,256,033	36,280,449	28,975,584	7.430 %
Other Benefits			58,944	3,021,490	38,285	2,983,205	0.760 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..		58,944	3,021,490	38,285	2,983,205	0.760 %
f	Health professions education (from Worksheet 5) ..		77	103,950		103,950	0.030 %
g	Subsidized health services (from Worksheet 6) ..		28,665	22,455,906	12,948,585	9,507,321	2.440 %
h	Research (from Worksheet 7)		98	158,981		158,981	0.040 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)		846	1,017,128	1,070	1,016,058	0.260 %
j	Total. Other Benefits ..	0	88,630	26,757,455	12,987,940	13,769,515	3.530 %
k	Total. Add lines 7d and 7j .	0	191,588	92,013,488	49,268,389	42,745,099	10.960 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

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
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
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	0	0	0	0

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

20,542,190

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

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

Section B. Medicare

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

95,010,082

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

92,823,742

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

2,186,340

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1WEST CENTRAL OHIO GROUP LTD (DBA INSTITUTE FOR ORTHOPEDIC SURGERY)	ORTHOPEDIC HOSPITAL	51 %	0 %	49 %
2KIDNEY SERVICES OF WEST CENTRAL OHIO	DIALYSIS CENTER	51 %	0 %	49 %
3CORNERSTONE ALLIANCE	MEDICAL MANAGEMENT	50 %	0 %	50 %
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2013

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?2 Name, address, primary website address, and state license number
1	ST RITA'S MEDICAL CENTER 730 W MARKET STREET LIMA,OH45801 WWW.STRITAS.ORG 1103	X	X	X
2	INSTITUTE OF ORTHOPAEDIC SURGERY 801 MEDICAL DRIVE LIMA,OH45804 WWW.IOSHOSPITAL.COM 1445	X

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	ST RITA'S MEDICAL CENTER
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The health needs of the community

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

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

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

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

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): www.stritas.org

Other website (list url): www.mercy.com

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

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

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

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

Prioritization of health needs in its community

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

Other (describe in Part VI)

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

Yes

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

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

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

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

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

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

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

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Part VI)

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

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

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

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

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

Other (describe in Part VI)

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

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	INSTITUTE OF ORTHOPAEDIC SURGERY
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

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

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

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The health needs of the community

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

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

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

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

Other (describe in Part VI)

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

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

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

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

Hospital facility’s website (list url):

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

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

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

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

Prioritization of health needs in its community

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

Other (describe in Part VI)

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

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

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

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

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

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

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

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Part VI)

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

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

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

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

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

Other (describe in Part VI)

If "Yes," explain in Part VI.

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

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment	(1) - ST. RITA'S MEDICAL CENTER: RESOURCES USED TO GATHER COMMUNITY INPUT: ORGANIZATIONS CONTACTED: JEFF SPRAGUE, VICE PRESIDENT, ALLEN COUNTY ECONOMIC DEVELOPMENT GROUP DAVE ROSEBROCK, HEALTH COMMISSIONER, ALLEN COUNTY HEALTH DEPARTMENT KATHY LUHN, DIRECTOR OF HEALTH EDUCATION, ALLEN COUNTY HEALTH DEPARTMENT JED METZGER, PRESIDENT/CEO, LIMA/ALLEN COUNTY CHAMBER OF COMMERCE THOMAS MAZUR, EXECUTIVE DIRECTOR, LIMA ALLEN COUNTY REGIONAL PLANNING COMMISSION EVELYN SMITH, ASSISTANT PLANNER, LIMA ALLEN COUNTY REGIONAL PLANNING COMMISSION MARLENE SCHUMAKER, GRANTS ADMINISTRATOR, LIMA ALLEN COUNTY REGIONAL PLANNING COMMISSION LISA STEFFEN, ASSOCIATE PLANNER, LIMA ALLEN COUNTY REGIONAL PLANNING COMMISSION MIKE SWICK, PRESIDENT/CHIEF EXECUTIVE OFFICER, LIMA MEMORIAL HEALTH SYSTEM KEN KURZ, DIRECTOR OF LIMA MEMORIAL FOUNDATION, LIMA MEMORIAL HEALTH SYSTEM CHERYL NAGY, DIRECTOR OF RISK MANAGEMENT, LIMA MEMORIAL HEALTH SYSTEM DOTTIE KAISER,DIRECTOR OF PASTORAL CARE AND SOCIAL SERVICES, LIMA MEMORIAL HEALTH SYSTEM REBECCA JENKINS, DIRECTOR OF MARKETING AND PUBLIC RELATIONS, LIMA MEMORIAL HEALTH SYSTEM MIKE KEITH, CHIEF, SHAWNEE TOWNSHIP POLICE PHILIP HAYNE, PRESIDENT AND CHIEF EXECUTIVE OFFICER, UNITED WAY OF GREATER LIMA TOM THOMPSON, LABOR STAFF REPRESENTATIVE, UNITED WAY OF GREATER LIMA JERRY COURTNEY, PRESIDENT, YMCA LEADERS, REPRESENTATIVES, OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS CONTACTED: SAM BASSITT, ALLEN COUNTY COMMISSIONER DAVID BERGER, MAYOR, CITY OF LIMA JACKIE FOX, CHIEF EXECUTIVE OFFICER, LIMA ALLEN COUNCIL ON COMMUNITY AFFAIRS MIKE SCHOENHOFER, EXECUTIVE DIRECTOR OF MENTAL HEALTH & RECOVERY SERVICES BOARD JANIS SUNDERHAUS, CHIEF EXECUTIVE OFFICER OF HEALTH PARTNERS OF WESTERN OHIO COMMUNITY MEMBERS FROM VARIOUS GROUPS, ORGANIZATIONS, AND SECTORS ESTABLISHED THE COMMUNITY SUSTAINABILITY ADVISORY COMMITTEE UNDER THE LIMA-ALLEN COUNTY REGIONAL PLANNING COMMISSION. THE COMMUNITY SUSTAINABILITY ADVISORY COMMITTEE WAS RESPONSIBLE FOR THE IMPLEMENTATION OF THE HEALTHY COMMUNITIES INSTITUTE SOFTWARE, WHICH WAS USED AS THE BASIS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE HEALTHY COMMUNITIES INSTITUTE WEBSITE PROVIDED A LIST OF IDENTIFIED HEALTH CONDITIONS AND RELATED INDICATORS FOR ALLEN COUNTY. THE INFORMATION FOR AUGLAIZE AND PUTNAM COUNTIES WAS ANALYZED UNDER THE SAME QUARTILE SYSTEM.;
Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined	(1) - ST. RITA'S MEDICAL CENTER: THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IS BASED UPON FEDERAL POVERTY LEVELS STATED IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.; (1) - INSTITUTE OF ORTHOPEDIC SURGERY: THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IS BASED UPON FEDERAL POVERTY LEVELS STATED IN THE HOSPITAL'LS FINANCIAL ASSISTANCE POLICY.;

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. 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?54
Name and address		Type of Facility (describe)
1	ST RITA'S OUTPATIENT SURGERY CENTER 770 W HIGH STREET SUITE 100 LIMA,OH45801	OUTPATIENT SURGERY CENTER
2	ST RITA'S WESTSIDE URGENT CARE 2195 ALLENTOWN ROAD LIMA,OH45805	URGENT CARE FACILITY
3	ST RITA'S HOME CARE 959 WEST NORTH STREET LIMA,OH45801	HOME CARE SERVICES
4	ST RITA'S HOME INFUSION 959 WEST NORTH STREET LIMA,OH45801	HOME INFUSION SERVICES
5	ST RITA'S HYPERBARIC OXYGEN THERAPY SERVICE 830 W HIGH STREET SUITE 250 LIMA,OH45801	OUTPATIENT OXYGEN THERAPY SERVICES
6	ST RITA'S SLEEP DISORDERS CENTER 830 W HIGH STREET SUITE 350 LIMA,OH45801	OUTPATIENT SLEEP DISORDERS CENTER
7	ST RITA'S OUTPATIENT ONCOLOGY 803 W MARKET STREET LIMA,OH45805	OUTPATIENT ONCOLOGY CENTER
8	ST RITA'S HEALTH MANAGEMENT GROUP 770 W HIGH STREET SUITE 450 LIMA,OH45801	OUTPATIENT CLINICS
9	ST RITA'S OP REHABILITATION SERVICES 830 W HIGH STREET SUITE 150 LIMA,OH45805	OUTPATIENT THERAPY & REHABILITATION CLINIC
10	ST RITA'S WAPAK IMAGING 1015 S BLACKHOOF STREET SUITE D WAPAKONETA,OH45895	DIAGNOSTIC CENTER
11	ST RITA'S OCCUPATIONAL HEALTH CENTER 1875 SOUTH DIXIE HIGHWAY LIMA,OH45804	OCCUPATIONAL HEALTH FACILITY
12	ST RITA'S HOSPICE 959 WEST NORTH STREET LIMA,OH45801	HOSPICE SERVICES
13	ST RITA'S OP REHABILITATION SERVICES 101 PUTNAM PARKWAY - SR 109 OTTAWA,OH45875	OUTPATIENT THERAPY CENTER
14	KIDNEY SERVICES OF WEST CENTRAL OH 750 W HIGH STREET SUITE 100 LIMA,OH45801	OUTPATIENT DIALYSIS CENTER
15	ST RITA'S HOME MEDICAL EQUIPMENT 770 W NORTH STREET LIMA,OH45801	HOME MEDICAL EQUIPMENT SERVICES
16	PUTNAM COUNTY AMBULATORY CARE CENTER 601 STATE ROUTE 224 GLANDORF,OH45848	EMERGENCY ROOM - 24 HOURS
17	DELPHOS AMBULATORY CARE CENTER 1800 E FIFTH STREET DELPHOS,OH45833	URGENT CARE FACILITY
18	ST RITA'S SPECIALTY CLINICS 830 W HIGH STREET SUITE 307 LIMA,OH45801	PEDIATRIC SPECIALTY CLINICS
19	ST RITA'S EASTSIDE URGENT CARE 967 BELLEFONTAINE AVENUE LIMA,OH45804	URGENT CARE FACILITY
20	ST RITA'S AUDIOLOGY 770 W HIGH STREET SUITE 230 LIMA,OH45801	OUTPATIENT AUDIOLOGY CENTER
21	NORTH CENTRAL OHIO PHYSICIAN'S SERVICES 770 W HIGH STREET SUITE 220 LIMA,OH45801	PHYSICIAN SERVICES
22	NEW VISION MEDICAL LABORATORY 750 W HIGH STREET SUITE 400 LIMA,OH45801	LABORATORY SERVICES
23	ST RITA'S OP REHABILITATION SERVICES 1100 DEFIANCE STREET WAPAKONETA,OH45895	OUTPATIENT THERAPY CENTER
24	ST RITA'S WOMEN'S WELLNESS CENTER 770 W HIGH ST SUITE 250 LIMA,OH45801	OUTPATIENT WOMEN'S BREAST CENTER
25	ALLISON RADIATION ONCOLOGY CENTER 803 WEST MARKET STREET LIMA,OH45805	OUTPATIENT RADIATION ONCOLOGY CENTER
26	ST RITA'S WOUND CARE CLINIC 830 W HIGH STREET SUITE 250 LIMA,OH45801	OUTPATIENT WOUND CARE CLINIC
27	ST RITA'S IP REHABILITATION UNIT 730 W MARKET STREET LIMA,OH45801	INPATIENT REHABILITATION SERVICES
28	ST RITA'S LIFE FLIGHT 1402 LAGRANGE TOLEDO,OH43608	AIR AMBULANCE SERVICES
29	ST RITA'S MED CARE CLINIC 939 W MARKET STREET LIMA,OH45805	OUTPATIENT MEDICAL SERVICES
30	ST RITA'S TRANSITIONAL CARE 730 W MARKET STREET LIMA,OH45801	SKILLED NURSING UNIT
31	ST RITA'S IP PSYCHIATRIC UNIT 730 W MARKET STREET LIMA,OH45801	INPATIENT PSYCHIATRIC SERVICES
32	ST RITA'S HEMODIALYSIS 730 W MARKET STREET LIMA,OH45801	DIALYSIS SERVICES
33	HEART SPECIALISTS 730 W MARKET STREET SUITE 2K LIMA,OH45801	PHYSICIAN PRACTICE
34	KIDNEY & HYPERTENSION ASSOCIATES 750 W HIGH STREET SUITE 150 LIMA,OH45801	PHYSICIAN PRACTICE
35	PHYSICIANS INC HOSPITALISTS 750 W HIGH STREET SUITE 250 LIMA,OH45801	PHYSICIAN PRACTICE
36	CENTER FOR PULMONARY MEDICINE 770 W HIGH STREET SUITE 240 LIMA,OH45801	PHYSICIAN PRACTICE
37	PYSCHIATRIC ASSOCIATES 770 W HIGH STREET SUITE 300 LIMA,OH45801	PHYSICIAN PRACTICE
38	LIMA UROLOGY 770 W HIGH STREET SUITE 350 LIMA,OH45801	PHYSICIAN PRACTICE
39	ENDOCRINE DIABETES AND METABOLISM CENTER 770 W HIGH STREET SUITE 450 LIMA,OH45801	PHYSICIAN PRACTICE
40	EAR NOSE THROAT AND SINUS ASSOCIATES 770 W HIGH STREET SUITE 460 LIMA,OH45801	PHYSICIAN PRACTICE
41	PEDIATRIC ENDO 830 W HIGH STREET SUITE 307 LIMA,OH45801	PHYSICIAN PRACTICE
42	ADVANCED SURGICAL ASSOCIATES 830 W HIGH STREET SUITE 360 LIMA,OH45801	PHYSICIAN PRACTICE
43	MARTIN & MARTZ FAMILY PRACTICE 825 W MARKET STREET SUITE 205 LIMA,OH45801	PHYSICIAN PRACTICE
44	ONCOLOGY SPECIALISTS OF SRPS 803 W MARKET STREET SUITE 200 LIMA,OH45801	PHYSICIAN PRACTICE
45	ONCOLOGY SPECIALISTS OF SRPS 900 HAVEMANN ROAD SUITE B CELINA,OH45822	PHYSICIAN PRACTICE
46	PRIMARY CARE ASSOCIATES 967 BELLEFONTAINE AVENUE SUITE 201 LIMA,OH45801	PHYSICIAN PRACTICE
47	ST RITA'S FAMILY MEDICINE - SHAWNEE 2745 FORT AMANDA ROAD LIMA,OH45806	PHYSICIAN PRACTICE
48	ST RITA'S FAMILY MEDICINE AT UNOH 3224 JARVIS DRIVE LIMA,OH45807	PHYSICIAN PRACTICE
49	FAMILY MEDICINE ASSOCIATES 582 N CABLE ROAD LIMA,OH45801	PHYSICIAN PRACTICE
50	FAMILY & SPORTS MEDICINE 110 SELHORST DRIVE OTTAWA,OH45875	PHYSICIAN PRACTICE
51	KLASS FAMILY MEDICINE 601 STATE ROUTE 224 GLANDORF,OH45848	PHYSICIAN PRACTICE
52	SPENCERVILLE PHYSICIANS 107 N CANAL STREET SPENCERVILLE,OH45887	PHYSICIAN PRACTICE
53	PRE-SERVICE CENTER 300 W MARKET STREET LIMA,OH45801	PHYSICIAN PRACTICE
54	ST RITA'S SPECIALTY PHYSICIANS (UROLOGY ENT CARDIOLOGY) 900 HAVEMANN ROAD SUITE D CELINA,OH45822	PHYSICIAN PRACTICE

Schedule H (Form 990) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference

Explanation

Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment

(1) - ST. RITA'S MEDICAL CENTER: RESOURCES USED TO GATHER COMMUNITY INPUT: ORGANIZATIONS CONTACTED: JEFF SPRAGUE, VICE PRESIDENT, ALLEN COUNTY ECONOMIC DEVELOPMENT GROUP DAVE ROSEBROCK, HEALTH COMMISSIONER, ALLEN COUNTY HEALTH DEPARTMENT KATHY LUHN, DIRECTOR OF HEALTH EDUCATION, ALLEN COUNTY HEALTH DEPARTMENT JED METZGER, PRESIDENT/CEO, LIMA/ALLEN COUNTY CHAMBER OF COMMERCE THOMAS MAZUR, EXECUTIVE DIRECTOR, LIMA ALLEN COUNTY REGIONAL PLANNING COMMISSION EVELYN SMITH, ASSISTANT PLANNER, LIMA ALLEN COUNTY REGIONAL PLANNING COMMISSION MARLENE SCHUMAKER, GRANTS ADMINISTRATOR, LIMA ALLEN COUNTY REGIONAL PLANNING COMMISSION LISA STEFFEN, ASSOCIATE PLANNER, LIMA ALLEN COUNTY REGIONAL PLANNING COMMISSION MIKE SWICK, PRESIDENT/CHIEF EXECUTIVE OFFICER, LIMA MEMORIAL HEALTH SYSTEM KEN KURZ, DIRECTOR OF LIMA MEMORIAL FOUNDATION, LIMA MEMORIAL HEALTH SYSTEM CHERYL NAGY, DIRECTOR OF RISK MANAGEMENT, LIMA MEMORIAL HEALTH SYSTEM DOTTIE KAISER,DIRECTOR OF PASTORAL CARE AND SOCIAL SERVICES, LIMA MEMORIAL HEALTH SYSTEM REBECCA JENKINS, DIRECTOR OF MARKETING AND PUBLIC RELATIONS, LIMA MEMORIAL HEALTH SYSTEM MIKE KEITH, CHIEF, SHAWNEE TOWNSHIP POLICE PHILIP HAYNE, PRESIDENT AND CHIEF EXECUTIVE OFFICER, UNITED WAY OF GREATER LIMA TOM THOMPSON, LABOR STAFF REPRESENTATIVE, UNITED WAY OF GREATER LIMA JERRY COURTNEY, PRESIDENT, YMCA LEADERS, REPRESENTATIVES, OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS CONTACTED: SAM BASSITT, ALLEN COUNTY COMMISSIONER DAVID BERGER, MAYOR, CITY OF LIMA JACKIE FOX, CHIEF EXECUTIVE OFFICER, LIMA ALLEN COUNCIL ON COMMUNITY AFFAIRS MIKE SCHOENHOFER, EXECUTIVE DIRECTOR OF MENTAL HEALTH & RECOVERY SERVICES BOARD JANIS SUNDERHAUS, CHIEF EXECUTIVE OFFICER OF HEALTH PARTNERS OF WESTERN OHIO COMMUNITY MEMBERS FROM VARIOUS GROUPS, ORGANIZATIONS, AND SECTORS ESTABLISHED THE COMMUNITY SUSTAINABILITY ADVISORY COMMITTEE UNDER THE LIMA-ALLEN COUNTY REGIONAL PLANNING COMMISSION. THE COMMUNITY SUSTAINABILITY ADVISORY COMMITTEE WAS RESPONSIBLE FOR THE IMPLEMENTATION OF THE HEALTHY COMMUNITIES INSTITUTE SOFTWARE, WHICH WAS USED AS THE BASIS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE HEALTHY COMMUNITIES INSTITUTE WEBSITE PROVIDED A LIST OF IDENTIFIED HEALTH CONDITIONS AND RELATED INDICATORS FOR ALLEN COUNTY. THE INFORMATION FOR AUGLAIZE AND PUTNAM COUNTIES WAS ANALYZED UNDER THE SAME QUARTILE SYSTEM.;

Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined

(1) - ST. RITA'S MEDICAL CENTER: THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IS BASED UPON FEDERAL POVERTY LEVELS STATED IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.; (1) - INSTITUTE OF ORTHOPEDIC SURGERY: THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IS BASED UPON FEDERAL POVERTY LEVELS STATED IN THE HOSPITAL'LS FINANCIAL ASSISTANCE POLICY.;

Schedule H (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
ST RITA'S MEDICAL CENTER

Employer identification number
34-1105619

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) SRHC FOUNDATION 730 W MARKET STREET LIMA,OH45801	34-1368429	501(C)(3)	301,000	MISSION SUPPORT
(2) ALLEN COUNTY HEALTH PARTNERS 441 E 8TH STREET LIMA,OH458042482	56-2330309	501(C)(3)	294,275	COMMUNITY BENEFITS AND CARE FOR THE POOR PROGRAMS
(3) WALGREENS PO BOX 90480 CHICAGO,IL606960480	36-1924024		199,786	INDIGENT MEDICAL PROGRAM
(4) AMERICAN CANCER SOCIETY - OHIO DIVISION 740 COMMERCE DRIVE PERRYSBURG,OH43551	25-1798733	501(C)(3)	30,750	MISSION SUPPORT
(5) EQUESTRIAN THERAPY PROGRAM AT FASSETT FARM BOWSHER ROAD CRIDERSVILLE,OH45806	34-1376159	501(C)(3)	26,250	CARE FOR THE POOR PROGRAM
(6) OUR DAILY BREAD KITCHEN 1275 S CENTRAL LIMA,OH45802	34-1134252	501(C)(3)	25,100	MISSION SUPPORT
(7) ALLEN COUNTY HEALTH DEPARTMENT 219 E MARKET STREET LIMA,OH45802	34-6400019	501(C)(3)	23,584	HEALTH MINISTRIES PROGRAM
(8) AMERICAN RED CROSS 610 SOUTH COLETT LIMA,OH45805	34-4428650	501(C)(3)	20,000	MISSION SUPPORT
(9) UNITED WAY OF GREATER LIMA 615 SOUTH COLLETT LIMA,OH45805	34-4466356	501(C)(3)	17,800	MISSION SUPPORT
(10) FAMILY PROMISE OF LIMA ALLEN COUNTY 1295 PIERCE STREET LIMA,OH45801	20-8987019	501(C)(3)	15,000	MISSION SUPPORT
(11) STAR SPANGLED SPECTACULAR P O BOX 1602 LIMA,OH45802	26-4000194	501(C)(3)	15,000	MISSION SUPPORT
(12) LIMA-ALLEN COUNTY REGIONAL PLANNING COMMISSION 130 WEST NINTH STREET LIMA,OH458014311	34-1162237	ALLEN COUNTY	10,000	MISSION SUPPORT
(13) SAMARITAN HOUSE 328 W MCKIBBEN TREET LIMA,OH45801	34-1595265	501(C)(3)	10,000	MISSION SUPPORT
(14) AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS,TX75231	13-5613797	501(C)(3)	10,000	MISSION SUPPORT
(15) MARCH OF DIMES FOUNDATION 1275 MAMARONECK AVENUE WHITE PLAINS,NY10605	13-1846366	501(C)(3)	5,000	MISSION SUPPORT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2013

Page 2

Part III

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

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant
(1) AUTOMATED EXTERNAL DEFIBRILLATOR VESTS	10	30,000

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

Schedule I, Part I, Line 2, Procedures for monitoring use of grant funds

EACH ORGANIZATION MUST PROVIDE A COMPLETED FORM DEMONSTRATING TO ST. RITA'S THEIR NEEDS AND HOW THE MONEY IS TO BE USED, AS WELL AS A COPY OF THEIR 990. THE APPLICATIONS ARE SCREENED AND EVAULATED BASED ON COMMUNITY NEED, CARE FOR THE POOR, AND ALIGNMENT WITH OUR MISSION. DONATIONS OVER $10,000 MUST BE APPROVED BY THE BOARD OF DIRECTORS, WHILE ANY DONATION OVER $5,000 IS APPROVED BY AN ADMINISTRATION LEVEL COUNCIL. FOR ONGOING DONATIONS, WE RECEIVE FEEDBACK FROM THE ORGANIZATION ON HOW THE MONEY HAS BEEN USED.

Schedule I (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST RITA'S MEDICAL CENTER

Employer identification number

34-1105619

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2013

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)ROBERT BAXTERMARKET PRESIDENT & CEO, SRHP	(i) (ii)	374,258 0	0 0	43,191 0	32,793 0	29,019 0	479,261 0	0 0
(2)JAMES MAYBOARD MEMBER, CHP EVP & COO	(i) (ii)	0 734,698	0 262,703	0 797,477	0 10,200	0 34,828	0 1,839,906	0 0
(3)JOHN RENNERTREASURER, MARKET CFO	(i) (ii)	71,912 0	0 0	238,617 0	-122,607 0	22,807 0	210,729 0	0 0
(4)TIMOTHY RIEGERTREASURER, MARKET CFO	(i) (ii)	194,825 0	9,201 0	932 0	-24,967 0	2,084 0	182,075 0	0 0
(5)BRIAN SMITHFORMER KEY EMPLOYEE	(i) (ii)	367,343 244,896	135,000 90,000	92,433 61,622	-68,164 4,080	7,382 4,921	533,994 405,519	0 0
(6)HERBERT SCHUMM MDVP - MEDICAL AFFAIRS	(i) (ii)	342,566 0	0 0	89,783 0	711 0	28,842 0	461,902 0	0 0
(7)KAY WELLMANSVP - CHIEF NURSE EXECUTIVE	(i) (ii)	69,956 0	0 0	226,023 0	-58,900 0	8,974 0	246,053 0	0 0
(8)CHRISTINE PROVAZNIKVICE PRESIDENT	(i) (ii)	192,389 0	0 0	43,074 0	-22,444 0	11,440 0	224,459 0	0 0
(9)JOHN MEYERSVP - REGIONAL CARE SYSTEMS	(i) (ii)	237,661 0	0 0	33,413 0	-12,847 0	29,109 0	287,336 0	0 0
(10)WILBERT CASONVP - HUMAN RESOURCES	(i) (ii)	189,952 0	0 0	62,474 0	8,837 0	21,086 0	282,349 0	0 0
(11)MARK SKAJAVP - MISSION SERVICES	(i) (ii)	155,736 0	0 0	39,043 0	-12,700 0	28,758 0	210,837 0	0 0
(12)MIKE BISSEGGERVP & GENERAL COUNSEL	(i) (ii)	204,758 0	12,540 0	2,764 0	-4,155 0	20,986 0	236,893 0	0 0
(13)RONDA LEHMANCOO	(i) (ii)	179,723 0	0 0	29,780 0	-12,334 0	27,565 0	224,734 0	0 0
(14)DAVID MURPHYEXECUTIVE DIRECTOR, SRPS	(i) (ii)	210,872 0	31,164 0	464 0	2,071 0	27,685 0	272,256 0	0 0
(15)JODI PAHLCHIEF NURSE EXECUTIVE	(i) (ii)	186,826 0	0 0	601 0	1,959 0	29,591 0	218,977 0	0 0
(16)DR ZOHEIR ABDELBAKICARDIOLOGIST	(i) (ii)	701,144 0	928,566 0	790 0	2,550 0	28,502 0	1,661,552 0	0 0
(17)DR JULIUS KATOCARDIOLOGIST	(i) (ii)	494,380 0	571,294 0	1,242 0	2,550 0	26,276 0	1,095,742 0	0 0
(18)DR CRAIG A NICHOLSONUROLOGIST	(i) (ii)	567,496 0	224,533 0	9,711 0	2,550 0	28,668 0	832,958 0	0 0
(19)DR JASON BOWERSTOCKGENERAL SURGEON	(i) (ii)	325,479 0	502,046 0	17,824 0	2,550 0	28,018 0	875,917 0	0 0
(20)DR BEKELE AYELECARDIOLOGIST	(i) (ii)	438,430 0	401,972 0	17,235 0	2,550 0	10,130 0	870,317 0	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
Schedule J, Part I, Line 3, Arrangement used to establish the top management official's compensation	THE COMPENSATION OF ROBERT BAXTER, PRESIDENT AND CEO, IS DETERMINED BY CATHOLIC HEALTH PARTNERS (CHP), A RELATED TAX-EXEMPT ORGANIZATION. CHP UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A COMPENSATION SURVEY, AND APPROVAL BY BOARD OR COMPENSATION COMMITTEE WHEN DETERMINING MR. BAXTER'S COMPENSATION.
Schedule J, Part I, Line 4a, Severance or change-of-control payment	SEVERANCE BENEFITS CONSISTING OF CONTINUATION OF BASE SALARY AND INSURANCE BENEFITS WERE PROVIDED TO LISTED INDIVIDUALS FOR SPECIFIED PERIODS. THE LISTED INDIVIDUALS EXECUTED RELEASES AND WAIVERS OF CLAIMS IN EXCHANGE FOR THE SEVERANCE BENEFITS. SALARY CONTINUATION AMOUNTS PROVIDED DURING THE REPORTING YEAR TO LISTED INDIVIDUALS WERE AS FOLLOWS: JOHN RENNER $230,474; KAY WELLMAN $143,027.
Schedule J, Part I, Line 4b, Supplemental nonqualified retirement plan	THE ST. RITA'S MEDICAL CENTER 457(F) PLAN PROVIDES A FLEXIBLE BENEFIT ALLOWANCE TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. THIS ALLOWANCE, WHICH IS BASED ON A SPECIFIED PERCENTAGE OF COMPENSATION, MAY BE ALLOCATED AMONG VARIOUS INSURANCE AND DEFERRED COMPENSATION BENEFIT OPTIONS. AMOUNTS INCLUDIBLE IN TAXABLE COMPENSATION FOR LISTED PARTICIPATING INDIVIDUALS IN THS REPORTING YEAR WERE AS FOLLOWS: HERBERT SCHUMM, MD $69,886; KAY WELLMAN $61,283; CHRISTINE PROVAZNIK $23,531; JOHN MEYER $27,269; WILBERT CASON $41,570; MARK SKAJA $19,922; RONDA LEHMAN $12,242; ROBERT BAXTER $24,000.
SCHEDULE J, PART I, LINE 4B, THE CHP SERP PLAN	THE CHP SERP PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST 50%, 75%, AND 100% IN THEIR ACCOUNTS AFTER 5, 6, AND 7 YEARS OF SERVICE, RESPECTIVELY, VESTING OCCURS EARLIER FOR DEATH OR TOTAL DISABILITY OR REACHING AGE 60 WHILE EMPLOYED, OR INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION OR DUE TO POSITION ELIMINATION, PAYMENTS DURING EMPLOYMENT ARE MADE FOR REQUIRED TAX WITHHOLDINGS. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS AFTER TERMINATION OF EMPLOYMENT. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO SERP PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: JAMES MAY $154,309; BRIAN SMITH $129,575.
SCHEDULE J, PART I, LINE 4B, TERMS AND CONDITIONS OF CHP EXECUTIVE RETENTION PLAN 457(F)	THE CATHOLIC HEALTH PARTNERS (CHP) EXECUTIVE RETENTION PLAN IS A DEFERRED COMPENSATION PLAN WHICH PROVIDES EMPLOYMENT CONTINUATION INCENTIVES TO PERSONS SELECTED BY THE BOARD OF TRUSTEES OR ITS DELEGATE. IT PROVIDES ANNUAL CREDITS OF A SPECIFIED PERCENTAGE OF COMPENSATION AND ANNUAL INTEREST CREDITS. PARTICIPANTS VEST AND CEASE TO RECEIVE CREDITS AFTER 5 YEARS OF PLAN PARTICIPATION PROVIDED THEY REMAIN EMPLOYED. VESTING AND CESSATION OF CREDITS OCCUR EARLIER FOR DEATH OR TOTAL DISABILITY WHILE EMPLOYED, INVOLUNTARY TERMINATION OF EMPLOYMENT WITHIN 24 MONTHS AFTER A CHANGE IN CONTROL OF THE ORGANIZATION, OR, FOR CERTAIN PARTICIPANTS, UPON BEING OFFERED A SPECIFIED PROMOTION. PAYMENT OF THE VESTED ACCOUNT BALANCE IN A LUMP SUM OCCURS UPON VESTING. AMOUNTS INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS DUE TO RETENTION PLAN PARTICIPATION IN THE REPORTING YEAR WERE AS FOLLOWS: JAMES MAY $593,585; MICHAEL BISSEGGER $0.
Schedule J, Part I, Line 7, Non-fixed payments	THE ORGANIZATION PROVIDES ANNUAL INCENTIVE COMPENSATION FOR LISTED INDIVIDUALS. THE ORGANIZATION'S BOARD OF TRUSTEES ESTABLISHES OBJECTIVE THRESHOLDS FOR QUALITY, COMMUNITY BENEFIT, AND FINANCIAL PERFORMANCE WHICH MUST BE ACHIEVED FOR INCENTIVES TO BE AWARDED. THE BOARD ALSO ESTABLISHES THRESHOLD, TARGET AND MAXIMUM LEVELS FOR INCENTIVE AWARDS. WITHIN THESE ESTABLISHED PARAMETERS, THE BOARD DETERMINES THE CEO'S INCENTIVE AWARD AND INCENTIVE AWARDS FOR OTHER LISTED INDIVIDUALS ARE DETERMINED BY THE CEO AND DISCLOSED TO THE BOARD. THE BOARD MAY AUTHORIZE MODIFIED INCENTIVE AWARDS WHEN APPROPRIATE IN ITS JUDGEMENT
SCHEDULE J, PART II, COLUMN (C), REPORTING NEGATIVE DEFERRED COMPENSATION	ANNUAL ACTUARIALLY-DETERMINED CONTRIBUTIONS TO DEFINED BENEFIT PLANS, WHICH ARE BASED ON PRIOR PLAN CONTRIBUTIONS, CHANGES IN INTEREST RATES, THE PRESENT VALUE OF ACCRUED BENEFITS, AND OTHER DATA AND ASSUMPTIONS ABOUT THE FUTURE, MAY, FOR SOME PLAN PARTICIPANTS AND FOR SOME YEARS, RESULT IN NEGATIVE CONTRIBUTION AMOUNTS.

Schedule J (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST RITA'S MEDICAL CENTER

Employer identification number

34-1105619

Part I

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

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

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

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

Part II

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

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






Total ...... $

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2013

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) PERRYPROTECH	BARRY CLARK (BOARD MEMBER) IS AN OFFICER	765,378	INDEPENDENT CONTRACTOR		No
(2) LIMA PATHOLOGY INC	KIRK GRIFFITH, MD (BOARD MEMBER) HAS AN OWNERSHIP INTEREST	681,600	INDEPENDENT CONTRACTOR		No
(3) TERESA CLIFFORD	SPOUSE OF DAN CLIFFORD, BOARD MEMBER	14,458	EMPLOYMENT		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE N
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Liquidation, Termination, Dissolution, or Significant Disposition of Assets

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

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

Attach to Form 990 or 990-EZ.
bullet

Information about Schedule N (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
ST RITA'S MEDICAL CENTER

Employer identification number
34-1105619

Part I

Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" to Form 990, Part IV, line 31, or Form 990-EZ, line 36.
Part I can be duplicated if additional space is needed.

1(a)Description of asset(s) distributed or transaction expenses paid	(b)Date of distribution	(c)Fair market value of asset(s) distributed or amount of transaction expenses	(d)Method of determining FMV for asset(s) distributed or transaction expenses	(e)EIN of recipient	(f)Name and address of recipient	(g)IRC section of recipient(s) (if tax-exempt) or type of entity
ALL ASSETS AND LIABILITIES OF ST. RITA'S MEDICAL CENTER	01-01-2014	507,878,312	GAAP	34-1105619	ST RITA'S MEDICAL CENTER LLC 730 W MARKET STREET LIMA,OH45801	501(C)(3)

Yes

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

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

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

Yes

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

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

If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet

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

Cat. No. 50087Z

Schedule N (Form 990 or 990-EZ) (2013)

Page 2

Part I

Liquidation, Termination, or Dissolution (continued)

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

Yes

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

Yes

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

Yes

If "Yes," did the organization provide such notice? . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

Yes

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

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

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

Part II

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

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

Yes

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

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

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

Yes

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

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

If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet

Schedule N(Form 990 or 990-EZ) (2013)

Schedule N (Form 990 or 990-EZ) (2013)

Page 3

Part III

Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.

Return Reference	Explanation
Schedule N, Part I, Line 2b, Interested person is an employee or ind. contractor of successor org.	ALL OFFICERS AND KEY EMPLOYEES OF ST. RITA'S MEDICAL CENTER BECAME EMPLOYEES OF ST. RITA'S MEDICAL CENTER LLC.

Schedule N (Form 990 or 990-EZ) (2013)

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

ST RITA'S MEDICAL CENTER

Employer identification number

34-1105619

Return Reference	Explanation
FORM 990, PART IV, LINE 12A, CONSOLIDATED AUDITED FINANCIAL STATEMENTS	THE FILING ORGANIZATION DOES NOT HAVE SEPARATE, INDEPENDENT AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION IS INCLUDED IN CATHOLIC HEALTH PARTNERS' CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH ARE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. CATHOLIC HEALTH PARTNERS' AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT.
FORM 990, PART VI, LINE 15A, POLICIES	THE COMPENSATION OF THE CEO OR TOP MANAGEMENT OFFICIAL IS DETERMINED BY CATHOLIC HEALTH PARTNERS, A RELATED TAX-EXEMPT ORGANIZATION.
Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders	CATHOLIC HEALTH PARTNERS (CHP) IS THE SOLE MEMBER OF ST. RITA'S MEDICAL CENTER.
Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body	CATHOLIC HEALTH PARTNERS ELECTS ALL MEMBERS WHO HAVE FULL VOTING RIGHTS.
Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders	CERTAIN MATTERS REQUIRE APPROVAL OF THE CHP CORPORATE MEMBER, CHP GOVERNING BODY, OR CHP CEO. THE REGULATIONS OF THE ORGANIZATION DESCRIBE THE LEVEL OF APPROVAL REQUIRED FOR VARIOUS DECISIONS.
Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body	THE FORM 990 IS PREPARED BY CATHOLIC HEALTH PARTNER'S TAX DEPARTMENT AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. A COPY OF THE FORM 990 IS THEN REVIEWED BY MANAGEMENT. ONCE THE FORM 990 IS REVIEWED BY ALL APPLICABLE PARTIES, A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING.
Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy	ALL BOARD MEMBERS ARE COVERED BY THE CATHOLIC HEALTH PARTNERS (CHP) CONFLICT OF INTEREST POLICY WHICH REQUIRES DISCLOSURE ON AN ANNUAL BASIS. ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY CHP CORPORATE COMPLIANCE OFFICER. AT THE BEGINNING OF EACH BOARD MEETING ALL BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. BOARD MEMBERS DETERMINED TO HAVE A CONFLICT OF INTEREST ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISION-MAKING FOR THE TRANSACTION IN WHICH THE CONFLICT EXISTS.
Form 990, Part VI, Sec B, Line 15b, Process to establish compensation of other employees	THE MARKET CEO RECOMMENDS COMPENSATION FOR OFFICERS AND KEY EMPLOYEES. THE COMMITTEE REVIEWS AND APPROVES OR ADJUSTS THE RECOMMENDED ADJUSTMENTS TO THE OFFICERS AND KEY EMPLOYEES' BASE COMPENSATION AND INCENTIVE AWARD, WITHIN SUCH ESTABLISHED PARAMETERS. A FORMAL PERFORMANCE APPRAISAL PROCESS IS INCORPORATED IN THE COMPENSATION ADJUSTMENT AND AWARD PROCESS. IT UTILIZES A MULTI-PERSPECTIVE APPROACH AND PERFORMANCE MEASURES WHICH ARE LINKED TO THE ORGANIZATION'S ACHIEVEMENT OF TEAM AND INDIVIDUAL OBJECTIVES AND PERFORMANCE. COMPENSATION-RELATED DETERMINATIONS ARE CONDUCTED IN ACCORDANCE WITH APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE AND REGULATIONS TO QUALIFY FOR THE PRESUMPTION THAT THE COMPENSATION IS REASONABLE, INCLUDING BUT NOT LIMITED TO APPROVAL BY AN AUTHORIZED BODY COMPOSED OF INDIVIDUALS WHO DO NOT HAVE A CONFLICT OF INTEREST, OBTAINING AND RELYING ON APPROPRIATE DATA AS TO COMPARABILITY, AND CONCURRENT DOCUMENTATION OF THE BASIS FOR THE COMPENSATION DETERMINATIONS.
Form 990, Part VI, Sec C, Line 19, Required documents available to the public	THE SYSTEM-WIDE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE POSTED ON THE CATHOLIC HEALTH PARTNERS WEBSITE.
Form 990, Part IX, Line 11g, Other Expenses	MEDICAL PROFESSIONAL FEE - TOTAL EXPENSE: 15464519, PROGRAM SERVICE EXPENSE: 15464519, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; CONSULTING - TOTAL EXPENSE: 1275666, PROGRAM SERVICE EXPENSE: 1084316, MANAGEMENT AND GENERAL EXPENSES: 191350, FUNDRAISING EXPENSES: ; COLLECTION SERVICES - TOTAL EXPENSE: 1377045, PROGRAM SERVICE EXPENSE: 1170488, MANAGEMENT AND GENERAL EXPENSES: 206557, FUNDRAISING EXPENSES: ; MAINTENANCE AND SERVICE AGREEMENT - TOTAL EXPENSE: 2780027, PROGRAM SERVICE EXPENSE: 2363023, MANAGEMENT AND GENERAL EXPENSES: 417004, FUNDRAISING EXPENSES: ; AFFILIATE ASSESMENTS - TOTAL EXPENSE: 41232636, PROGRAM SERVICE EXPENSE: 35047741, MANAGEMENT AND GENERAL EXPENSES: 6184895, FUNDRAISING EXPENSES: ; OTHER PURCHASED SERVICES - TOTAL EXPENSE: 21332442, PROGRAM SERVICE EXPENSE: 18132576, MANAGEMENT AND GENERAL EXPENSES: 3199866, FUNDRAISING EXPENSES: ;
Form 990 , Part XI, Line 9, Other changes in net assets or fund balances	OPEB YE TRUE UP - 831481; PENSION TRUE UP - 43936689; RECLASS CORP STIMULUS - -102096; FINANCE TRANSFORMATION SEVERANCE COST ADJUSTMENT - -50970; FUND BALANCE TRANSFER - -XXX-XX-XXXX;

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST RITA'S MEDICAL CENTER

Employer identification number

34-1105619

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) LACP - ST RITA'S MEDICAL CENTER LLC 303 W SPRING STREET LIMA,OH45801 26-2878453	AMBULANCE SVC	OH	2,935,813	3,483,912	ST RITA'S MEDICAL CENTER
(2) ST RITA'S PROFESSIONAL SERVICES LLC 730 W MARKET STREET LIMA,OH45801 26-2788491	PHYSICIAN PRACTICES	OH	29,884,869	-5,112,470	ST RITA'S MEDICAL CENTER

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 entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) CATHOLIC HEALTH PARTNERS 615 ELSINORE PLACE CINCINNATI,OH45202 31-1161086	HEALTHCARE SYSTEM PARENT	OH	501(C)(3)	11 - Type III - FI	NA		No
(2) CATHOLIC HEALTH PARTNERS FOUNDATION 615 ELSINORE PLACE CINCINNATI,OH45202 20-1072726	FUNDRAISING	OH	501(C)(3)	7	CATHOLIC HEALTH PARTNERS		No
(3) CATHOLIC HEALTHCARE PARTNERS HOUSING DEVELOPMENT 615 ELSINORE PLACE CINCINNATI,OH45202 20-8943658	HUD PARENT	OH	501(C)(3)	9	CATHOLIC HEALTH PARTNERS		No
(4) CATHOLIC HEALTHCARE PARTNERS RETIREMENT TRUST 615 ELSINORE PLACE CINCINNATI,OH45202 31-6046304	RETIREMENT TRUST	OH	501(C)(3)	8	CATHOLIC HEALTH PARTNERS		No
(5) COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM 3700 KOLBE ROAD LORAIN,OH44053 27-0071694	MARKET PARENT	OH	501(C)(3)	11 - Type II	CATHOLIC HEALTH PARTNERS		No
(6) COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER 3700 KOLBE ROAD LORAIN,OH44053 34-0714704	HOSPITAL	OH	501(C)(3)	3	COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM		No
(7) ALLEN MEDICAL CENTER 200 WEST LORAIN ST OBERLIN,OH44074 34-0864230	HOSPITAL	OH	501(C)(3)	3	COMMUNITY HEALTH PARTNERS REGIONAL HEALTH SYSTEM		No
(8) COMMUNITY HEALTH PARTNERS REGIONAL FOUNDATION 3700 KOLBE ROAD LORAIN,OH44053 34-1504558	FOUNDATION	OH	501(C)(3)	11 - Type III - FI	COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER		No
(9) COMMUNITY HEALTH PARTNERS PHYSICIANS OFFICE BUILDINGS 3700 KOLBE ROAD LORAIN,OH44053 34-1268828	MEDICAL OFFICE RENTAL	OH	501(C)(3)	9	COMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTER		No
(10) ALLEN MEDICAL CENTER MEDICAL OFFICE BUILDING 200 WEST LORAIN ST OBERLIN,OH44074 36-4504991	MEDICAL OFFICE RENTAL	OH	501(C)(3)	11 - Type II	ALLEN MEDICAL CENTER		No
(11) MERCY HEALTH PARTNERS OF SOUTHWEST OHIO 4600 MCAULEY PLACE CINCINNATI,OH45242 31-1063783	MARKET PARENT	OH	501(C)(3)	11 - Type III - FI	CATHOLIC HEALTH PARTNERS		No
(12) MERCY HEALTH PARTNERS OF SOUTHWEST OHIO FOUNDATION 4600 MCAULEY PLACE CINCINNATI,OH45242 31-1217563	FOUNDATION	OH	501(C)(3)	7	MERCY HEALTH PARTNERS OF SOUTHWEST OHIO		No
(13) MERCY HOSPITALS WEST 2446 KIPLING AVENUE CINCINNATI,OH45239 31-1091597	HOSPITAL	OH	501(C)(3)	3	MERCY HEALTH PARTNERS OF SOUTHWEST OHIO		No
(14) MERCY HOSPITAL ANDERSON 7500 STATE ROAD CINCINNATI,OH45255 31-0537085	HOSPITAL	OH	501(C)(3)	3	MERCY HEALTH PARTNERS OF SOUTHWEST OHIO		No
(15) THE SISTERS OF MERCY OF HAMILTON OHIO 3000 MACK ROAD FAIRFIELD,OH45014 31-0538532	HOSPITAL	OH	501(C)(3)	3	MERCY HEALTH PARTNERS OF SOUTHWEST OHIO		No
(16) THE SISTERS OF MERCY OF CLERMONT COUNTY OHIO 3000 HOSPITAL DRIVE BATAVIA,OH45103 31-0830955	HOSPITAL	OH	501(C)(3)	3	MERCY HEALTH PARTNERS OF SOUTHWEST OHIO		No
(17) MERCY FRANCISCAN SENIOR HEALTH AND HOUSING SERVICES INC 7010 ROWAN HILLS DR CINCINNATI,OH45227 31-1308729	RETIREMENT HOME	OH	501(C)(3)	9	MERCY HEALTH PARTNERS OF SOUTHWEST OHIO		No
(18) MERCY SACRED HEART INC 2120 PAYNE STREET LOUISVILLE,KY40206 61-1318326	RETIREMENT HOME	KY	501(C)(3)	9	MERCY HEALTH PARTNERS OF SOUTHWEST OHIO		No
(19) MERCY LONG TERM CARE INITIATIVE 4915 CHARLESTOWN RD NEW ALBANY,IN47150 31-1332491	RETIREMENT HOME	IN	501(C)(3)	9	MERCY HEALTH PARTNERS OF SOUTHWEST OHIO		No
(20) MERCY FRANCISCAN SOCIAL MINISTRIES INC 1800 LOGAN STREET CINCINNATI,OH45210 31-1222942	LOW INCOME HOUSING	OH	501(C)(3)	7	MERCY HEALTH PARTNERS OF SOUTHWEST OHIO		No
(21) MERCY FRANCISCAN AT ST RAPHAEL INC 610 HIGH STREET HAMILTON,OH45011 20-2934871	SERVICES TO THE POOR	OH	501(C)(3)	7	MERCY HEALTH PARTNERS OF SOUTHWEST OHIO		No
(22) COMMUNITY MERCY HEALTH SYSTEM ONE S LIMESTONE ST SPRINGFIELD,OH45502 30-0272454	MARKET PARENT	OH	501(C)(3)	11 - Type III - FI	CATHOLIC HEALTH PARTNERS		No
(23) COMMUNITY MERCY HEALTH PARTNERS ONE S LIMESTONE ST SPRINGFIELD,OH45502 31-0785684	HOSPITAL	OH	501(C)(3)	3	COMMUNITY MERCY HEALTH SYSTEM		No
(24) THE COMMUNITY MERCY FOUNDATION 1343 N FOUNTAIN BLVD SPRINGFIELD,OH45504 31-1443778	FOUNDATION	OH	501(C)(3)	7	COMMUNITY MERCY HEALTH SYSTEM		No
(25) C H HEALTH SERVICES COMPANY ONE S LIMESTONE ST SPRINGFIELD,OH45502 31-1181984	HOSPITAL	OH	501(C)(3)	3	COMMUNITY MERCY HEALTH SYSTEM		No
(26) CLARKE & CHAMPAIGN COUNTIES HEALTH INFORMATION EXCHANGE 1150 E HOME ROAD SPRINGFIELD,OH45503 26-0698515	MEDICAL INFORMATION EXCHANGE	OH	501(C)(3)	9	COMMUNITY MERCY HEALTH SYSTEM		No
(27) THE WALLACE S MURRAY AND FRANCES RABBITTS MURRAY MEMORIAL TRUST ONE S LIMESTONE ST SPRINGFIELD,OH45502 34-6827136	INDIGENT MEDICAL CARE	OH	501(C)(3)	11 - Type I	NA		No
(28) MERCY HEALTH SYSTEM - NORTHERN REGION 2200 JEFFERSON AVENUE TOLEDO,OH43604 34-1344482	MARKET PARENT	OH	501(C)(3)	11 - Type III - FI	CATHOLIC HEALTH PARTNERS		No
(29) MERCY PROPERTY HOLDINGS 2200 JEFFERSON AVENUE TOLEDO,OH43604 30-0699825	TITLE HOLDING COMPANY	OH	501(C)(2)	N/A	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(30) ST CHARLES MERCY HOSPITAL OF OREGON OHIO 2600 NAVARRE AVENUE OREGON,OH43616 34-4445373	HOSPITAL	OH	501(C)(3)	3	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(31) RIVERSIDE MERCY HOSPITAL 3404 W SYLVANIA AVE TOLEDO,OH43623 31-1556401	HOSPITAL	OH	501(C)(3)	3	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(32) MERCY HOME CARE INC 2200 JEFFERSON AVENUE TOLEDO,OH43604 34-1587572	HOME HEALTHCARE	OH	501(C)(3)	9	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(33) MERCY COLLEGE OF OHIO 2221 MADISON AVENUE TOLEDO,OH43604 34-1726619	MEDICAL COLLEGE	OH	501(C)(3)	2	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(34) MERCY COLLEGE OF OHIO FOUNDATION INC 2221 MADISON AVENUE TOLEDO,OH43604 14-1963204	FOUNDATION	OH	501(C)(3)	11 - Type I	MERCY COLLEGE OF OHIO		No
(35) MERCY HOSPITAL OF TIFFIN OHIO 45 ST LAWRENCE DRIVE TIFFIN,OH44883 34-4431174	HOSPITAL	OH	501(C)(3)	3	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(36) MERCY TIFFIN HEALTH FOUNDATION 45 ST LAWRENCE DRIVE TIFFIN,OH44883 34-1499894	FOUNDATION	OH	501(C)(3)	11 - Type III - FI	MERCY HOSPITAL OF TIFFIN OHIO		No
(37) THE SISTERS OF MERCY OF WILLARD OHIO 110 EAST HOWARD ST WILLARD,OH44890 34-1577110	HOSPITAL	OH	501(C)(3)	3	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(38) MERCY HOSPITAL OF WILLARD FOUNDATION 110 EAST HOWARD ST WILLARD,OH44890 11-3742347	FOUNDATION	OH	501(C)(3)	11 - Type III - FI	THE SISTERS OF MERCY OF WILLARD OHIO		No
(39) ST VINCENT MERCY MEDICAL CENTER 2213 CHERRY STREET TOLEDO,OH43608 34-4428250	HOSPITAL	OH	501(C)(3)	3	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(40) MERCY FOUNDATION 2213 CHERRY STREET TOLEDO,OH43608 23-7393213	FOUNDATION	OH	501(C)(3)	11 - Type III - FI	ST VINCENT MERCY MEDICAL CENTER		No
(41) LIFESTAR AMBULANCE INC 2200 JEFFERSON AVENUE TOLEDO,OH43604 34-1354653	MEDICAL TRANSPORTATION	OH	501(C)(3)	11 - Type II	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(42) RSM MEDICAL FOUNDATION 2200 JEFFERSON AVENUE TOLEDO,OH43624 34-1693671	HOSPITAL	OH	501(C)(3)	3	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(43) SIMON OUTREACH SERVICES 2600 NAVARRE AVENUE OREGON,OH43616 34-1383325	MEDICAL OFFICE RENTAL	OH	501(C)(3)	11 - Type II	ST CHARLES MERCY HOSPITAL OF OREGON OHIO		No
(44) FARLEY HEALTHCARE CORPORATION 2200 JEFFERSON AVENUE TOLEDO,OH43604 34-1363204	HEALTH SERVICES	OH	501(C)(3)	9	MERCY HEALTH SYSTEM - NORTHERN REGION		No
(45) ST RITA'S MEDICAL CENTER 730 W MARKET STREET LIMA,OH45801 34-1105619	HOSPITAL	OH	501(C)(3)	3	CATHOLIC HEALTH PARTNERS		No
(46) SRHC FOUNDATION 730 W MARKET STREET LIMA,OH45801 34-1368429	FOUNDATION	OH	501(C)(3)	11 - Type III - FI	ST RITA'S MEDICAL CENTER		No
(47) NEW VISION MEDICAL LABORATORIES INC 750 W HIGH ST STE 400 LIMA,OH45801 34-1937267	MEDICAL LAB SERVICES	OH	501(C)(3)	11 - Type III - FI	ST RITA'S MEDICAL CENTER		No
(48) HUMILITY OF MARY HEALTH PARTNERS 1044 BELMONT AVENUE YOUNGSTOWN,OH44501 34-0505560	HOSPITAL	OH	501(C)(3)	3	CATHOLIC HEALTH PARTNERS		No
(49) THE ASSUMPTION VILLAGE 9800 N MARKET STREET NORTH LIMA,OH44452 34-1013695	NURSING HOME	OH	501(C)(3)	9	HUMILITY OF MARY HEALTH PARTNERS		No
(50) HOSPICE OF THE VALLEY 5190 MARKET STREET YOUNGSTOWN,OH44512 34-1288745	HOSPICE SERVICES	OH	501(C)(3)	9	HUMILITY OF MARY HEALTH PARTNERS		No
(51) HUMILITY OF MARY DEVELOPMENT FOUNDATION 1044 BELMONT AVENUE YOUNGSTOWN,OH44501 34-1826978	FOUNDATION	OH	501(C)(3)	11 - Type III - FI	HUMILITY OF MARY HEALTH PARTNERS		No
(52) HUMILITY HOUSE 755 OHLTOWN ROAD AUSTINTOWN,OH44515 34-1894783	NURSING HOME	OH	501(C)(3)	9	HUMILITY OF MARY HEALTH PARTNERS		No
(53) ST JOSEPH HEALTH CENTER AUXILIARY 677 EASTLAND SE WARREN,OH44484 34-6556121	FUNDRAISING	OH	501(C)(3)	9	HUMILITY OF MARY HEALTH PARTNERS		No
(54) MERCY HEALTH PARTNERS - LOURDES INC 1530 LONE OAK ROAD PADUCAH,KY42003 61-0600313	HOSPITAL	KY	501(C)(3)	3	CATHOLIC HEALTH PARTNERS		No
(55) LOURDES FOUNDATION INC 1530 LONE OAK ROAD PADUCAH,KY42003 61-1258960	FOUNDATION	KY	501(C)(3)	7	MERCY HEALTH PARTNERS - LOURDES INC		No
(56) LOURDES HOSPITAL AUXILIARY GIFT SHOP 1530 LONE OAK ROAD PADUCAH,KY42003 61-0927805	FUNDRAISING	KY	501(C)(3)	11 - Type III - FI	LOURDES FOUNDATION INC		No
(57) MARCUM AND WALLACE MEMORIAL HOSPITAL INC 60 MERCY COURT IRVINE,KY40336 61-0927491	HOSPITAL	KY	501(C)(3)	3	MERCY HEALTH PARTNERS - LOURDES INC		No
(58) MARCUM AND WALLACE HOSPITAL FOUNDATION INC 60 MERCY COURT IRVINE,KY40336 32-0026557	FOUNDATION	KY	501(C)(3)	11 - Type III - FI	MARCUM AND WALLACE MEMORIAL HOSPITAL INC		No
(59) MERCY HEALTH PARTNERS INC 615 ELSINORE PLACE CINCINNATI,OH45202 73-1627534	MARKET PARENT	TN	501(C)(3)	11 - Type I	CATHOLIC HEALTH PARTNERS		No
(60) MERCY HEALTH PARTNERS - NORTHEAST REGION INC 615 ELSINORE PLACE CINCINNATI,OH45202 23-2813196	MARKET PARENT	PA	501(C)(3)	11 - Type III - FI	CATHOLIC HEALTH PARTNERS		No
(61) MERCY HOSPITAL OF WILKES-BARRE 746 JEFFERSON AVENUE SCRANTON,PA18510 24-0795625	HOSPITAL	PA	501(C)(3)	3	MERCY HEALTH PARTNERS - NORTHEAST REGION INC		No
(62) MERCY HEALTH CARE CENTER 746 JEFFERSON AVENUE SCRANTON,PA18510 23-2322809	HOSPITAL	PA	501(C)(3)	3	MERCY HEALTH PARTNERS - NORTHEAST REGION INC		No
(63) HEALTHSPAN PARTNERS 615 ELSINORE PLACE CINCINNATI,OH45202 46-3055925	MARKET PARENT	OH	501(C)(3)	11 - Type III - FI	CATHOLIC HEALTH PARTNERS		No
(64) HEALTHSPAN INTEGRATED CARE 1001 LAKESIDE AVE SUITE 1200 CLEVELAND,OH44114 34-0922268	HMO	OH	501(C)(3)	9	HEALTHSPAN PARTNERS		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2013

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) NWO INTEGRATED LABORATORIES MERCY LLC 2200 JEFFERSON AVENUE TOLEDO,OH43624 34-1898285	LABORATORY SERVICES	OH	NA	N/A
(2) TIFFIN AMBULATORY SURGICAL ASSOCIATES 45 ST LAWRENCE DRIVE TIFFIN,OH44833 37-1567866	AMBULATORY SURGERY CENTER	OH	NA	N/A
(3) NEW VISION MEDICAL LAB LLC 750 W HIGH STREET LIMA,OH45801 34-1913433	LAB SERVICES	OH	ST RITA'S MEDICAL CENTER	RELATED	82,263	1,271,284		No			No	80 %
(4) WEST CENTRAL OHIO GROUP LTD 801 MEDICAL DRIVE LIMA,OH45804 34-1848147	ORTHOPEDIC HOSPITAL	OH	ST RITA'S MEDICAL CENTER	RELATED	13,598,072	4,041,203		No			No	51 %
(5) KIDNEY SERVICES OF WEST CENTRAL OHIO 750 W HIGH STREET SUITE 100 LIMA,OH45801 06-1644264	DIALYSIS CENTER	OH	ST RITA'S MEDICAL CENTER	RELATED	937,503	3,696,275		No			No	57.25 %
(6) WEST CENTRAL OHIO REGIONAL HEALTHCARE ALLIANCE LTD 2615 FORT AMANDA ROAD LIMA,OH45805 34-1817078	HEALTHCARE	OH	ST RITA'S MEDICAL CENTER	RELATED	38,745	129,627		No			No	62 %
(7) ST ELIZABETH SOUTHWOODS IMAGING 250 DEBARTOLO PLACE BLDG B YOUNGSTOWN,OH44512 26-1626482	DIAGNOSTIC IMAGING	OH	NA	N/A
(8) UROLOGIC ONCOLOGY OF MAHONING VALLEY LLC 1044 BELMONT AVE YOUNGSTOWN,OH44501 26-2989686	RADIATION THERAPY	OH	NA	N/A
(9) HMHPUSP SURGERY CENTERS LLC 15305 DALLAS PKWY STE 1600 ADDISON,TX75001 27-1953122	SURGERY CENTER	TX	NA	N/A
(10) OSC-HMHP LLC 6505 MARKET ST BLDG B STE 101 BOARDMAN,OH44512 01-0724836	ORTHOPEDIC SURGERY CENTER	OH	NA	N/A
(11) LOURDES AMBULATORY SURGERY CENTER 225 MEDICAL CENTER DRIVE PADUCAH,KY42003 61-1258960	SURGERY CENTER	KY	NA	N/A
(12) ST ELIZABETH CARDIAC CATH LAB LLC P O BOX 16008 PITTSBURGH,PA15242 30-0023795	LAB SERVICES	PA	NA	N/A

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	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) CHP INSURANCE LTD 615 ELSINORE PLACE CINCINNATI,OH45202 98-0621978	INSURANCE	CJ	NA	C CORPORATION
(2) SISTERS OF MERCY WORKERS COMPENSATION SELF-INSURANCE TRUST 615 ELSINORE PLACE CINCINNATI,OH45202 31-0990309	WORKERS COMPENSATION TRUST	MA	NA	TRUST
(3) MHSWO HEALTH VENTURES INC 1 S LIMESTONE ST SPRINGFIELD,OH45502 31-1072139	PHYSICIAN PRACTICES	OH	NA	C CORPORATION
(4) NORTHPARKE MEDICAL COMMONS CONDO ASSN 333 N LIMESTONE ST SPRINGFIELD,OH45503 31-1391230	REAL PROPERTY MGMNT	OH	NA	C CORPORATION
(5) MERCY HEALTH AFFILIATES INC 2200 JEFFERSON AVENUE TOLEDO,OH43604 34-1372633	PHYSICIAN SERVICES	OH	NA	C CORPORATION
(6) PHYSICIAN'S HEALTH COLLABORATIVE 2200 JEFFERSON AVENUE TOLEDO,OH43604 20-3986844	MEDICAL & HOSPITAL SERVICES	OH	NA	C CORPORATION
(7) NORTHSIDE CORPORATION 2200 JEFFERSON AVENUE TOLEDO,OH43604 34-1318438	RESIDENT RENTALS	OH	NA	C CORPORATION
(8) MERCY WORK SOLUTIONS 2200 JEFFERSON AVENUE TOLEDO,OH43604 30-0066340	WORKERS COMPENSATION	OH	NA	C CORPORATION
(9) MERCY HEALTH SYSTEM PHO 2200 JEFFERSON AVENUE TOLEDO,OH43604 34-1778321	MEDICAL SERVICES	OH	NA	C CORPORATION
(10) PHYSICIAN MANAGED CARE INC 2200 JEFFERSON AVENUE TOLEDO,OH43604 34-1565320	HEALTH SERVICES	OH	NA	C CORPORATION
(11) MCAULEY MANAGEMENT SERVICES INC 730 W MARKET STREET LIMA,OH45801 34-1379037	PROPERTY RENTAL	OH	NA	C CORPORATION
(12) LIMA MEDICAL SUPPLIES INC 730 W MARKET STREET LIMA,OH45801 34-0944477	MEDICAL EQUIPMENT	OH	NA	C CORPORATION
(13) COMMUNITY HEALTH PARTNERS ENTERPRISES INC 3700 KOLBE ROAD LORAIN,OH44053 34-1455525	HOLDING COMPANY	OH	NA	C CORPORATION
(14) COMMUNITY HEALTH PARTNERS PHYSICIANS INC 3700 KOLBE ROAD LORAIN,OH44053 34-1803352	PHYSICIAN PRACTICES	OH	NA	C CORPORATION
(15) AMC PHYSICIANS INC 200 W LORAIN STREET OBERLIN,OH44074 37-1439554	PHYSICIAN SERVICES	OH	NA	C CORPORATION
(16) MERCY HEALTH VENTURES INC 4600 MCAULEY PLACE CINCINNATI,OH45242 31-1185477	DIVERSIFIED ACTIVITIES	OH	NA	C CORPORATION
(17) MERCY FRANCISCAN MEDICAL MANAGEMENT SERVICES 4600 MCAULEY PLACE CINCINNATI,OH45242 31-1640789	DIVERSIFIED ACTIVITIES	OH	NA	C CORPORATION
(18) MERCY FRANCISCAN AT WINTON WOODS I INC 10290 MILL ROAD CINCINNATI,OH45231 31-1658668	LOW-INCOME HOUSING	OH	NA	C CORPORATION
(19) MERCY HEALTH MANAGEMENT INC 1530 LONE OAK ROAD PADUCAH,KY42003 61-1086762	MEDICAL OFFICES	KY	NA	C CORPORATION
(20) HEALTH DYNAMICS INC 900 E OAK HILL AVENUE KNOXVILLE,TN37917 62-1247729	MEDICAL EQUIPMENT SALES	TN	NA	C CORPORATION
(21) HEALTH VENTURES INC & SUBSIDIARIES P O BOX 1788 KNOXVILLE,TN37901 62-1175587	MEDICAL SERVICES	TN	NA	C CORPORATION
(22) ANNE KILCAWLEY CHRISTMAN FOUNDATION 100 FEDERAL PLAZA EAST YOUNGSTOWN,OH44503 35-6735706	BENEFICIAL TRUST	OH	NA	TRUST
(23) RALPH EWE TRUST 270 PARK AVENUE NEW YORK,NY10017 34-6866422	BENEFICIAL TRUST	NY	NA	TRUST
(24) ELIZABETH HINES CATES TRUST PNC 1900 E 9TH ST CLEVELAND,OH44114 34-6515678	BENEFICIAL TRUST	OH	NA	TRUST
(25) WILLIS PARK TRUST PNC 1900 E 9TH ST CLEVELAND,OH44114 34-6519904	BENEFICIAL TRUST	OH	NA	TRUST
(26) ERMA GIBSON BALDWIN TRUST PNC 1900 E 9TH ST CLEVELAND,OH44114 34-6515566	BENEFICIAL TRUST	OH	NA	TRUST
(27) HEALTHSPAN INC 225 PICTORIA DR CINCINNATI,OH45246 31-1431434	INSURANCE	OH	NA	C CORPORATION

Schedule R (Form 990) 2013

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

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

Yes

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

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

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

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

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

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

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) SRHC FOUNDATION	B	301,000	GAAP
(2) NEW VISION MEDICAL LAB INC	Q	7,192,098	GAAP

Schedule R (Form 990) 2013

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

1	Briefly describe the organization’s mission or most significant activities: THE PRIMARY EXEMPT PURPOSE OF ST. RITA'S MEDICAL CENTER IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDERSERVED. WE COMMIT TO ACCOMPLISH THIS PURPOSE BY WORKING TOGETHER TO PROVIDE QUALITY CARE, SERVICE AND INFORMATION THAT IS VALUED BY THOSE WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	3,212
6	Total number of volunteers (estimate if necessary) .............	6	875
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	438,824
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	87,553

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	240,236	27,454
9	Program service revenue (Part VIII, line 2g) .........	408,187,230	425,195,919
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	8,802,077	12,935,021
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	7,465,853	10,253,807
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	424,695,396	448,412,201
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,330,637	1,552,298
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	196,251,258	190,401,325
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	193,999,482	199,516,722
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	391,581,377	391,470,345
19	Revenue less expenses. Subtract line 18 from line 12.......	33,114,019	56,941,856
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	597,140,928	0
21	Total liabilities (Part X, line 26).............	197,843,459	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	399,297,469	0

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 344,739,429 including grants of $ 1,552,298 ) (Revenue $ 428,438,750 )
	THE PRIMARY EXEMPT PURPOSE OF ST. RITA'S MEDICAL CENTER IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. ST. RITA'S MEDICAL CENTER ACCOMPLISHES THIS PURPOSE BY DEMONSTRATING BEHAVIORS REFLECTING OUR CORE VALUES OF COMPASSION, EXCELLENCE, HUMAN DIGNITY, JUSTICE, SACREDNESS OF LIFE AND SERVICE. TOTAL NET COMMUNITY BENEFIT PROVIDED IN 2013 WAS $42,745,099 SERVING APPROXIMATELY 192,000 INDIVIDUALS.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses344,739,429

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	9,363,728	2,191,396	201,140

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





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

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e		27,454

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

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			27,454
			Business Code
2a	NET PATIENT SERVICE REVENUE		621990	406,024,518	406,024,518
b	RENTAL INCOME FROM AFFILIATES		531120	2,359,614	2,359,614
c	VENDOR/PURCHASE DISCOUNTS		900099	45,976	45,976
d	INCOME FROM JV'S AND PARTNERSHIPS		621990	13,341,987	13,335,877	6,110
e	OTHER OPERATING REVENUES		900099	3,423,824	3,423,824
f	All other program service revenue .			0	0	0	0
g	Total. Add lines 2a–2f........			425,195,919
3	Investment income (including dividends, interest, and other similar amounts).......			2,599,974			2,599,974
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss).......			0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	10,331,757	3,290
b	Less: cost or other basis and sales expenses
c	Gain or (loss)	10,331,757	3,290
d	Net gain or (loss)..........			10,335,047			10,335,047
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	CAFETERIA		722210	1,778,306			1,778,306
b	HITECH STIMULUS FUNDS		900099	3,248,941	3,248,941
c				0
d	All other revenue ....			5,226,560	0	432,714	4,793,846
e	Total. Add lines 11a–11d ......			10,253,807
12	Total revenue. See Instructions......			448,412,201	428,438,750	438,824	19,507,173


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			6,519,111	1
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			64,285,322	4
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			186,247	7
8	Inventories for sale or use ..............			8,133,909	8
9	Prepaid expenses and deferred charges ..........			-410,369	9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation .....	10b	0	256,690,988	10c	0
11	Investments—publicly traded securities ..........			243,191,576	11
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............			8,254,445	14
15	Other assets. See Part IV, line 11 ...........			10,289,699	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)......			597,140,928	16	0
17	Accounts payable and accrued expenses .........			26,394,120	17
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	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..				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....................			171,449,339	25	0
26	Total liabilities. Add lines 17 through 25.........			197,843,459	26	0
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			399,297,469	27
28	Temporarily restricted net assets ...........				28
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			399,297,469	33	0
34	Total liabilities and net assets/fund balances ........			597,140,928	34	0