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) Milann Siegfried........................................................................ Chairperson	.60 .......................3.70	X	X		0	0	0
(2) Lee Ellsworth........................................................................ Vice Chairperson	.70 .......................0.00	X	X		0	0	0
(3) Robert Farris........................................................................ Treasurer	2.30 .......................0.00	X	X		0	0	0
(4) Joseph P Moran III........................................................................ Director	.50 ........................50	X			0	0	0
(5) Sr M Felicidad Chavez........................................................................ Director	40.00 .......................0.00	X			0	0	0
(6) Sr M Anastasia Joseph........................................................................ Director	10.00 .......................0.00	X			0	0	300
(7) Kenneth Setter MD........................................................................ Director	3.00 .......................0.00	X			0	0	0
(8) Charles Anderson........................................................................ VP OP/Ex-Officio	42.90 ........................90	X	X		543,250	0	42,282
(9) Bert W Walthall........................................................................ VP & CFO	40.00 .......................0.00		X		296,218	0	42,055
(10) Pamela Kiser........................................................................ VP & CNO	46.20 .......................0.00		X		254,732	0	25,768
(11) Kathleen C Smarinsky........................................................................ Vice President	40.40 .......................0.00		X		257,985	0	47,768
(12) Lex Anderson........................................................................ Treasurer/Sr. VP & CFO SJHS	.20 .......................46.00		X		0	630,463	12,798
(13) H William Allred........................................................................ VP of Med Affairs/Med. Ed.	46.20 .......................0.00		X		541,433	0	13,506
(14) Jeffrey D Nowlin........................................................................ President & CEO	46.20 .......................0.00		X		484,080	0	60,835
(15) Kevin Steck........................................................................ Corp. Resp. Off./Secretary	.20 .......................54.80		X		0	303,108	46,620
(16) David Lewis........................................................................ Transplant Admin.	40.00 .......................0.00			X	168,624	0	31,612
(17) Oliver D Hanson........................................................................ Chief Med. Physicist	40.00 .......................0.00			X	186,040	0	13,647

(A) Name and business address	(B) Description of services	(C) Compensation
Parallon Workforce Mgmt Solutions LLCPO Box 742697AtlantaGA303742697	Clinical Staffing	6,797,094
In His Image IncPO Box 1191TulsaOK74101	Educational Seminars	5,304,895
University of Oklahoma4502 E 41st StTulsaOK74135	Resident Education	2,787,774
Siemens Healthcare DiagnosticsPO Box 121102DallasTX753121102	Diagnostic Products (Sch. O)	2,752,705
Manhattan Construction Company5601 S 122nd East AveTulsaOK74146	Construction (Sch. O)	2,486,434
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 81

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	6,037,691	6,037,691
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	41,267	41,267
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	2,647,306	2,286,614	360,692
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	186,805,035	151,113,519	35,691,516
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	5,327,531	5,284,655	42,876
9	Other employee benefits .......	19,194,773	18,855,727	339,046
10	Payroll taxes ...........	10,579,300	10,327,641	251,659
11	Fees for services (non-employees):
a	Management ......	147,766		147,766
b	Legal .........	563,140		563,140
c	Accounting ...........	77,501		77,501
d	Lobbying ...........	19,696		19,696
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	63,696,361	62,802,354	894,007
12	Advertising and promotion ....	370,940	365,880	5,060
13	Office expenses .......
14	Information technology ......	2,829,900	1,108,276	1,721,624
15	Royalties ..
16	Occupancy ...........	6,048,057	5,970,268	77,789
17	Travel ............	404,706	377,765	26,941
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........	11,908,431	11,908,431
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	17,612,790	8,635,003	8,977,787
23	Insurance ..............	2,836,922		2,836,922
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	Supplies	121,768,598	120,221,907	1,546,691	0
b	Oklahoma's SHOPP Fee	11,743,949	11,743,949	0	0
c	Equipment Rental-Lease	2,692,085	2,692,085	0	0
d	Repairs and Maintenance	1,413,377	1,413,377	0	0
e	All other expenses	2,971,386	3,033,195	-61,809
25	Total functional expenses. Add lines 1 through 24e	477,738,508	424,219,604	53,518,904	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............		1
2	Savings and temporary cash investments .........	7,583,122	2	12,879,580
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	72,301,337	4	71,381,933
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5
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
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	11,862,348	8	12,843,636
9	Prepaid expenses and deferred charges ..........	562,863	9	234,634
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	223,188,315
b	Less: accumulated depreciation .....	10b	21,043,932	194,834,037	10c	202,144,383
11	Investments—publicly traded securities ..........		11
12	Investments—other securities. See Part IV, line 11 .....		12
13	Investments—program-related. See Part IV, line 11 .....	76,083,159	13	16,131,288
14	Intangible assets ...............	1,152,043	14	1,663,248
15	Other assets. See Part IV, line 11 ...........	9,576,312	15	40,985,850
16	Total assets. Add lines 1 through 15 (must equal line 34)......	373,955,221	16	358,264,552
	17	Accounts payable and accrued expenses .........	48,258,175	17	36,035,231
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..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	241,248,703	25	247,952,474
26	Total liabilities. Add lines 17 through 25.........	289,506,878	26	283,987,705
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	33,252,652	27	72,692,518
28	Temporarily restricted net assets ...........	51,195,691	28	1,584,329
29	Permanently restricted net assets ...........		29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	84,448,343	33	74,276,847
34	Total liabilities and net assets/fund balances ........	373,955,221	34	358,264,552

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

See separate instructions.
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 John Medical Center Inc

Employer identification number

73-0579286

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:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2013

Name of the organization

St John Medical Center Inc

Employer identification number

73-0579286

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization St John Medical Center Inc

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization St John Medical Center Inc

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
St John Medical Center Inc

Employer identification number

73-0579286

Part III

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

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

See separate instructions. 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 John Medical Center Inc

Employer identification number

73-0579286

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

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

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

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

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

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

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

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

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

Yes

19,696

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

19,696

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
Part II-B, Line 1:	Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. John Medical Center, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office.

Schedule C (Form 990 or 990EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990. SchDMd Bullet

See separate instructions. 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 John Medical Center Inc

Employer identification number

73-0579286

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 ....	10,000,000	10,000,000	10,012,212	10,261,160	10,610,000
b	Contributions ........
c	Net investment earnings, gains, and losses			136,854	106,052	201,160
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........			149,066	355,000	550,000
f	Administrative expenses ....
g	End of year balance ......	10,000,000	10,000,000	10,000,000	10,012,212	10,261,160

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

0 %

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

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

Yes

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

3a(i)

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

3a(ii)

Yes

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

Yes

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

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	10,082,018		10,082,018
b	Buildings ................	158,779,939	9,272,279	149,507,660
c	Leasehold improvements ............	138,383	10,823	127,560
d	Equipment ................	52,000,247	11,674,195	40,326,052
e	Other .................	2,187,728	86,635	2,101,093
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				202,144,383

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
(1) A/P Intraco (within HM & within SO)				30,150,590
(2) Other Assets				10,835,260







Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				40,985,850

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
Intercompany Payable		241,248,703
Misc. Liabilities		632,734
Estimated Settlement to Third Party Payor		6,071,037






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		247,952,474
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
Part V, Line 4:	The "Chapman Fund for Uncompensated Care" endowment was created to underwrite medical services for the uninsured and underinsured residents of the Tulsa Metropolitan Area. Funds are held and administered by St. John Health System Foundation, Inc. on behalf of St. John Medical Center, Inc.
Part X, Line 2:	From the consolidated audited financial statements of St. John Health System, Inc., which includes the activity of St. John Medical Center, Inc.: The Health Ministry accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return.

Schedule D (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990. MediumBullet

See separate instructions.
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 John Medical Center Inc

Employer identification number

73-0579286

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 30000.0000000000 %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	21,340,616	3,150,931	18,189,685	3.810 %
b	Medicaid (from Worksheet 3, column a) ....	46,002,695	43,099,040	2,903,655	0.610 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	67,343,311	46,249,971	21,093,340	4.420 %
Other Benefits		3,998,310		3,998,310	0.840 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	3,998,310		3,998,310	0.840 %
f	Health professions education (from Worksheet 5) ..	16,519,457	2,454,500	14,064,957	2.940 %
g	Subsidized health services (from Worksheet 6) ..
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)
j	Total. Other Benefits ..	20,517,767	2,454,500	18,063,267	3.780 %
k	Total. Add lines 7d and 7j .	87,861,078	48,704,471	39,156,607	8.200 %

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.

		(f) Percent of total expense
1	Physical improvements and housing	0 %
2	Economic development	0 %
3	Community support	0 %
4	Environmental improvements	0 %
5	Leadership development and training for community members	0 %
6	Coalition building	0 %
7	Community health improvement advocacy	0 %
8	Workforce development	0 %
9	Other	0 %
10	Total

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. ......

8,331,672

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).....

191,280,938

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

213,646,266

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

-22,365,328

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 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?3 Name, address, primary website address, and state license number						Other (Describe)	Facility reporting group
1	St John Medical Center Inc 1923 South Utica Avenue Tulsa,OK74104 www.stjohnhealthsystem.com 2265	X	X	X	X		A
2	St John Dialysis LLC 1923 South Utica Avenue Tulsa,OK74104 www.stjohnhealthsystem.com 2265	X	X			SJMC Outpatient Department	A
3	St John Home Care LLC 1923 South Utica Avenue Tulsa,OK74104 www.stjohnhealthsystem.com 2265	X	X			SJMC Home Health	A

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)

	Facility Reporting Group - A
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 12

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................................

Yes

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

Yes

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

Hospital facility’s website (list url): See Narrative

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 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: 300.000000000000% 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: 300.000000000000% 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 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
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 1: St. John Medical Center, Inc., - Facility 2: St. John Dialysis, LLC, - Facility 3: St. John Home Care, LLC
Facility 1 -- St. John Medical Center, Inc. Part V, Section B, line 3:	The Tulsa County Health Departmet led the completion of the Community Health Needs Assessment. The determination of priority needs was based on research findings, and priorities were developed in collaboration with many other stakeholders, including other hospitals, community service agencies, state and local leaders, interested philantropists, universities and associated medical schools, and other parties, including public health experts and representatives of the communities served. In addition, the Tulsa County Health Department's research included randomly selected households for one on one interviews and some "county resident" focus groups. St. John sits on a Pathways to Health Steering Committee and Working Group to coordinate and direct community health activities in the service area.
Facility 1 -- St. John Medical Center, Inc. Part V, Section B, line 4:	The other hospital facilities with which the reporting Hospital facility conducted its CHNA, include: St. John Broken Arrow, Inc.Owasso Medical Facility, Inc.St. John Sapulpa, Inc.Jane Phillips Memorial Medical Center (Bartlesville)Jane Phillips Nowata Hospital, Inc.
Facility 1 -- St. John Medical Center, Inc. Part V, Section B, line 7:	The Hospital facility's Implementation Strategy is listed on the following website:http://www.stjohnhealthsystem.com/about/community-needs-health-assessment
Facility 1 -- St. John Medical Center, Inc. Part V, Section B, line 14g:	Signs are posted in waiting rooms and at the admissions offices to notify patients that the Hospital has a Financial Assistance Policy. In addition, every billing statement, the Hospital's website, and admission packets include information regarding the Financial Assistance Policy. The Policy is provided at the request of the patient.
Facility 1 -- St. John Medical Center, Inc. Part V, Section B, line 20d:	St. John Medical Center, Inc. provides a 30% discount on gross charges and a 15% prompt pay discount to all uninsured patients. Patients who are determined to be eligible for financial assistance receive an additional charity care discount equal to 100% of the remaining amount due.
Facility 2 -- St. John Dialysis, LLC Part V, Section B, line 3:	The Tulsa County Health Departmet led the completion of the Community Health Needs Assessment. The determination of priority needs was based on research findings, and priorities were developed in collaboration with many other stakeholders, including other hospitals, community service agencies, state and local leaders, interested philantropists, universities and associated medical schools, and other parties, including public health experts and representatives of the communities served. In addition, the Tulsa County Health Department's research included randomly selected households for one on one interviews and some "county resident" focus groups. St. John sits on a Pathways to Health Steering Committee and Working Group to coordinate and direct community health activities in the service area.
Facility 2 -- St. John Dialysis, LLC Part V, Section B, line 4:	The other hospital facilities with which the reporting Hospital facility conducted its CHNA, include: St. John Broken Arrow, Inc.Owasso Medical Facility, Inc.St. John Sapulpa, Inc.Jane Phillips Memorial Medical Center (Bartlesville)Jane Phillips Nowata Hospital, Inc.
Facility 2 -- St. John Dialysis, LLC Part V, Section B, line 7:	The Hospital facility's Implementation Strategy is listed on the following website:http://www.stjohnhealthsystem.com/about/community-needs-health-assessment
Facility 2 -- St. John Dialysis, LLC Part V, Section B, line 14g:	Signs are posted in waiting rooms and at the admissions offices to notify patients that the Hospital has a Financial Assistance Policy. In addition, every billing statement, the Hospital's website, and admission packets include information regarding the Financial Assistance Policy. The Policy is provided at the request of the patient.
Facility 2 -- St. John Dialysis, LLC Part V, Section B, line 20d:	St. John Medical Center, Inc. provides a 30% discount on gross charges and a 15% prompt pay discount to all uninsured patients. Patients who are determined to be eligible for financial assistance receive an additional charity care discount equal to 100% of the remaining amount due.
Facility 3 -- St. John Home Care, LLC Part V, Section B, line 3:	The Tulsa County Health Departmet led the completion of the Community Health Needs Assessment. The determination of priority needs was based on research findings, and priorities were developed in collaboration with many other stakeholders, including other hospitals, community service agencies, state and local leaders, interested philantropists, universities and associated medical schools, and other parties, including public health experts and representatives of the communities served. In addition, the Tulsa County Health Department's research included randomly selected households for one on one interviews and some "county resident" focus groups. St. John sits on a Pathways to Health Steering Committee and Working Group to coordinate and direct community health activities in the service area.
Facility 3 -- St. John Home Care, LLC Part V, Section B, line 4:	The other hospital facilities with which the reporting Hospital facility conducted its CHNA, include: St. John Broken Arrow, Inc.Owasso Medical Facility, Inc.St. John Sapulpa, Inc.Jane Phillips Memorial Medical Center (Bartlesville)Jane Phillips Nowata Hospital, Inc.
Facility 3 -- St. John Home Care, LLC Part V, Section B, line 7:	The Hospital facility's Implementation Strategy is listed on the following website:http://www.stjohnhealthsystem.com/about/community-needs-health-assessment
Facility 3 -- St. John Home Care, LLC Part V, Section B, line 14g:	Signs are posted in waiting rooms and at the admissions offices to notify patients that the Hospital has a Financial Assistance Policy. In addition, every billing statement, the Hospital's website, and admission packets include information regarding the Financial Assistance Policy. The Policy is provided at the request of the patient.
Facility 3 -- St. John Home Care, LLC Part V, Section B, line 20d:	St. John Medical Center, Inc. provides a 30% discount on gross charges and a 15% prompt pay discount to all uninsured patients. Patients who are determined to be eligible for financial assistance receive an additional charity care discount equal to 100% of the remaining amount due.
Schedule H, Section B, Line 5a:	The Hospital facility's CHNA is listed on the following website:http://www.stjohnhealthsystem.com/about/community-needs-health-assessment

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

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
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 1: St. John Medical Center, Inc., - Facility 2: St. John Dialysis, LLC, - Facility 3: St. John Home Care, LLC
Facility 1 -- St. John Medical Center, Inc. Part V, Section B, line 3:	The Tulsa County Health Departmet led the completion of the Community Health Needs Assessment. The determination of priority needs was based on research findings, and priorities were developed in collaboration with many other stakeholders, including other hospitals, community service agencies, state and local leaders, interested philantropists, universities and associated medical schools, and other parties, including public health experts and representatives of the communities served. In addition, the Tulsa County Health Department's research included randomly selected households for one on one interviews and some "county resident" focus groups. St. John sits on a Pathways to Health Steering Committee and Working Group to coordinate and direct community health activities in the service area.
Facility 1 -- St. John Medical Center, Inc. Part V, Section B, line 4:	The other hospital facilities with which the reporting Hospital facility conducted its CHNA, include: St. John Broken Arrow, Inc.Owasso Medical Facility, Inc.St. John Sapulpa, Inc.Jane Phillips Memorial Medical Center (Bartlesville)Jane Phillips Nowata Hospital, Inc.
Facility 1 -- St. John Medical Center, Inc. Part V, Section B, line 7:	The Hospital facility's Implementation Strategy is listed on the following website:http://www.stjohnhealthsystem.com/about/community-needs-health-assessment
Facility 1 -- St. John Medical Center, Inc. Part V, Section B, line 14g:	Signs are posted in waiting rooms and at the admissions offices to notify patients that the Hospital has a Financial Assistance Policy. In addition, every billing statement, the Hospital's website, and admission packets include information regarding the Financial Assistance Policy. The Policy is provided at the request of the patient.
Facility 1 -- St. John Medical Center, Inc. Part V, Section B, line 20d:	St. John Medical Center, Inc. provides a 30% discount on gross charges and a 15% prompt pay discount to all uninsured patients. Patients who are determined to be eligible for financial assistance receive an additional charity care discount equal to 100% of the remaining amount due.
Facility 2 -- St. John Dialysis, LLC Part V, Section B, line 3:	The Tulsa County Health Departmet led the completion of the Community Health Needs Assessment. The determination of priority needs was based on research findings, and priorities were developed in collaboration with many other stakeholders, including other hospitals, community service agencies, state and local leaders, interested philantropists, universities and associated medical schools, and other parties, including public health experts and representatives of the communities served. In addition, the Tulsa County Health Department's research included randomly selected households for one on one interviews and some "county resident" focus groups. St. John sits on a Pathways to Health Steering Committee and Working Group to coordinate and direct community health activities in the service area.
Facility 2 -- St. John Dialysis, LLC Part V, Section B, line 4:	The other hospital facilities with which the reporting Hospital facility conducted its CHNA, include: St. John Broken Arrow, Inc.Owasso Medical Facility, Inc.St. John Sapulpa, Inc.Jane Phillips Memorial Medical Center (Bartlesville)Jane Phillips Nowata Hospital, Inc.
Facility 2 -- St. John Dialysis, LLC Part V, Section B, line 7:	The Hospital facility's Implementation Strategy is listed on the following website:http://www.stjohnhealthsystem.com/about/community-needs-health-assessment
Facility 2 -- St. John Dialysis, LLC Part V, Section B, line 14g:	Signs are posted in waiting rooms and at the admissions offices to notify patients that the Hospital has a Financial Assistance Policy. In addition, every billing statement, the Hospital's website, and admission packets include information regarding the Financial Assistance Policy. The Policy is provided at the request of the patient.
Facility 2 -- St. John Dialysis, LLC Part V, Section B, line 20d:	St. John Medical Center, Inc. provides a 30% discount on gross charges and a 15% prompt pay discount to all uninsured patients. Patients who are determined to be eligible for financial assistance receive an additional charity care discount equal to 100% of the remaining amount due.
Facility 3 -- St. John Home Care, LLC Part V, Section B, line 3:	The Tulsa County Health Departmet led the completion of the Community Health Needs Assessment. The determination of priority needs was based on research findings, and priorities were developed in collaboration with many other stakeholders, including other hospitals, community service agencies, state and local leaders, interested philantropists, universities and associated medical schools, and other parties, including public health experts and representatives of the communities served. In addition, the Tulsa County Health Department's research included randomly selected households for one on one interviews and some "county resident" focus groups. St. John sits on a Pathways to Health Steering Committee and Working Group to coordinate and direct community health activities in the service area.
Facility 3 -- St. John Home Care, LLC Part V, Section B, line 4:	The other hospital facilities with which the reporting Hospital facility conducted its CHNA, include: St. John Broken Arrow, Inc.Owasso Medical Facility, Inc.St. John Sapulpa, Inc.Jane Phillips Memorial Medical Center (Bartlesville)Jane Phillips Nowata Hospital, Inc.
Facility 3 -- St. John Home Care, LLC Part V, Section B, line 7:	The Hospital facility's Implementation Strategy is listed on the following website:http://www.stjohnhealthsystem.com/about/community-needs-health-assessment
Facility 3 -- St. John Home Care, LLC Part V, Section B, line 14g:	Signs are posted in waiting rooms and at the admissions offices to notify patients that the Hospital has a Financial Assistance Policy. In addition, every billing statement, the Hospital's website, and admission packets include information regarding the Financial Assistance Policy. The Policy is provided at the request of the patient.
Facility 3 -- St. John Home Care, LLC Part V, Section B, line 20d:	St. John Medical Center, Inc. provides a 30% discount on gross charges and a 15% prompt pay discount to all uninsured patients. Patients who are determined to be eligible for financial assistance receive an additional charity care discount equal to 100% of the remaining amount due.
Schedule H, Section B, Line 5a:	The Hospital facility's CHNA is listed on the following website:http://www.stjohnhealthsystem.com/about/community-needs-health-assessment

Schedule H (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990
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 John Medical Center Inc

Employer identification number
73-0579286

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) Good Samaritan Health Service Inc 7600 S Lewis Tulsa,OK741366836	73-1559561	501(c)(3)	645,750	Medical Assistance
(2) OMNI Medical Group Inc PO Box 21228 Dept 333 Tulsa,OK74121	73-1335536	N/A	567,456	Medical Assistance
(3) Regional Medical Laboratories Inc 4142 S Mingo Road Tulsa,OK741463632	73-1131608	N/A	30,947	Medical Assistance
(4) St Gregory's University 5801 E 41st St Suite 900 Tulsa,OK741355631	73-0685198	Gov't Entity	50,000	Nursing Program
(5) St John Anesthesia Services Inc PO Box 2128 Dept 151 Tulsa,OK741211228	20-3690446	N/A	20,432	Medical Assistance
(6) St John Broken Arrow Inc 1000 W Boise Cr Broken Arrow,OK740124900	38-3833117	501(c)(3)	12,727	Medical Assistance
(7) Owasso Medical Facility Inc 12451 E 100th St No Owasso,OK740554600	20-3700131	501(c)(3)	12,562	Medical Assistance
(8) St John Physicians Inc PO Box 21228 Dept 334 Tulsa,OK74121	73-1321032	N/A	108,578	Medical Assistance
(9) Surgery Inc 1725 E 19th St 800 Tulsa,OK741046520	73-0768966	N/A	55,945	Medical Assistance
(10) Tulsa Day Center for the Homeless 415 W Archer St Tulsa,OK741031807	73-0662663	501(c)(3)	271,950	Medical Assistance
(11) Tulsa Radiology Associates PO Box 4939 Tulsa,OK741590939	73-6017987	N/A	44,904	Medical Assistance
(12) University of Oklahoma 4502 E 41st St Tulsa,OK741352512	73-6017987	501(c)(3)	4,177,790	Resident Program
(13) Urologic Specialists of Oklahoma Inc 10901 E 48th St Tulsa,OK741465830	73-0729369	N/A	31,725	Medical Assistance

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) Medical Assistance	1	41,267

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
Part I, Line 2:	Grants to organizations - St. John Medical Center, Inc. ("SJMC") provides funds to selected unaffiliated entities to fund their operations. SJMC determines the amount of the funds provided on an annual basis.

Schedule I (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

Complete if the organization answered "Yes" to Form 990, Part IV, 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 John Medical Center Inc

Employer identification number

73-0579286

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)Charles AndersonVP OP/Ex-Officio	(i) (ii)	460,609 0	34,282 0	48,359 0	23,000 0	19,282 0	585,532 0	31,269 0
(2)Bert W WalthallVP & CFO	(i) (ii)	239,762 0	26,767 0	29,689 0	21,216 0	20,839 0	338,273 0	20,748 0
(3)Pamela KiserVP & CNO	(i) (ii)	206,203 0	23,021 0	25,508 0	17,500 0	8,268 0	280,500 0	13,964 0
(4)Kathleen C SmarinskyVice President	(i) (ii)	206,628 0	23,068 0	28,289 0	40,000 0	7,768 0	305,753 0	20,241 0
(5)Lex AndersonTreasurer/Sr. VP & CFO SJHS	(i) (ii)	0 490,729	0 73,048	0 66,686	0 0	0 12,798	0 643,261	0 39,712
(6)H William AllredVP of Med Affairs/Med. Ed.	(i) (ii)	469,708 0	29,791 0	41,934 0	0 0	13,506 0	554,939 0	27,000 0
(7)Jeffrey D NowlinPresident & CEO	(i) (ii)	424,368 0	47,377 0	12,335 0	35,000 0	25,835 0	544,915 0	0 0
(8)Kevin SteckCorp. Resp. Off./Secretary	(i) (ii)	0 231,739	0 33,913	0 37,456	0 38,731	0 7,889	0 349,728	0 24,863
(9)David LewisTransplant Admin.	(i) (ii)	158,947 0	9,540 0	137 0	22,500 0	9,112 0	200,236 0	0 0
(10)Oliver D HansonChief Med. Physicist	(i) (ii)	185,645 0	298 0	97 0	0 0	13,647 0	199,687 0	0 0
(11)Tseggy KharkhuuPhysicist II	(i) (ii)	180,759 0	295 0	102 0	0 0	8,354 0	189,510 0	0 0
(12)Philip A PrestonDir. Operations Improv.	(i) (ii)	178,197 0	10,830 0	229 0	0 0	4,196 0	193,452 0	0 0
(13)Patricia A Wright EvansRN Dir. Operating Room	(i) (ii)	161,792 0	7,458 0	368 0	0 0	9,093 0	178,711 0	0 0
(14)Jessie DragooFormer Vice President - Nursing	(i) (ii)	0 0	0 0	130,622 0	12,981 0	3,944 0	147,547 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
Part I, Line 3	St. John Health System, Inc., a related organization of St. John Medical Center, Inc., uses the following methods to establish the compensation of the Organization's President: -Compensation Committee -Independent Compensation Consultant -Compensation Survey or Study -Approval by the Board or Compensation Committee
Part I, Line 4a:	The following Former Officer received severance payments from the organization or a related organization during the calendar year 2013: Jessie Dragoo $97,174
Part I, Line 4b:	Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the Organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individual received current year distributions of: Charles Anderson $31,269 Bert W. Walthall $20,748 Pamela Kiser $13,964 Kathleen C. Smarinsky $20,241 H. Wiliam Allred $27,000 Lex Anderson $39,712 Kevin Steck $24,863
Part I, Line 7:	St. John Health System, Inc. is the controlling member organization of an integrated healthcare system ("System"). The System has established an executive accountability and financial incentive plan that encourages the executives' participation in the significant improvements of the quality, financial, growth, and human resource related operations of the Organization. Eligibility is triggered when the System meets certain earnings and community benefits targets; however payments received under the plan are not based on the earnings of the Organization. Executives receive points under a plan scoring system for meeting their predetermined goals. The points are then entered into the plan formula to determine the executives' incentive compensation. Maximum payments under the financial incentive plan are twenty percent of base pay for most executives and 25% of base pay for the System CEO. There is a small discretionary element to the plan, generally equal up to 6.0% of base pay (up to 30% of the total plan pay out).

Schedule J (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
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 John Medical Center Inc

Employer identification number

73-0579286

Return Reference	Explanation
Form 990, Part III, Line 4a	(the "Medical Center"), St. John Sapulpa, Inc. ("St. John Sapulpa"), Jane Phillips Memorial Medical Center ("Jane Phillips"), Utica Services, Inc. ("Utica"), St. John Villas, Inc. ("St. John Villas"), Owasso Medical Facility, Inc. ("St. John Owasso"), St. John Health System Foundation, Inc. ("St. John Foundation"), St. John Building Corporation ("SJBC"), and St. John Broken Arrow, Inc. ("St. John Broken Arrow"). St. John, these subsidiaries, and all other subsidiaries under St. John's direct or indirect control or ownership are referred to herein as "the St. John System". All hospitals and other facilities or organizations owned or managed by the St. John System are operated in accordance with the mission and values of St. John. Mission and Values: As a Catholic healthcare organization, St. John carries on the mission of its sponsors, through Ascension Health, of continuing the healing ministry of Jesus Christ. It aspires to provide health care that works, health care that is safe, and health care that leaves no one behind, with a promise to our patients and the communities we serve of providing medical excellence and compassionate care. It operates in conformance with "the ethical and religious directives for Catholic health facilities." Faithful to the sponsorship mission, philosophy and values, St. John's mission is to provide healthcare and related ministries for the people served, especially the sick, the poor and the powerless. The board of directors, management and employees of St. John are guided in their day-to-day actions and interactions with those who serve and who are served by the values of service to the poor, wisdom, reverence, creativity, dedication and integrity. St. John and the Medical Center collaborate with other individuals and institutions in the various communities it serves to ascertain community needs and provide a broad range of services along the healthcare continuum to help meet those needs. Programs and services include preventive, diagnostic, therapeutic and rehabilitative programs, including emphasis on health promotion and disease prevention. St. John also advocates for public policies which advance a healthy and just society. St. John works with local, state and national leaders and organizations to bring about a healthcare delivery system that provides dignified access to and affordable, high quality healthcare for all persons. Community Needs Assessment: Each owned hospital in the St. John System (including the Medical Center) has completed a Community Health Needs Assessment and plan of response and those have been posted to each Hospital's website and also the Health System website. St. John continues to look for ways to meet unmet community needs in a sustainable and collaborative way with other organizations to build healthier communities. Governance: The administrative powers of the Medical Center are vested in its board of directors, which controls and manages the properties, affairs and funds of the Medical Center, subject to reservation of certain powers by St. John. The board meets regularly and it works in concert with, and when appropriate, under the direction of the St. John Health System, Inc. board. Community Benefit: In measuring and reporting quantifiable community benefit, St. John follows guidelines promulgated by the Catholic Health Association of the United States and endorsed by other organizations. Uncompensated care and other elements of community benefit are measured at the unreimbursed estimated cost of services or resources provided. The St. John System serves as an important safety net provider of a broad continuum of health care services to the citizens of Northeastern Oklahoma and the surrounding region. Each of the six main hospitals operates a full-service, 24-hour, 365-day emergency room providing both urgent and emergency care to all individuals, regardless of their ability to pay. The Medical Center, located in Tulsa, Oklahoma, is a full-service tertiary hospital which provides a broad range of inpatient and outpatient health care services. The Medical Center is a tertiary referral center and serves as one of two primary trauma referral centers for Tulsa and Northeastern Oklahoma. It serves as a primary Tulsa teaching hospital for The University of Oklahoma's School of Community Medicine residency programs for internal medicine and surgery. It is also the primary teaching hospital for the In His Image Family Medicine residency program. It is also Northeastern Oklahoma's only "magnet" accredited hospital, signifying excellence in nursing care. St. John Medical Center, Inc. is Tulsa's and Northeastern Oklahoma's only ACS Level II Trauma Center and only Joint Commission-accredited comprehensive stroke center. The Medical Center offers advanced services in trauma, neurological and neurosurgical (including stroke) care, cardiology and cardiothoracic surgery, kidney transplant, adult, pediatric and neonatal intensive care, cancer treatment, joint replacement, and many other areas. Patients seen in the St. John System for the fiscal year ended June 30, 2014: Beds in Service (including 37 newborn bassinets) 782 Total Discharges (excluding normal newborns) 38,704 Total Observation Days 19,086 Combined Discharges and Observation Days 57,790 Total Patient Days (excl. normal newborn and observations) 176,450 Average Length of Stay in Days (excl. normal newborn and obs.) 4.56 Births 3,248 Emergency Room Visits 140,150 Outpatient Visits (excl. emergency room & one day surgeries) 394,526 Inpatient Surgical Cases 9,855 Outpatient Surgical Cases 15,545 Physician Office Patient Visits 617,023 Urgent Care Clinic Patient Visits 58,368 Combined Physician Office and Urgent Care Visits 675,391 Total Laboratory Procedures (incl. hospital and reference labs) 8,184,993 Patients seen in St. John Medical Center, Inc. for the fiscal year ended June 30, 2014: Beds in Service (including 20 newborn bassinets) 547 Total Discharges (excluding normal newborn) 28,728 Total Observation Days 12,382 Combined Discharges and Observation Days 41,110 Total Patient Days (excl. normal newborn and observation) 149,969 Average Length of Stay in Days (excl. normal newborn & obs.) 5.22 Births - 2,205 Emergency Room Visits 60,547 Outpatient Visits (excl. emergency room & one day surgeries) 250,795 Inpatient Surgical Cases 7,775 Outpatient Surgical Cases 10,815 In its fiscal year ended June 30, 2014, St. John was able to identify and quantify an initial estimate of more than $81.1 million of total net consolidated quantifiable community benefit provided to thousands of individuals directly served. This represents more than 8% of total St. John System operating expenses. In addition to the quantifiable community benefit described above, the St. John System charged millions of dollars to the consolidated provision for bad debts in 2014 which were not included in the total quantifiable community benefit for the year. Also, unlike many other non-profit health systems based in states other than Oklahoma, the St. John System is not exempt from state and local sales taxes and, in fact, pays sales tax on many equipment, supplies and other purchases. When payments from certain government programs for direct graduate medical education and Oklahoma Trauma Fund participation are applied to community benefit expense, the net consolidated quantifiable community benefit expense for St. John Health System, Inc. for 2014 was estimated to be at least $74.9 million. The St. John System considers care for the poor to be an essential part of its mission of service to the community. The total cost of care for the poor includes the cost of charity care, the unreimbursed cost of services to Medicaid beneficiaries (together referred to as "uncompensated care for the poor"), and the cost of special programs or other activities specifically targeted to increase access to care or provide other services to the poor. "Care for the Poor" includes the estimated cost of care classified as charity care plus the estimated excess of the cost of services provided to Medicaid beneficiaries over the payments received from Medicaid. "Care for the Poor" does not include the cost of services classified and written off as bad debts or the excess of the cost of services provided to Medicare beneficiaries over the payments received from Medicare. Charity and Uncompensated Care: The St. John System's Hospitals, senior-care and other facilities provide services without regard to a patient's ability to pay. In 2014, the St. John System Hospitals provided a discount of at least 30% of billed charges to all uninsured patients. Uninsured patients also could qualify for an additional 15% prompt pay discount. In addition to these automatic discounts, patients can apply for financial assistance up to and including free care. The determination of the patient's qualification for financial assistance is based on an objective determination of the patient's financial
Form 990, Part V, Line 1a and 2a:	Statements Regarding Other IRS Filings and Tax Compliance The number of independent contractors during the tax year for the filing organization and all other entities within the St. John Medical Center, Inc. master pay group are reflected in Part V, Line 1a of the filing organization. Compensation for independent contractors is reported on the Form 1096, Annual Summary and Transmittal of the U.S. Information Returns, of St. John Medical Center, Inc. (SJMC), EIN 73-0579286. Expenses from all entities in the SJMC master pay group are allocated to and reimbursed by the filing organization to SJMC and are reported on Form 990, Part VII, Section B and Part IX by the respective filing organization that incurred the expense. The salaries reflected on Form 990 were all reported on the Form 941 Employer's Quarterly Federal Tax Return of St. John Medical Center, Inc. These salaries were reimbursed to SJMC by the filing organization and were included in the number of employees on SJMC's calendar year 2013 Form W-3. The number of employees reported on Part V, Line 2a of Form 990 by the filing organization represents the number of employees providing services to the filing organization during calendar year 2013.
Form 990, Part VI, Section A, line 2	Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by St. John Health System, Inc. related entities.
Form 990, Part VI, Section A, line 6	St. John Medical Center, Inc. has a single corporate member, St. John Health System, Inc.
Form 990, Part VI, Section A, line 7a	St. John Medical Center, Inc. has a single corporate member, St. John Health System, Inc., who has the ability to elect members to the governing body of St. John Medical Center, Inc.
Form 990, Part VI, Section A, line 7b	All decisions that have a material impact to St. John Medical Center, Inc.'s financial information or corporation as a whole are subject to approval by its sole corporate member, St. John Health System, Inc. Ascension Health, the sole corporate member of St. John Health System, Inc., has designated a system authority matrix which assigns authority for key decisions that are necessary in the operation of the System. Specific areas that are identified in the authority matrix are: new organizations and major transactions; governing documents; appointments/removals; evaluations; debt limits; strategic and financial plans; assets; system policies and procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix.
Form 990, Part VI, Section B, line 11	St. John Medical Center, Inc. (SJMC) is an affiliate of St. John Health System, Inc. (SJHS). SJHS has hired a third party preparer experienced in the preparation of Form 990 to assist in the preparation of the return. The Senior Vice President/Chief Financial Officer and SJHS personnel will work closely with the paid preparer in gathering the information for the return and will perform the initial detailed review of the return. The return will then be reviewed by the SJHS Audit Committee (as delegated by the Board of the filing organization). A copy of the return will be provided to all voting Board Members of the filing Organization prior to filing.
Form 990, Part VI, Section B, line 12c	At every fiscal year end, St. John Health System, Inc. (SJHS) distributes a copy of the current Conflict of Interest Policy and Procedure Bulletin, together with an explanation and questionnaire to the members of the Board of Directors, administrative officers and key employees of SJHS, its subsidiaries and affiliates, including Jane Phillips Nowata Hospital, Inc. The Board Members, administrative officers and key employees of SJHS, its subsidiaries and affiliates must complete the questionnaire and return it to the designated SJHS official within two weeks of receipt. Completed questionnaires are reviewed and summarized by the Vice President, Corporate Compliance and Integrity, or his/her designee. That individual then presents the questionnaire results to the heads of each hospital for further provision to the various boards' Audit and Compliance Committees. The Audit and Compliance Committees, as appropriate, submit a confidential report to their Board Chairman summarizing the questionnaire results. The Board Chairman, as appropriate, may review with the Executive Committee the responses to the questionnaire results. Members of a committee with governing board delegated powers annually sign a statement which affirms such person has received a copy of the Conflict of Interest Policy, has read and understands the Policy, has agreed to comply with the Policy, and understands that the Organization is charitable and, in order to maintain its federal tax exemption, it must engage primarily in activities which accomplish its tax-exempt purpose.
Form 990, Part VI, Section B, line 15	Compensation for all executives in St. John Health System, Inc. ("SJHS"), of which St. John Medical Center, Inc. is a part, is analyzed by an independent health care consulting firm. The analysis includes a fair market value assessment and establishment of a range for each position based on research of comparable health care systems of similar size. The report and recommended compensation levels for each executive management position is reviewed and approved by the Executive Compensation Committee of the SJHS Board of Directors. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes.
Form 990, Part VI, Section C, line 19	The Organization will provide any documents open to public inspection upon request.
Form 990, Part VII, Line 7b:	Amounts paid to Manhattan Construction Company and Siemens Healthcare Diagnostics represent payments for both services and goods. These amounts cannot be separated.
Form 990, Part IX, line 11g	Professional Services: Program service expenses 37,984,027. Management and general expenses 639,797. Fundraising expenses 0. Total expenses 38,623,824. Contracted Services: Program service expenses 9,345,551. Management and general expenses 195,688. Fundraising expenses 0. Total expenses 9,541,239. Purchased Services: Program service expenses 3,510,308. Management and general expenses 58,522. Fundraising expenses 0. Total expenses 3,568,830. Laboratory: Program service expenses 11,860,179. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,860,179. Miscellaneous: Program service expenses 102,289. Management and general expenses 0. Fundraising expenses 0. Total expenses 102,289.
Form 990, Part XI, line 9:	Transfers to Affiliates -28,856,750. Contributions 5,794,556. Released from Restrictions -7,757,985. Other Temporarily Restricted Net Assets 1,440,000. Other Resticted Activity -48,339,405. Other Unrestricted Activity 705,636.

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:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" 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 John Medical Center Inc

Employer identification number

73-0579286

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) St John Dialysis LLC 1923 South Utica Avenue Tulsa,OK74104 73-1594503	Dialysis	OK	0	0	St John Medical Center Inc
(2) St John Home Care LLC 1923 South Utica Avenue Tulsa,OK74104 38-4662704	Health Care	OK	0	0	St John Medical Center Inc

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) Ascension Health Alliance PO Box 45998 St Louis,MO631455998 45-3358926	National Health System	MO	501(c)(3)	Schedule A, Line 11a	N/A		No
(2) Ascension Health PO Box 45998 St Louis,MO63134 31-1662309	National Health System	MO	501(c)(3)	Schedule A, Line 11a	Ascension Health Alliance		No
(3) St John Health System Inc 1923 South Utica Avenue Tulsa,OK74104 73-1215174	System Parent	OK	501(c)(3)	Schedule A, Line 11a	Ascension Health		No
(4) Craig County Medical Services Corp 1923 South Utica Avenue Tulsa,OK74104 73-1487478	Health Care	OK	501(c)(3)	Schedule A, Line 9	St John Health System Inc	Yes
(5) St John Sapulpa Inc 1923 South Utica Avenue Tulsa,OK74104 73-0662663	Health Care	OK	501(c)(3)	Schedule A, Line 3	St John Health System Inc	Yes
(6) Jane Phillips Nowata Hospital Inc 237 South Locust Nowata,OK74048 73-1440267	Health Care	OK	501(c)(3)	Schedule A, Line 3	Jane Phillips Memorial Medical Center	Yes
(7) Jane Phillips Memorial Medical Center 3500 E Frank Phillips Blvd Bartlesville,OK74006 73-0606129	Health Care	OK	501(c)(3)	Schedule A, Line 3	St John Health System Inc	Yes
(8) Jane Phillips Health Care Foundation 3500 E Frank Phillips Blvd Bartlesville,OK74006 73-1250611	Rural Health Clinics	OK	501(c)(3)	Schedule A, Line 3	Jane Phillips Memorial Medical Center	Yes
(9) Bartlett Homes Inc 1008 E Cleveland Sapulpa,OK74066 73-1301822	HUD Housing	OK	501(c)(3)	Schedule A, Line 7	St John Sapulpa Inc	Yes
(10) Bethel Manor Inc 619 S Division Sapulpa,OK74066 73-1216617	HUD Housing	OK	501(c)(3)	Schedule A, Line 7	St John Sapulpa Inc	Yes
(11) St John Building Corporation 1923 South Utica Avenue Tulsa,OK74104 61-1659782	Real Estate	OK	501(c)(2)	N/A	St John Health System Inc	Yes
(12) St John Health System Foundation Inc 1923 South Utica Avenue Tulsa,OK74104 73-1133139	Health Care	OK	501(c)(3)	Schedule A, Line 7	St John Health System Inc	Yes
(13) St John Management Services Inc 1923 South Utica Avenue Tulsa,OK74104 20-3742040	Health Care	OK	501(c)(3)	Schedule A, Line 7	St John Health System Inc	Yes
(14) St John Villas Inc 1923 South Utica Avenue Tulsa,OK74104 73-1077367	Nursing Home	OK	501(c)(3)	Schedule A, Line 9	St John Health System Inc	Yes
(15) Owasso Medical Facility Inc 1923 South Utica Avenue Tulsa,OK74104 20-3700131	Health Care	OK	501(c)(3)	Schedule A, Line 3	St John Health System Inc	Yes
(16) St John Broken Arrow Inc 1923 South Utica Avenue Tulsa,OK74104 38-3833117	Health Care	OK	501(c)(3)	Schedule A, Line 3	St John Health System Inc	Yes
(17) St John Auxiliary 1923 South Utica Avenue Tulsa,OK74104 73-0999759	Health Care	OK	501(c)(3)	Schedule A, Line 9	St John Health System Inc	Yes
(18) St Teresa of Avila Villas Inc 6859 South Canton Avenue Tulsa,OK74136 20-4791422	HUD Housing	OK	501(c)(3)	Schedule A, Line 7	St John Villas Inc	Yes

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	(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 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) Platnum Fitness & Rehab Center LLC 4804 South 109th East Avenue Tulsa,OK74146 20-1879493	Health Club	OK	N/A
(2) Memorial Surgery Center LLC 8131 South Memorial Avenue Tulsa,OK74133 20-1167151	Operate ASC	OK	N/A
(3) Broken Arrow Development LLC 1924 South Utica Avenue Tulsa,OK74104 26-0748994	Medical Services	OK	N/A
(4) UticaUSP Tulsa LLC 15305 Dallas Pkwy Ste 1600 LB 28 Addison,TX75001 27-0408231	Medical Services	TX	N/A
(5) JPHC LLC 3500 SE Frank Phillips Blvd Bartlesville,OK74006 61-1498699	Medical Services	OK	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) Utica Services Inc 1923 South Utica Avenue Tulsa,OK74104 73-1057650	Medical Services	OK	N/A	C				No
(2) Regional Medical Laboratories Inc 1923 South Utica Avenue Tulsa,OK74104 73-1131608	Medical Services	OK	N/A	C				No
(3) Physician Support Services Inc 1923 South Utica Avenue Tulsa,OK74104 73-1437252	Medical Services	OK	N/A	C				No
(4) OMNI Medical Group Inc 1923 South Utica Avenue Tulsa,OK74104 73-1335536	Medical Services	OK	N/A	C				No
(5) Outbound Medical Network Inc 1923 South Utica Avenue Tulsa,OK74104 73-1255463	Medical Services	OK	N/A	C				No
(6) St John Urgent Care Clinic Inc 1923 South Utica Avenue Tulsa,OK74104 20-4990275	Medical Services	OK	N/A	C				No
(7) St John Anesthesia Services Inc 1923 South Utica Avenue Tulsa,OK74104 20-3690446	Medical Services	OK	N/A	C				No
(8) St John Physicians Inc 1923 South Utica Avenue Tulsa,OK74104 73-1321032	Medical Services	OK	N/A	C				No
(9) Ceres Medical Practice Inc 3400 E Frank Phillips Blvd Bartlesville,OK74006 73-1522656	Medical Services	OK	N/A	C				No
(10) Doctors Building of Bartlesville 3500 State Street Bartlesville,OK74006 73-0759185	Building Rental	OK	N/A	C				No
(11) Gemini Medical Group Inc 3400 E Frank Phillips Blvd Bartlesville,OK74006 73-1503529	Medical Services	OK	N/A	C				No
(12) Gemini After Hours Clinic Inc 3400 E Frank Phillips Blvd Bartlesville,OK74006 30-0375407	Medical Services	OK	N/A	C				No
(13) Jane Phillips Specialty Physicians Inc 3400 E Frank Phillips Blvd Bartlesville,OK74006 01-0879962	Medical Services	OK	N/A	C				No
(14) Professional Credit Recovery 4100 SE Adams Blvd Bartlesville,OK74006 73-1057187	Collections Services	OK	N/A	C				No
(15) Synergy Hospitalist Grp Inc 3400 E Frank Phillips Blvd Bartlesville,OK74006 30-0375404	Medical Services	OK	N/A	C				No
(16) Professional Medical Insurance Risk Retention Group Inc 201 Merchant Street Suite 2400 Honolulu,HI96813 73-1525831	Insurance	HI	N/A	C				No
(17) Jane Phillips Support Services Inc 3400 E Frank Phillips Blvd Bartlesville,OK74006 75-1530296	Holding Company	OK	N/A	C				No

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

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

Yes

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

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) . . . . . . . . . . . . . . . . . . . . .

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) St John Health System Inc	O	164,146,024	FMV
(2) Utica Services Inc	S	145,581,418	FMV
(3) St John Health System Inc	P	129,835,951	FMV
(4) Utica Services Inc	O	103,132,228	FMV
(5) St John Health System Inc	L	102,759,288	FMV
(6) St John Health System Inc	S	51,559,509	FMV
(7) St John Building Corporation	L	24,348,152	FMV
(8) St John Building Corporation	S	21,043,332	FMV
(9) Utica Services Inc	M	20,376,142	FMV
(10) St John Sapulpa Inc	Q	20,223,737	FMV
(11) St John Broken Arrow Inc	S	18,908,847	FMV
(12) St John Health System Inc	E	17,217,829	FMV
(13) St John Broken Arrow Inc	L	15,624,438	FMV
(14) St John Broken Arrow Inc	O	12,766,454	FMV
(15) Owasso Medical Facility Inc	O	10,941,391	FMV
(16) St John Broken Arrow Inc	Q	9,514,585	FMV
(17) St John Sapulpa Inc	O	8,446,315	FMV
(18) St John Sapulpa Inc	R	8,368,940	FMV
(19) Owasso Medical Facility Inc	S	8,190,693	FMV
(20) St John Villas Inc	Q	7,827,310	FMV
(21) Owasso Medical Facility Inc	Q	7,017,003	FMV
(22) Utica Services Inc	P	4,717,122	FMV
(23) St John Villas Inc	O	4,537,084	FMV
(24) Owasso Medical Facility Inc	L	4,241,655	FMV
(25) St John Health System Foundation Inc	L	3,935,773	FMV
(26) St John Health System Foundation Inc	C	3,640,083	FMV
(27) St John Villas Inc	L	3,462,167	FMV
(28) Ascension Health	L	3,436,883	FMV
(29) St John Sapulpa Inc	L	3,388,192	FMV
(30) St John Health System Foundation Inc	Q	3,050,000	FMV
(31) Jane Phillips Memorial Medical Center Inc	S	2,362,944	FMV
(32) Jane Phillips Memorial Medical Center Inc	L	2,255,388	FMV
(33) St John Building Corporation	Q	2,173,622	FMV
(34) St John Health System Foundation Inc	S	1,207,159	FMV
(35) St John Building Corporation	K	856,515	FMV
(36) St John Building Corporation	O	673,214	FMV
(37) OMNI Medical Group Inc	B	567,456	FMV
(38) St John Villas Inc	S	386,537	FMV
(39) St John Health System Inc	J	328,123	FMV
(40) St John Health System Foundation Inc	O	320,386	FMV
(41) Craig County Medical Services Corp	Q	242,035	FMV
(42) St John Villas Inc	D	214,596	FMV
(43) Jane Phillips Memorial Medical Center Inc	O	136,696	FMV
(44) Craig County Medical Services Corp	R	124,501	FMV
(45) Craig County Medical Services Corp	L	117,534	FMV
(46) St John Physicians Inc	B	108,578	FMV
(47) Utica Services Inc	D	108,211	FMV

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:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: To provide medical excellence and compassionate care to all who need it.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	8
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	7
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	3,752
6	Total number of volunteers (estimate if necessary) .............	6	647
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	6,949,244	11,784,612
9	Program service revenue (Part VIII, line 2g) .........	391,139,696	514,353,959
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	20,614,831	14,630,657
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	3,452,318	3,811,732
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	422,156,089	544,580,960
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,727,189	6,078,958
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)	169,256,479	224,553,945
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)....	180,422,182	247,105,605
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	351,405,850	477,738,508
19	Revenue less expenses. Subtract line 18 from line 12.......	70,750,239	66,842,452
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	373,955,221	358,264,552
21	Total liabilities (Part X, line 26).............	289,506,878	283,987,705
22	Net assets or fund balances. Subtract line 21 from line 20.....	84,448,343	74,276,847

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 424,219,604 including grants of $ 6,078,958 ) (Revenue $ 509,466,863 )
	St. John Medical Center, Inc. (the "Medical Center"), located in Tulsa, Oklahoma, is a full-service tertiary hospital which provides a broad range of inpatient and outpatient health care services.St. John Health System, Inc. ("St. John"), and affiliates, own and operate a comprehensive tertiary health care delivery system which provides a full spectrum of health-related services throughout Northeastern Oklahoma. St. John, headquartered in Tulsa, Oklahoma, is a wholly-owned subsidiary of Ascension Health. St. John conducts its operations through several wholly-owned or wholly-controlled subsidiaries, including: St. John Medical Center, Inc.

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 expenses424,219,604

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,403,014	933,571	375,759

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Tseggy Kharkhuu........................................................................ Physicist II	40.00 .......................0.00	X		181,156	0	8,354
(19) Philip A Preston........................................................................ Dir. Operations Improv.	40.00 .......................0.00	X		189,256	0	4,196
(20) Patricia A Wright Evans........................................................................ RN Dir. Operating Room	40.00 .......................0.00	X		169,618	0	9,093
(21) Jessie Dragoo........................................................................ Former Vice President - Nursing	0.00 .......................0.00		X	130,622	0	16,925

				(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		3,640,083
e	Government grants (contributions)1e		22,400

f	All other contributions, gifts, grants, and similar amounts not included above1f		8,122,129

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			11,784,612
			Business Code
2a	Net Patient Revenue		621990	506,315,932	506,315,932
b	Fitness/Wellness/Edu.		900099	3,365,246			3,365,246
c	Trauma Care Assistance		612990	3,150,931	3,150,931
d	Prescription Sales		410001	787,244			787,244
e	Medical Records		621990	205,415			205,415
f	All other program service revenue .			529,191			529,191
g	Total. Add lines 2a–2f........			514,353,959
3	Investment income (including dividends, interest, and other similar amounts).......			721,638			721,638
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	589,366
b	Less: rental expenses	0
c	Rental income or (loss)	589,366
d	Net rental income or (loss).......			589,366			589,366
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		15,602,955
b	Less: cost or other basis and sales expenses	1,400,533	293,403
c	Gain or (loss)	-1,400,533	15,309,552
d	Net gain or (loss)..........			13,909,019			13,909,019
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..
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...
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..
Miscellaneous Revenue			Business Code
11a	Food Service		721000	3,114,748			3,114,748
b	Miscellaneous Income		900099	107,618			107,618
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			3,222,366
12	Total revenue. See Instructions......			544,580,960	509,466,863	0	23,329,485


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............				1
2	Savings and temporary cash investments .........			7,583,122	2	12,879,580
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			72,301,337	4	71,381,933
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
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
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			11,862,348	8	12,843,636
9	Prepaid expenses and deferred charges ..........			562,863	9	234,634
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	223,188,315
b	Less: accumulated depreciation .....	10b	21,043,932	194,834,037	10c	202,144,383
11	Investments—publicly traded securities ..........				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 .....			76,083,159	13	16,131,288
14	Intangible assets ...............			1,152,043	14	1,663,248
15	Other assets. See Part IV, line 11 ...........			9,576,312	15	40,985,850
16	Total assets. Add lines 1 through 15 (must equal line 34)......			373,955,221	16	358,264,552
17	Accounts payable and accrued expenses .........			48,258,175	17	36,035,231
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..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			241,248,703	25	247,952,474
26	Total liabilities. Add lines 17 through 25.........			289,506,878	26	283,987,705
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			33,252,652	27	72,692,518
28	Temporarily restricted net assets ...........			51,195,691	28	1,584,329
29	Permanently restricted net assets ...........				29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			84,448,343	33	74,276,847
34	Total liabilities and net assets/fund balances ........			373,955,221	34	358,264,552