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) CHARLES LUCORE........................................................................ CHIEF EXECUTIVE OFFICER AND PRESIDENT	75.00 .......................0	X	X	0	0	0
(2) JOHN SLAYTON........................................................................ CHAIRPERSON	5.00 .......................2.00	X	X	0	0	0
(3) LAWRENCE SCHUMACHER........................................................................ INTERIM PRESIDENT	10.00 .......................51.00	X	X	0	1,234,818	204,518
(4) ROBERT BUNN........................................................................ VICE CHAIR	1.00 .......................0	X	X	0	0	0
(5) DONALD GRAHAM MD........................................................................ DIRECTOR	1.00 .......................0	X		0	0	0
(6) J MICHAEL HOUSTON........................................................................ DIRECTOR	1.00 .......................0	X		0	0	0
(7) LYNN SCOTT........................................................................ DIRECTOR	1.00 .......................0	X		0	0	0
(8) MARK PUCZYNSKI MD........................................................................ DIRECTOR	1.00 .......................0	X		0	0	0
(9) RICHARD CORKERY........................................................................ DIRECTOR	1.00 .......................0	X		0	0	0
(10) ROGER SABLES........................................................................ DIRECTOR	1.00 .......................0	X		0	0	0
(11) SR MARY KELLY OSF........................................................................ Director	1.00 .......................0	X		0	0	0
(12) SR MARYBETH CULNAN OSF........................................................................ DIRECTOR	1.00 .......................10.00	X		0	0	0
(13) TRUDY NELSON........................................................................ DIRECTOR	1.00 .......................0	X		0	0	0
(14) ANN M CARR........................................................................ TREASURER	.25 .......................61.75		X	0	318,955	255,068
(15) DAVID OLEJNICZAK........................................................................ CHIEF OPERATING OFFICER	55.00 .......................20.00		X	403,341	0	89,256
(16) EVERT J KUIPER........................................................................ Central Illinois Division CEO	25.00 .......................50.00		X	0	158,209	0
(17) GERALD PAULE........................................................................ DIVISION FINANCIAL OFFICER	45.00 .......................30.00		X	0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
WALSH MIRON301 N EIGHT STREETSPRINGFIELDIL62701	CONTRACTORS	48,943,455
SOUTHERN IL UNIV SCHOOL OF MEDICINEPO BOX 19230SPRINGFIELDIL62704	PHYSICIANS	25,111,712
SANGAMON ASSOCIATED ANESTHESIOLOGIST800 EAST CARPENTERSPRINGFIELDIL62769	PHYSICIANS	6,819,909
SODEXO INC4880 PAYSPHERE CIRCLECHICAGOIL60674	FOOD SRVC & HSKPNG MGT	3,233,049
MISSISSIPPI VALLEY REGIONAL BLOOD CENTERPO BOX 3655DAVENPORTIA52808	BLOOD PROCESSING	1,954,319
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 130

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	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	16,146	16,146
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,590,718		1,590,718
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	141,144,494	125,468,308	15,676,186
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	8,249,084	7,332,901	916,183
9	Other employee benefits .......	27,005,409	24,006,058	2,999,351
10	Payroll taxes ...........	10,869,815	9,662,561	1,207,254
11	Fees for services (non-employees):
a	Management ......	32,995,530	1,259,582	31,735,948
b	Legal .........	794,039		794,039
c	Accounting ...........	-48,690		-48,690
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	68,161,717	59,510,529	8,651,188	0
12	Advertising and promotion ....	3,047,970	465,910	2,582,060
13	Office expenses .......	5,948,694	5,288,894	659,800
14	Information technology ......	9,303,417	8,889,417	414,000
15	Royalties ..	0
16	Occupancy ...........	9,027,828	8,921,339	106,489
17	Travel ............	437,297	379,940	57,357
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	2,469,044	274,224	2,194,820
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	26,322,098	21,907,054	4,415,044
23	Insurance ..............	6,247,754	32,488	6,215,266
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	PROVISION FOR BAD DEBT	28,110,656	28,021,031	89,625
b	MEDICAID TAXES	17,203,486	34,182	17,169,304
c	LICENSES, BOOKS AND LEASES	8,321,339	4,430,597	3,890,742
d	MEDICAL SUPPLIES	78,634,434	78,342,377	292,057
e	All other expenses	3,937,853	2,921,317	1,016,536	0
25	Total functional expenses. Add lines 1 through 24e	489,790,132	387,164,855	102,625,277	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).	0

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	310,069	1	1,601,321
2	Savings and temporary cash investments .........	1,891,054	2	6,497,922
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	93,360,414	4	94,061,113
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	10,975,241	8	9,807,986
9	Prepaid expenses and deferred charges ..........	3,607,325	9	4,037,384
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	772,208,258
b	Less: accumulated depreciation .....	10b	387,231,576	331,112,423	10c	384,976,682
11	Investments—publicly traded securities ..........	346,456,301	11	317,018,617
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	4,857,001	15	11,351,809
16	Total assets. Add lines 1 through 15 (must equal line 34)......	792,569,828	16	829,352,834
	17	Accounts payable and accrued expenses .........	46,907,910	17	41,306,373
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	228,054,515	20	277,435,412
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21	1,275,000
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	87,148,529	25	69,888,933
26	Total liabilities. Add lines 17 through 25.........	362,110,954	26	389,905,718
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	402,509,500	27	407,664,069
28	Temporarily restricted net assets ...........	25,457,798	28	29,181,080
29	Permanently restricted net assets ...........	2,491,576	29	2,601,967
	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 ...........	430,458,874	33	439,447,116
34	Total liabilities and net assets/fund balances ........	792,569,828	34	829,352,834

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SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

See separate instructions.
right arrow

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

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

ST JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

Employer identification number

37-0661238

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

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

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

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

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

Yes

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

11g(i)

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

11g(ii)

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

11g(iii)

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

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

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

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

Section C. Computation of Public Support Percentage

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

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

16a

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

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

17a

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

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

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

Schedule A (Form 990 or 990-EZ) 2013

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

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

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

Section C. Computation of Public Support Percentage

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

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

Section D. Computation of Investment Income Percentage

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

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

19a

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

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

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

Schedule A (Form 990 or 990-EZ) 2013

Page 4

Part IV

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

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

Schedule 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'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

Employer identification number

37-0661238

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'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

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'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

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'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

Employer identification number

37-0661238

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:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

See separate instructions. SchCMd Bullet

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

OMB No. 1545-0047

2013

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

ST JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

Employer identification number

37-0661238

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

52,393

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

52,393

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
Schedule C, Part II-B, Line 1, Description of the activities reported on Lines 1a through 1i	ST. JOHN'S HOSPITAL (THE HOSPITAL) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, WITH PART OF THESE DUES BEING ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.

Return Reference

Explanation

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

ST. JOHN'S HOSPITAL (THE HOSPITAL) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE ILLINOIS HEALTH ASSOCIATION ("IHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, WITH PART OF THESE DUES BEING ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.

Schedule C (Form 990 or 990EZ) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990. SchDMd Bullet

See separate instructions. SchDMd Bullet

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

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

Employer identification number

37-0661238

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

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


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

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

Yes No

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

Part V

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

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

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	22,961,448		22,961,448
b	Buildings ................	261,809,175	95,144,917	166,664,258
c	Leasehold improvements ............	10,301,273	5,729,097	4,572,176
d	Equipment ................	236,322,421	180,190,911	56,131,510
e	Other .................	240,813,941	106,166,651	134,647,290
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				384,976,682

Schedule D (Form 990) 2013

Page 3

Part VII

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

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








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

Part VIII

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

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









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

Part IX

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

(a) Description				(b) Book value









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

Part X

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

1.(a) Description of liability		(b) Book value
Federal income taxes		0
ACCRUED BENEFIT LIABILITY		37,564,900
SETTLEMENT VALUE OF INT RATE SWAP PROGRAM		7,116,383
THIRD PARTY REIMBURSEMENT PROGRAM		15,315,056
ASSET RETIREMENT OBLIGATION		9,892,594





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		69,888,933
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................

Schedule D (Form 990) 2013

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference	Explanation
Schedule D, Part IV, Line 2b, Explanation of escrow agreement	IN FISCAL YEAR 2014, ST JOHN'S PURCHASED THE TANGIBLE AND INTANGIBLE ASSETS OF THE AMBULATORY SURGERY CENTER LOCATED AT 2020 WEST ILES AVENUE, SPRINGFILED, ILLINOIS FROM PRAIRIE SURGICENTER ASSOCIATES. AS PART OF THAT PURCHASE AGREEMENT 15% OF THE PURCHASE PRICE, $1,275,000 (ESCROW AMOUNT) WAS DEPOSITED BY THE BUYER (SJS) WITH JP MORGAN CHASE BANK (THE ESCROW AGENT) VIA FEDERAL WIRE TRANSFER TO AN ACCOUNT ESTABLISHED BY THE ESCROW AGENT PRIOR TO THE CLOSING DATE. ANY PORTION OF THE ESCROW AMOUNT THAT HAS NOT BEEN PAID BY THE ESCROW AGENT TO BUYER INDEMNIFIED PARTIES TO SATISFY INDEMNITY CLAIMS OF SUCH BUYER INDEMNIFIED PARTIES SHALL BE RELEASED BY THE ESCROW AGENT TO PRAIRIE SURGICENTER ASSOCIATES ON THE FIRST ANNIVERSARY OF THE CLOSING DATE; PROVIDED, HOWEVER, THAT IF ON OR PRIOR TO SUCH DATE A BUYER INDEMNIFIED PARTY HAS, IN GOOD FAITH GIVEN NOTICE TO THE ESCROW AGENT AND PRAIRIE SURGICENTER ASSOCIATES OF ANY CLAIM OR LIABILITY FOR WHICH SUCH BUYER INDEMNIFIED PARTY IS DULY ENTITLED TO INDEMNIFICATION BY PRAIRIE SURGICENTER ASSOCIATES, A PORTION OF THE ESCROW AMOUNT EQUAL TO THE AGGREGATE AMOUNT THAT WOULD BE PAYABLE TO SUCH BUYER INDEMNIFIED IF IT WERE DETERMINED TO BE ENTITLED TO INDEMNIFICATION WITH RESPECT TO SUCH CLAIM OR LIABILITY IS RESOLVED. SJS AND PRAIRIE SURGICENTER ASSOCIATES WILL EACH BE RESPONSIBLE FOR ONE-HALF OF THE FEES AND EXPENSES OF THE ESCROW AGENT.
Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote	HSHS AND THE FOUNDATION ARE ILLINOIS NOT FOR PROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASIS AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING THE ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN INCOME IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. IN ASSESSING THE REALIZABILITY OF DEFERRED TAX ASSETS, MANAGEMENT CONSIDERS WHETHER IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED. THE ULTIMATE REALIZATION OF DEFERRED TAX ASSETS IS DEPENDENT UPON THE GENERATION OF FUTURE TAXABLE INCOME DURING THE PERIODS IN WHICH THOSE TEMPORARY DIFFERENCES BECOME DEDUCTIBLE. MANAGEMENT CONSIDERS PROJECTED FUTURE TAXABLE INCOME AND TAX PLANNING STRATEGIES IN MAKING THIS ASSESSMENT. BASED UPON THE LEVEL OF HISTORICAL TAXABLE LOSSES AND PROJECTIONS FOR FUTURE TAXABLE LOSSES OVER THE PERIODS FOR WHICH THE DEFERRED TAX ASSETS ARE DEDUCTIBLE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT KIARA, INC. WILL NOT REALIZE THE MAJORITY OF THE BENEFITS OF THESE DEDUCTIBLE DIFFERENCES. THE DEFERRED TAX ASSETS ATTRIBUTABLE TO THE NET OPERATING LOSS CARRYFORWARDS NOT REALIZED AS OF JUNE 30, 2014 AND 2013 HAVE BEEN FULLY RESERVED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DUE TO THE UNCERTAINTY OF REALIZATION. HSHS RECOGNIZES THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. AS OF JUNE 30, 2014 AND 2013, HSHS DOES NOT HAVE ANY LIABILITIES FOR UNRECOGNIZED TAX BENEFITS.

Return Reference

Explanation

Schedule D, Part IV, Line 2b, Explanation of escrow agreement

IN FISCAL YEAR 2014, ST JOHN'S PURCHASED THE TANGIBLE AND INTANGIBLE ASSETS OF THE AMBULATORY SURGERY CENTER LOCATED AT 2020 WEST ILES AVENUE, SPRINGFILED, ILLINOIS FROM PRAIRIE SURGICENTER ASSOCIATES. AS PART OF THAT PURCHASE AGREEMENT 15% OF THE PURCHASE PRICE, $1,275,000 (ESCROW AMOUNT) WAS DEPOSITED BY THE BUYER (SJS) WITH JP MORGAN CHASE BANK (THE ESCROW AGENT) VIA FEDERAL WIRE TRANSFER TO AN ACCOUNT ESTABLISHED BY THE ESCROW AGENT PRIOR TO THE CLOSING DATE. ANY PORTION OF THE ESCROW AMOUNT THAT HAS NOT BEEN PAID BY THE ESCROW AGENT TO BUYER INDEMNIFIED PARTIES TO SATISFY INDEMNITY CLAIMS OF SUCH BUYER INDEMNIFIED PARTIES SHALL BE RELEASED BY THE ESCROW AGENT TO PRAIRIE SURGICENTER ASSOCIATES ON THE FIRST ANNIVERSARY OF THE CLOSING DATE; PROVIDED, HOWEVER, THAT IF ON OR PRIOR TO SUCH DATE A BUYER INDEMNIFIED PARTY HAS, IN GOOD FAITH GIVEN NOTICE TO THE ESCROW AGENT AND PRAIRIE SURGICENTER ASSOCIATES OF ANY CLAIM OR LIABILITY FOR WHICH SUCH BUYER INDEMNIFIED PARTY IS DULY ENTITLED TO INDEMNIFICATION BY PRAIRIE SURGICENTER ASSOCIATES, A PORTION OF THE ESCROW AMOUNT EQUAL TO THE AGGREGATE AMOUNT THAT WOULD BE PAYABLE TO SUCH BUYER INDEMNIFIED IF IT WERE DETERMINED TO BE ENTITLED TO INDEMNIFICATION WITH RESPECT TO SUCH CLAIM OR LIABILITY IS RESOLVED. SJS AND PRAIRIE SURGICENTER ASSOCIATES WILL EACH BE RESPONSIBLE FOR ONE-HALF OF THE FEES AND EXPENSES OF THE ESCROW AGENT.

Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote

HSHS AND THE FOUNDATION ARE ILLINOIS NOT FOR PROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASIS AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING THE ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN INCOME IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. IN ASSESSING THE REALIZABILITY OF DEFERRED TAX ASSETS, MANAGEMENT CONSIDERS WHETHER IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED. THE ULTIMATE REALIZATION OF DEFERRED TAX ASSETS IS DEPENDENT UPON THE GENERATION OF FUTURE TAXABLE INCOME DURING THE PERIODS IN WHICH THOSE TEMPORARY DIFFERENCES BECOME DEDUCTIBLE. MANAGEMENT CONSIDERS PROJECTED FUTURE TAXABLE INCOME AND TAX PLANNING STRATEGIES IN MAKING THIS ASSESSMENT. BASED UPON THE LEVEL OF HISTORICAL TAXABLE LOSSES AND PROJECTIONS FOR FUTURE TAXABLE LOSSES OVER THE PERIODS FOR WHICH THE DEFERRED TAX ASSETS ARE DEDUCTIBLE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT KIARA, INC. WILL NOT REALIZE THE MAJORITY OF THE BENEFITS OF THESE DEDUCTIBLE DIFFERENCES. THE DEFERRED TAX ASSETS ATTRIBUTABLE TO THE NET OPERATING LOSS CARRYFORWARDS NOT REALIZED AS OF JUNE 30, 2014 AND 2013 HAVE BEEN FULLY RESERVED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DUE TO THE UNCERTAINTY OF REALIZATION. HSHS RECOGNIZES THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. AS OF JUNE 30, 2014 AND 2013, HSHS DOES NOT HAVE ANY LIABILITIES FOR UNRECOGNIZED TAX BENEFITS.

Schedule D (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

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

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

Employer identification number

37-0661238

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

200% 250% 300% 350% 400% Other 600 %

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..			7,437,483		7,437,483	1.610 %
b	Medicaid (from Worksheet 3, column a) ....			98,873,832	93,536,548	5,337,284	1.160 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs .	0	0	106,311,315	93,536,548	12,774,767	2.770 %
Other Benefits				1,297,926	525	1,297,401	0.280 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..			1,297,926	525	1,297,401	0.280 %
f	Health professions education (from Worksheet 5) ..			18,762,156	5,992,859	12,769,297	2.770 %
g	Subsidized health services (from Worksheet 6) ..			145,688		145,688	0.030 %
h	Research (from Worksheet 7)			582,000		582,000	0.130 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)			751,950		751,950	0.160 %
j	Total. Other Benefits ..	0	0	21,539,720	5,993,384	15,546,336	3.370 %
k	Total. Add lines 7d and 7j .	0	0	127,851,035	99,529,932	28,321,103	6.140 %

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

Schedule H (Form 990) 2013

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing					0	0 %
2	Economic development					0	0 %
3	Community support	5		29,801		29,801	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members	1		0		0	0 %
6	Coalition building	2		28,838	3,250	25,588	0 %
7	Community health improvement advocacy	1		0		0	0 %
8	Workforce development	2		4,411	0	4,411	0 %
9	Other					0	0 %
10	Total	11	0	63,050	3,250	59,800	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

28,110,656

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. ......

1,205,947

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).....

130,342,051

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

161,440,196

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

-31,098,145

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 %
1PRAIRIE HEART INSTITUTE ST JOHN'S LLC	HEALTH CARE	50 %
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?1 Name, address, primary website address, and state license number
1	ST JOHN'S HOSPITAL 800 EAST CARPENTER STREET SPRINGFIELD,IL62769 HTTPS://WWW.ST-JOHNS.ORG/ 1927332	X	X	X	X	X

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	ST JOHN'S HOSPITAL
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 11

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): https://www.st-johns.org/stjohns/community-needs-assessment.aspx

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 ........

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

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

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

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: 600% 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
Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment	(1) - ST. JOHN'S HOSPITAL: ST. JOHN'S HOSPITAL COMMISSIONED A SURVEY THROUGH LEEDE RESEARCH TO HELP GAUGE THE NEEDS OF THE POPULATION IN SANGAMON AND THE COLLAR COUNTIES. IN ADDITION TO THIS SURVEY AND THE RESULTING DATA, SECONDARY DATA FROM THE *BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, THE ILLINOIS PLANNING FOR LOCAL ASSESSMENT OF NEED (IPLAN), AND OTHER SOURCES WERE ALSO INCLUDED IN THE ASSESSMENT PROCESS. PRIMARY DATA FOR THE STUDY WAS COLLECTED BY LEEDE RESEARCH USING A TELEPHONE SURVEY WITH THE GOAL OF MEASURING COMMUNITY HEALTH, IDENTIFYING SENSITIVE HEALTH ISSUES IN THE COMMUNITY AND EXPLORING PERCEPTIONS OF HEALTH ISSUES IN THE COMMUNITY. THE SURVEY WAS DEVELOPED THROUGH WORK BETWEEN ST. JOHN'S HOSPITAL, LEEDE RESEARCH AND HOSPITAL SISTERS HEALTH SYSTEM (HSHS). THE SURVEY TOOL WAS APPROVED BY THE INTERNAL COMMUNITY BENEFIT COMMITTEE, MADE UP OF ST. JOHN'S HOSPITAL COLLEAGUES, AND THE COMMUNITY BENEFIT SUB COMMITTEE, MADE UP OF COMMUNITY STAKEHOLDERS. THE SURVEY REGION CONSISTED OF SANGAMON COUNTY AND ITS COLLAR COUNTIES. THE ONLY EXCEPTION WAS MONTGOMERY COUNTY, WHICH WAS NOT INCLUDED BECAUSE IT IS SERVED BY ANOTHER SYSTEM HOSPITAL. THESE ARE THE AREAS FROM WHICH ST. JOHN'S HOSPITAL PATIENTS MOST COMMONLY COME. A TOTAL OF 400 COMPLETED INTERVIEWS WERE CONDUCTED IN THIS STUDY. THE SAMPLE USED IN THE STUDY WAS PROVIDED BY NATIONAL SAMPLE SOURCE SURVEY SAMPLING AND WAS A REPRESENTATIVE SAMPLE OF MEMBERS IN THE TARGETED GEOGRAPHIC AREA AT THE TIME OF THE STUDY. A PROPORTIONATE STRATIFIED SAMPLE WAS USED TO GIVE THE ENTIRE SERVICE AREA EQUAL REPRESENTATION BY ZIP CODE POPULATION. USING UNLIMITED POPULATION SAMPLING, THE STUDY RESULTED IN A MAXIMUM ERROR OF +/- 4/9% BASED ON 95% CONFIDENCE. LEEDE RESEARCH COMPLETED ALL VALIDATION, REPORTING, ANALYSIS AND PRESENTATION MATERIALS. LEEDE RESEARCH REVIEWED PRELIMINARY DATA FROM THE STUDY COMPARED TO DEMOGRAPHIC INFORMATION FROM THE SERVICE AREA, AND ON THE BASIS OF THIS REVIEW, THEY DETERMINED THAT THE SAMPLE REQUIRED WEIGHTED ADJUSTMENTS TO AGE AND INCOME RATIOS. THE YOUNGER AND POPULATIONS AND LOWER INCOME LEVELS WERE UNDER-REPRESENTED IN THE OVERALL STUDY. LEEDE RESEARCH WEIGHTED THE STUDY SAMPLE BY AGE AND INCOME TO MORE ACCURATELY MATCH THE ACTUAL POPULATION OF THE SERVICE AREA. THE GOAL OF THIS WEIGHTING WAS THE IMPROVEMENT OF THE OVERALL ACCURACY OF THE INFORMATION TO BETTER IDENTIFY COMMUNITY NEEDS. THIS FORMED THE BASIS OF THE ANALYSIS OF THE SURVEY DATA. SECONDARY DATA FOR THIS ASSESSMENT WAS GATHERED FROM SOURCES SUCH AS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, IPLAN AND THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH (IDPH). THIS SECONDARY DATA HELPED TO INFORM CONCERNS BROUGHT UP THROUGH THE NEEDS ASSESSMENT PROCESS. AT EACH STEP OF THE PROCESS, MEMBERS OF THE INTERNAL COMMUNITY BENEFIT COMMITTEE AND COMMUNITY BENEFIT SUB COMMITTEE WERE ASKED TO REVIEW THE DATA, TOOLS AND RESULTS OF THE RESEARCH, AND THEIR INPUT WAS INCLUDED TO MAXIMIZE THE RELEVANCE AND EFFECTIVENESS OF THE RESEARCH. COMMUNITY REPRESENTATION THE AGE BREAKDOWN OF THE RESPONDENTS TO THE TELEPHONE SURVEY WAS 23.8% IN THE 18-34 GROUP, 39.1% IN THE AGES OF 35-54, 22.8% IN THE 55-74 AGE GROUP AND 14.4% OF RESPONDENTS WERE 75+. THE MAJORITY (61.0%) OF RESPONDENTS WERE MARRIED, WHILE 13.4% WERE SINGLE, 13.6% SEPARATED, 11.7% WERE DIVORCED AND 0.3% WERE WIDOWED. FIFTY-FIVE PERCENT OF RESPONDENTS HAD CHILDREN LIVING AT HOME. EIGHTY-NINE PERCENT OF RESPONDENTS WERE CAUCASIAN, WITH 5.5% AFRICAN AMERICAN AND THE REMAINDER A MIXTURE OF OTHER RACES AND MULTIRACIAL INDIVIDUALS. THIRTY-THREE PERCENT OF THE STUDY GROUP WERE HIGH SCHOOL GRADUATES OR GED HOLDERS, 20.4% HAD COMPLETED SOME COLLEGE OR A TECHNICAL SCHOOL. THREE PERCENT HAD COMPLETED A TECHNICAL DEGREE, 28.7% WERE FOUR YEAR DEGREE HOLDERS AND 13.2% HAD AN ADVANCED OR PROFESSIONAL DEGREE. THE INCOME BREAK DOWN RESULTED IN A MAJORITY OF THE POPULATION FALLING BETWEEN 35,000 AND 99,999 ANNUAL HOUSEHOLD INCOME. ABOUT 35% OF THE POPULATION WAS BELOW $35,000, AND LESS THAN 10% WAS AT $100,000 OR HIGHER. SIXTY-TWO PERCENT OF RESPONDENTS WERE FEMALE AND 37.9% WERE MALE. THE COMMUNITY BENEFIT SUB COMMITTEE ALSO REPRESENTED THE COMMUNITY IN THIS NEEDS ASSESSMENT PROCESS. THIS GROUP INCLUDES LOCAL HEALTH CARE PROVIDERS; HOSPITAL REPRESENTATIVES; PUBLIC HEALTH OFFICIALS ; COMMUNITY STAKEHOLDERS INCLUDING NONPROFIT EMPLOYEES WORKING WITH UNDERSERVED COMMUNITIES; SCHOOL BOARD AND DISTRICT REPRESENTATIVES; AND LEADERS AND REPRESENTATIVES OF UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. PUBLIC HEALTH OFFICIALS SERVING ON THE COMMITTEE WERE ALSO ABLE TO REPRESENT THE NEEDS OF PERSONS WITH CHRONIC DISEASES. THE COMMUNITY BENEFIT SUB COMMITTEE WAS ORGANIZED TO 1) TO GUIDE AND PARTICIPATE IN THE PLANNING, DEVELOPMENT AND IMPLEMENTATION OF PROJECTS AND PROGRAMS AIMED AT IMPROVING THE HEALTH OF THE ST. JOHN'S HOSPITAL SERVICE AREA; 2) TO ADDRESS THE NEEDS OF THOSE COMMUNITIES WHERE THERE ARE DISPROPORTIONATE UNMET HEALTH NEEDS AND 3) TO ENSURE ST. JOHN'S REMAINS COMMITTED TO ITS CHARITABLE MISSION BY IMPROVING THE QUALITY OF LIVES IN SANGAMON COUNTY AND THE SURROUNDING REGION. THE COMMITTEE IS RESPONSIBLE FOR RECOMMENDING AND OVERSEEING COMMUNITY BENEFIT POLICIES AND PROGRAMS DESIGNED TO CARRY OUT THE MISSION OF ST. JOHN'S HOSPITAL TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES TO THE PEOPLE OF CENTRAL ILLINOIS. ;
Schedule H, Part V Sec B, Line 5a, Hospital Facility's Website (list URL)	(1) - ST. JOHN'S HOSPITAL: HTTPS://WWW.ST-JOHNS.ORG/STJOHNS/COMMUNITY-NEEDS-ASSESSMENT.ASPX;
Schedule H, Part V Sec B, Line 5d, Availability of Needs Assessment	(1) - ST. JOHN'S HOSPITAL: ORGANIZATIONS MAKING UP OUR COMMUNITY BENEFIT SUB COMMITTEE RECEIVED COPIES TO SHARE WITH THEIR CONSTITUENTS. THE DOCUMENT IS ALSO AVAILABLE THROUGH OUR HEALTH SCIENCES LIBRARY AND MAY BE OBTAINED BY CALLING COMMUNITY RELATIONS: (217) 814-4308.;
Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment	(1) - ST. JOHN'S HOSPITAL: TWENTY TOP ISSUES WERE UNCOVERED FROM PRIMARY AND SECONDARY DATA GATHERED THROUGH THE SURVEY AND EXISTING DATA SETS INCLUDING: BLOOD PRESSURE, CHILDHOOD OBESITY, HIGH CHOLESTEROL, DIABETES, SMOKING, ASTHMA, HEART DISEASE, STROKE, FRUIT AND VEGETABLE CONSUMPTION, FAST FOOD CONSUMPTION, EXERCISE, MENTAL HEALTH, DRUG USE, DRINKING, TEEN PREGNANCY, SEXUALLY TRANSMITTED DISEASES, LACK OF MOTIVATION, LACK OF EXERCISE TOOLS, FLU SHOTS, AND BICYCLE HELMETS. BEFORE PRIORITIZING NEEDS, THE INTERNAL COMMUNITY BENEFIT COMMITTEE WAS PROVIDED A LIST OF THE TOP 20 NEEDS DERIVED FROM OUR PRIMARY AND SECONDARY DATA COLLECTION. OUR INTERNAL COMMUNITY BENEFIT COMMITTEE IS COMPRISED OF LEADERS AND PHYSICIAN EXPERTS FROM ST. JOHN'S HOSPITAL. MEMBERS GAVE INPUT THAT COMBINED VARIOUS ISSUES ACCORDING TO COMMON FACTORS, YIELDING A LIST OF TEN PRIORITIES INCLUDING: METABOLIC SYNDROME, CARDIOVASCULAR DISEASE, LIFESTYLE, ASTHMA, MENTAL HEALTH, HEALTH ENVIRONMENT, SUBSTANCE ABUSE, TEEN PREGNANCY, BICYCLE HELMETS, AND SEXUALLY TRANSMITTED INFECTIONS. THIS GROUPING OF TEN IDENTIFIED NEEDS WAS THEN SUBMITTED TO THE EXTERNAL COMMUNITY BENEFIT SUB COMMITTEE AND PRIORITIZED TO ADDRESS THE THREE TOP NEEDS BY RANKING EACH ISSUE BY MAGNITUDE, SERIOUSNESS AND FEASIBILITY. ABOUT HALF OF THE ORIGINAL NEEDS WERE COMBINED WITH OTHER PRIORITY AREAS IN ORDER TO NARROW THE LIST DOWN FROM THE ORIGINAL TWENTY AREAS OF NEED. OF THE TEN THAT WERE RANKED BY THE INTERNAL AND EXTERNAL COMMITTEES, SEVEN WERE NOT CONSIDERED A PRIMARY FOCUS FOR ST. JOHN'S HOSPITAL. THIS DECISION WAS MADE BASED ON TWO PRIMARY FACTORS: 1. THE NEED IS CURRENTLY BEING ADDRESSED BY ANOTHER ORGANIZATION IN THE COMMUNITY; AND 2. THERE IS ANOTHER ORGANIZATION WITHIN THE COMMUNITY BETTER EQUIPPED TO ADDRESS THE NEED. WHILE THE LIST BELOW WILL NOT BE AREAS OF PRIMARY FOCUS FOR ST. JOHN'S, THE HOSPITAL WILL CONTINUE TO PARTICIPATE IN EFFORTS WITH OTHER ORGANIZATIONS AS APPROPRIATE AND WHERE THE HOSPITAL CAN LEND SUPPORT. - ASTHMA REMAINS A CONCERN IN THE COMMUNITY BECAUSE SANGAMON COUNTY HAS IMPORTANT RISK FACTORS SUCH AS POPULATION DENSITY AND DEMOGRAPHICS. THE MOST IMPORTANT ACTOR AGAINST ASTHMA IS THE LOCAL PUBLIC HEALTH DEPARTMENT WHICH EDUCATES AND HELPS TO TREAT AFFECTED COMMUNITY MEMBERS. - HEALTH ENVIRONMENT: NONPROFIT GROUPS SUCH AS GENH AND OTHERS ARE WORKING TO EXPAND HEALTHY OPTIONS IN THE LOCAL AREA. - SUBSTANCE ABUSE: THE GATEWAY FOUNDATION AND THE TRIANGLE CENTER BOTH WORK TO FIGHT SUBSTANCE ABUSE IN SANGAMON COUNTY IN ADDITION TO PUBLIC HEALTH EDUCATION AND LAW ENFORCEMENT PROGRAMS. - TEEN PREGNANCY: ORGANIZATIONS LIKE THE SPRINGFIELD PREGNANCY CENTER OPERATE IN SANGAMON COUNTY AND ARE ONE OF THE MAIN SOURCES OF RELIEF FROM THIS ISSUE FOR COMMUNITY MEMBERS. - BICYCLE HELMETS: ST. JOHNS AND OTHER ORGANIZATIONS CURRENTLY PROVIDE FREE HELMETS TO CHILDREN. - SEXUALLY TRANSMITTED INFECTIONS: ORGANIZATIONS SUCH AS THE SANGAMON COUNTY DEPARTMENT OF PUBLIC HEALTH ARE PROVIDING RELIEF FROM THIS ISSUE FOR COMMUNITY MEMBERS. - MENTAL HEALTH: THE SANGAMON COUNTY DEPARTMENT OF PUBLIC HEALTH IS ONE OF THE MAIN ORGANIZATIONS FOR MENTAL HEALTH SUPPORT IN THE AREA. OVER 20 OTHER ORGANIZATIONS OR RESOURCES EXIST IN AND AROUND THE COLLAR COUNTIES INCLUDING THE NATIONAL ALLIANCE FOR THE MENTALLY ILL AND MACOUPIN COUNTY MENTAL HEALTH. DUE TO A PREVALENT NEED FOR MENTAL HEALTH SERVICES, ST. JOHN'S HOSPITAL HAS DECIDED TO PUT A GROUP IN PLACE TO LOOK AT THE EXPANSION OF INTERNAL SERVICES AND PARTNERSHIPS WITH EXTERNAL SERVICES. IT IS OUR HOPE TO BETTER POSITION THE HOSPITAL AND COMMUNITY PARTNERS TO ADDRESS MENTAL HEALTH NEEDS IN THE FUTURE. ;
Schedule H, Part V Sec B, Line 14g, Other ways hospital publicized Financial Assistance Policy	(1) - ST. JOHN'S HOSPITAL: COMMUNICATION/NOTIFICATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY FROM HSHS INCLUDES THE FOLLOWING: A. FINANCIAL ASSISTANCE APPLICATIONS: THE FINANCIAL ASSISTANCE APPLICATION IS PROVIDED TO PATIENTS UPON REQUEST AND THROUGHOUT THE REGISTRATION AND POSTREGISTRATION PROCESS. THIS APPLICATION COMPLIES WITH CURRENT ILLINOIS AND WISCONSIN STATUTES AND ANY APPLICABLE FEDERAL STATUTES. B. POSTERS: THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM IS ADVERTISED ON POSTER-SIZED SIGNAGE LOCATED IN ADMISSIONS, OUTPATIENT, WAITING ROOM AREAS. A TOLL-FREE PHONE NUMBER IS INCLUDED. C. BROCHURES: BROCHURES OUTLINING THE FINANCIAL ASSISTANCE PROGRAM, APPLICATION PROCESS AND TOLL-FREE PHONE NUMBER ARE AVAILABLE AT ALL PATIENT REGISTRATION DESKS AND IN ALL WAITING AREAS. D. INTERNET: THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM AND ILLINOIS UNINSURED DISCOUNT ACT OF 2009 ARE POSTED ON THE HSHS INTERNET HOME PAGE. E. PATIENT STATEMENTS: EACH BILL, INVOICE OR OTHER SUMMARY OF CHARGES TO AN UNINSURED PATIENT INCLUDES WITH IT, OR ON IT, A PROMINENT STATEMENT THAT AN UNINSURED PATIENT WHO MEETS CERTAIN INCOME REQUIREMENTS MAY QUALIFY FOR AN UNINSURED DISCOUNT AND INFORMATION REGARDING HOW AN UNINSURED PATIENT MAY APPLY FOR CONSIDERATION UNDER THE HSHS FINANCIAL ASSISTANCE PROGRAM. IN ADDITION, REFERRAL OF PATIENTS MAY BE MADE BY ANY MEMBER OF THE HSHS STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAIN'S, AND RELIGIOUS SPONSORS. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.;

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
Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment	(1) - ST. JOHN'S HOSPITAL: ST. JOHN'S HOSPITAL COMMISSIONED A SURVEY THROUGH LEEDE RESEARCH TO HELP GAUGE THE NEEDS OF THE POPULATION IN SANGAMON AND THE COLLAR COUNTIES. IN ADDITION TO THIS SURVEY AND THE RESULTING DATA, SECONDARY DATA FROM THE *BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, THE ILLINOIS PLANNING FOR LOCAL ASSESSMENT OF NEED (IPLAN), AND OTHER SOURCES WERE ALSO INCLUDED IN THE ASSESSMENT PROCESS. PRIMARY DATA FOR THE STUDY WAS COLLECTED BY LEEDE RESEARCH USING A TELEPHONE SURVEY WITH THE GOAL OF MEASURING COMMUNITY HEALTH, IDENTIFYING SENSITIVE HEALTH ISSUES IN THE COMMUNITY AND EXPLORING PERCEPTIONS OF HEALTH ISSUES IN THE COMMUNITY. THE SURVEY WAS DEVELOPED THROUGH WORK BETWEEN ST. JOHN'S HOSPITAL, LEEDE RESEARCH AND HOSPITAL SISTERS HEALTH SYSTEM (HSHS). THE SURVEY TOOL WAS APPROVED BY THE INTERNAL COMMUNITY BENEFIT COMMITTEE, MADE UP OF ST. JOHN'S HOSPITAL COLLEAGUES, AND THE COMMUNITY BENEFIT SUB COMMITTEE, MADE UP OF COMMUNITY STAKEHOLDERS. THE SURVEY REGION CONSISTED OF SANGAMON COUNTY AND ITS COLLAR COUNTIES. THE ONLY EXCEPTION WAS MONTGOMERY COUNTY, WHICH WAS NOT INCLUDED BECAUSE IT IS SERVED BY ANOTHER SYSTEM HOSPITAL. THESE ARE THE AREAS FROM WHICH ST. JOHN'S HOSPITAL PATIENTS MOST COMMONLY COME. A TOTAL OF 400 COMPLETED INTERVIEWS WERE CONDUCTED IN THIS STUDY. THE SAMPLE USED IN THE STUDY WAS PROVIDED BY NATIONAL SAMPLE SOURCE SURVEY SAMPLING AND WAS A REPRESENTATIVE SAMPLE OF MEMBERS IN THE TARGETED GEOGRAPHIC AREA AT THE TIME OF THE STUDY. A PROPORTIONATE STRATIFIED SAMPLE WAS USED TO GIVE THE ENTIRE SERVICE AREA EQUAL REPRESENTATION BY ZIP CODE POPULATION. USING UNLIMITED POPULATION SAMPLING, THE STUDY RESULTED IN A MAXIMUM ERROR OF +/- 4/9% BASED ON 95% CONFIDENCE. LEEDE RESEARCH COMPLETED ALL VALIDATION, REPORTING, ANALYSIS AND PRESENTATION MATERIALS. LEEDE RESEARCH REVIEWED PRELIMINARY DATA FROM THE STUDY COMPARED TO DEMOGRAPHIC INFORMATION FROM THE SERVICE AREA, AND ON THE BASIS OF THIS REVIEW, THEY DETERMINED THAT THE SAMPLE REQUIRED WEIGHTED ADJUSTMENTS TO AGE AND INCOME RATIOS. THE YOUNGER AND POPULATIONS AND LOWER INCOME LEVELS WERE UNDER-REPRESENTED IN THE OVERALL STUDY. LEEDE RESEARCH WEIGHTED THE STUDY SAMPLE BY AGE AND INCOME TO MORE ACCURATELY MATCH THE ACTUAL POPULATION OF THE SERVICE AREA. THE GOAL OF THIS WEIGHTING WAS THE IMPROVEMENT OF THE OVERALL ACCURACY OF THE INFORMATION TO BETTER IDENTIFY COMMUNITY NEEDS. THIS FORMED THE BASIS OF THE ANALYSIS OF THE SURVEY DATA. SECONDARY DATA FOR THIS ASSESSMENT WAS GATHERED FROM SOURCES SUCH AS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, IPLAN AND THE ILLINOIS DEPARTMENT OF PUBLIC HEALTH (IDPH). THIS SECONDARY DATA HELPED TO INFORM CONCERNS BROUGHT UP THROUGH THE NEEDS ASSESSMENT PROCESS. AT EACH STEP OF THE PROCESS, MEMBERS OF THE INTERNAL COMMUNITY BENEFIT COMMITTEE AND COMMUNITY BENEFIT SUB COMMITTEE WERE ASKED TO REVIEW THE DATA, TOOLS AND RESULTS OF THE RESEARCH, AND THEIR INPUT WAS INCLUDED TO MAXIMIZE THE RELEVANCE AND EFFECTIVENESS OF THE RESEARCH. COMMUNITY REPRESENTATION THE AGE BREAKDOWN OF THE RESPONDENTS TO THE TELEPHONE SURVEY WAS 23.8% IN THE 18-34 GROUP, 39.1% IN THE AGES OF 35-54, 22.8% IN THE 55-74 AGE GROUP AND 14.4% OF RESPONDENTS WERE 75+. THE MAJORITY (61.0%) OF RESPONDENTS WERE MARRIED, WHILE 13.4% WERE SINGLE, 13.6% SEPARATED, 11.7% WERE DIVORCED AND 0.3% WERE WIDOWED. FIFTY-FIVE PERCENT OF RESPONDENTS HAD CHILDREN LIVING AT HOME. EIGHTY-NINE PERCENT OF RESPONDENTS WERE CAUCASIAN, WITH 5.5% AFRICAN AMERICAN AND THE REMAINDER A MIXTURE OF OTHER RACES AND MULTIRACIAL INDIVIDUALS. THIRTY-THREE PERCENT OF THE STUDY GROUP WERE HIGH SCHOOL GRADUATES OR GED HOLDERS, 20.4% HAD COMPLETED SOME COLLEGE OR A TECHNICAL SCHOOL. THREE PERCENT HAD COMPLETED A TECHNICAL DEGREE, 28.7% WERE FOUR YEAR DEGREE HOLDERS AND 13.2% HAD AN ADVANCED OR PROFESSIONAL DEGREE. THE INCOME BREAK DOWN RESULTED IN A MAJORITY OF THE POPULATION FALLING BETWEEN 35,000 AND 99,999 ANNUAL HOUSEHOLD INCOME. ABOUT 35% OF THE POPULATION WAS BELOW $35,000, AND LESS THAN 10% WAS AT $100,000 OR HIGHER. SIXTY-TWO PERCENT OF RESPONDENTS WERE FEMALE AND 37.9% WERE MALE. THE COMMUNITY BENEFIT SUB COMMITTEE ALSO REPRESENTED THE COMMUNITY IN THIS NEEDS ASSESSMENT PROCESS. THIS GROUP INCLUDES LOCAL HEALTH CARE PROVIDERS; HOSPITAL REPRESENTATIVES; PUBLIC HEALTH OFFICIALS ; COMMUNITY STAKEHOLDERS INCLUDING NONPROFIT EMPLOYEES WORKING WITH UNDERSERVED COMMUNITIES; SCHOOL BOARD AND DISTRICT REPRESENTATIVES; AND LEADERS AND REPRESENTATIVES OF UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. PUBLIC HEALTH OFFICIALS SERVING ON THE COMMITTEE WERE ALSO ABLE TO REPRESENT THE NEEDS OF PERSONS WITH CHRONIC DISEASES. THE COMMUNITY BENEFIT SUB COMMITTEE WAS ORGANIZED TO 1) TO GUIDE AND PARTICIPATE IN THE PLANNING, DEVELOPMENT AND IMPLEMENTATION OF PROJECTS AND PROGRAMS AIMED AT IMPROVING THE HEALTH OF THE ST. JOHN'S HOSPITAL SERVICE AREA; 2) TO ADDRESS THE NEEDS OF THOSE COMMUNITIES WHERE THERE ARE DISPROPORTIONATE UNMET HEALTH NEEDS AND 3) TO ENSURE ST. JOHN'S REMAINS COMMITTED TO ITS CHARITABLE MISSION BY IMPROVING THE QUALITY OF LIVES IN SANGAMON COUNTY AND THE SURROUNDING REGION. THE COMMITTEE IS RESPONSIBLE FOR RECOMMENDING AND OVERSEEING COMMUNITY BENEFIT POLICIES AND PROGRAMS DESIGNED TO CARRY OUT THE MISSION OF ST. JOHN'S HOSPITAL TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES TO THE PEOPLE OF CENTRAL ILLINOIS. ;
Schedule H, Part V Sec B, Line 5a, Hospital Facility's Website (list URL)	(1) - ST. JOHN'S HOSPITAL: HTTPS://WWW.ST-JOHNS.ORG/STJOHNS/COMMUNITY-NEEDS-ASSESSMENT.ASPX;
Schedule H, Part V Sec B, Line 5d, Availability of Needs Assessment	(1) - ST. JOHN'S HOSPITAL: ORGANIZATIONS MAKING UP OUR COMMUNITY BENEFIT SUB COMMITTEE RECEIVED COPIES TO SHARE WITH THEIR CONSTITUENTS. THE DOCUMENT IS ALSO AVAILABLE THROUGH OUR HEALTH SCIENCES LIBRARY AND MAY BE OBTAINED BY CALLING COMMUNITY RELATIONS: (217) 814-4308.;
Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment	(1) - ST. JOHN'S HOSPITAL: TWENTY TOP ISSUES WERE UNCOVERED FROM PRIMARY AND SECONDARY DATA GATHERED THROUGH THE SURVEY AND EXISTING DATA SETS INCLUDING: BLOOD PRESSURE, CHILDHOOD OBESITY, HIGH CHOLESTEROL, DIABETES, SMOKING, ASTHMA, HEART DISEASE, STROKE, FRUIT AND VEGETABLE CONSUMPTION, FAST FOOD CONSUMPTION, EXERCISE, MENTAL HEALTH, DRUG USE, DRINKING, TEEN PREGNANCY, SEXUALLY TRANSMITTED DISEASES, LACK OF MOTIVATION, LACK OF EXERCISE TOOLS, FLU SHOTS, AND BICYCLE HELMETS. BEFORE PRIORITIZING NEEDS, THE INTERNAL COMMUNITY BENEFIT COMMITTEE WAS PROVIDED A LIST OF THE TOP 20 NEEDS DERIVED FROM OUR PRIMARY AND SECONDARY DATA COLLECTION. OUR INTERNAL COMMUNITY BENEFIT COMMITTEE IS COMPRISED OF LEADERS AND PHYSICIAN EXPERTS FROM ST. JOHN'S HOSPITAL. MEMBERS GAVE INPUT THAT COMBINED VARIOUS ISSUES ACCORDING TO COMMON FACTORS, YIELDING A LIST OF TEN PRIORITIES INCLUDING: METABOLIC SYNDROME, CARDIOVASCULAR DISEASE, LIFESTYLE, ASTHMA, MENTAL HEALTH, HEALTH ENVIRONMENT, SUBSTANCE ABUSE, TEEN PREGNANCY, BICYCLE HELMETS, AND SEXUALLY TRANSMITTED INFECTIONS. THIS GROUPING OF TEN IDENTIFIED NEEDS WAS THEN SUBMITTED TO THE EXTERNAL COMMUNITY BENEFIT SUB COMMITTEE AND PRIORITIZED TO ADDRESS THE THREE TOP NEEDS BY RANKING EACH ISSUE BY MAGNITUDE, SERIOUSNESS AND FEASIBILITY. ABOUT HALF OF THE ORIGINAL NEEDS WERE COMBINED WITH OTHER PRIORITY AREAS IN ORDER TO NARROW THE LIST DOWN FROM THE ORIGINAL TWENTY AREAS OF NEED. OF THE TEN THAT WERE RANKED BY THE INTERNAL AND EXTERNAL COMMITTEES, SEVEN WERE NOT CONSIDERED A PRIMARY FOCUS FOR ST. JOHN'S HOSPITAL. THIS DECISION WAS MADE BASED ON TWO PRIMARY FACTORS: 1. THE NEED IS CURRENTLY BEING ADDRESSED BY ANOTHER ORGANIZATION IN THE COMMUNITY; AND 2. THERE IS ANOTHER ORGANIZATION WITHIN THE COMMUNITY BETTER EQUIPPED TO ADDRESS THE NEED. WHILE THE LIST BELOW WILL NOT BE AREAS OF PRIMARY FOCUS FOR ST. JOHN'S, THE HOSPITAL WILL CONTINUE TO PARTICIPATE IN EFFORTS WITH OTHER ORGANIZATIONS AS APPROPRIATE AND WHERE THE HOSPITAL CAN LEND SUPPORT. - ASTHMA REMAINS A CONCERN IN THE COMMUNITY BECAUSE SANGAMON COUNTY HAS IMPORTANT RISK FACTORS SUCH AS POPULATION DENSITY AND DEMOGRAPHICS. THE MOST IMPORTANT ACTOR AGAINST ASTHMA IS THE LOCAL PUBLIC HEALTH DEPARTMENT WHICH EDUCATES AND HELPS TO TREAT AFFECTED COMMUNITY MEMBERS. - HEALTH ENVIRONMENT: NONPROFIT GROUPS SUCH AS GENH AND OTHERS ARE WORKING TO EXPAND HEALTHY OPTIONS IN THE LOCAL AREA. - SUBSTANCE ABUSE: THE GATEWAY FOUNDATION AND THE TRIANGLE CENTER BOTH WORK TO FIGHT SUBSTANCE ABUSE IN SANGAMON COUNTY IN ADDITION TO PUBLIC HEALTH EDUCATION AND LAW ENFORCEMENT PROGRAMS. - TEEN PREGNANCY: ORGANIZATIONS LIKE THE SPRINGFIELD PREGNANCY CENTER OPERATE IN SANGAMON COUNTY AND ARE ONE OF THE MAIN SOURCES OF RELIEF FROM THIS ISSUE FOR COMMUNITY MEMBERS. - BICYCLE HELMETS: ST. JOHNS AND OTHER ORGANIZATIONS CURRENTLY PROVIDE FREE HELMETS TO CHILDREN. - SEXUALLY TRANSMITTED INFECTIONS: ORGANIZATIONS SUCH AS THE SANGAMON COUNTY DEPARTMENT OF PUBLIC HEALTH ARE PROVIDING RELIEF FROM THIS ISSUE FOR COMMUNITY MEMBERS. - MENTAL HEALTH: THE SANGAMON COUNTY DEPARTMENT OF PUBLIC HEALTH IS ONE OF THE MAIN ORGANIZATIONS FOR MENTAL HEALTH SUPPORT IN THE AREA. OVER 20 OTHER ORGANIZATIONS OR RESOURCES EXIST IN AND AROUND THE COLLAR COUNTIES INCLUDING THE NATIONAL ALLIANCE FOR THE MENTALLY ILL AND MACOUPIN COUNTY MENTAL HEALTH. DUE TO A PREVALENT NEED FOR MENTAL HEALTH SERVICES, ST. JOHN'S HOSPITAL HAS DECIDED TO PUT A GROUP IN PLACE TO LOOK AT THE EXPANSION OF INTERNAL SERVICES AND PARTNERSHIPS WITH EXTERNAL SERVICES. IT IS OUR HOPE TO BETTER POSITION THE HOSPITAL AND COMMUNITY PARTNERS TO ADDRESS MENTAL HEALTH NEEDS IN THE FUTURE. ;
Schedule H, Part V Sec B, Line 14g, Other ways hospital publicized Financial Assistance Policy	(1) - ST. JOHN'S HOSPITAL: COMMUNICATION/NOTIFICATION ABOUT FINANCIAL ASSISTANCE AVAILABILITY FROM HSHS INCLUDES THE FOLLOWING: A. FINANCIAL ASSISTANCE APPLICATIONS: THE FINANCIAL ASSISTANCE APPLICATION IS PROVIDED TO PATIENTS UPON REQUEST AND THROUGHOUT THE REGISTRATION AND POSTREGISTRATION PROCESS. THIS APPLICATION COMPLIES WITH CURRENT ILLINOIS AND WISCONSIN STATUTES AND ANY APPLICABLE FEDERAL STATUTES. B. POSTERS: THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM IS ADVERTISED ON POSTER-SIZED SIGNAGE LOCATED IN ADMISSIONS, OUTPATIENT, WAITING ROOM AREAS. A TOLL-FREE PHONE NUMBER IS INCLUDED. C. BROCHURES: BROCHURES OUTLINING THE FINANCIAL ASSISTANCE PROGRAM, APPLICATION PROCESS AND TOLL-FREE PHONE NUMBER ARE AVAILABLE AT ALL PATIENT REGISTRATION DESKS AND IN ALL WAITING AREAS. D. INTERNET: THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM AND ILLINOIS UNINSURED DISCOUNT ACT OF 2009 ARE POSTED ON THE HSHS INTERNET HOME PAGE. E. PATIENT STATEMENTS: EACH BILL, INVOICE OR OTHER SUMMARY OF CHARGES TO AN UNINSURED PATIENT INCLUDES WITH IT, OR ON IT, A PROMINENT STATEMENT THAT AN UNINSURED PATIENT WHO MEETS CERTAIN INCOME REQUIREMENTS MAY QUALIFY FOR AN UNINSURED DISCOUNT AND INFORMATION REGARDING HOW AN UNINSURED PATIENT MAY APPLY FOR CONSIDERATION UNDER THE HSHS FINANCIAL ASSISTANCE PROGRAM. IN ADDITION, REFERRAL OF PATIENTS MAY BE MADE BY ANY MEMBER OF THE HSHS STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAIN'S, AND RELIGIOUS SPONSORS. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.;

Schedule H (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990
lBullet

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

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
ST JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

Employer identification number
37-0661238

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	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

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) FEDERAL WORK STUDY GRANT	7	8,481
(2) FEDERAL SUPPLEMENTAL EDUCATION OPPORTUNITY GRANT	14	7,665

Part IV

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

Return Reference	Explanation
Schedule I, Part I, Line 2, Procedures for monitoring use of grant funds	ST. JOHN'S HOSPITAL PARTICIPATES IN VARIOUS FEDERAL LOAN AND GRANT PROGRAMS. THESE PROGRAMS ARE ADMINISTERED IN ACCORDANCE WITH GUIDELINES ESTABLISHED BY THE U.S. DEPARTMENT OF EDUCATION, AND THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. THESE PROGRAMS ARE AUDITED ANNUALLY IN ACCORDANCE WITH OMB CIRCULAR A-133 "AUDITS OF INSTITUTIONS OF HIGHER EDUCATION AND OTHER NONPROFIT INSTITUTIONS".

Schedule I (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

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

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

Employer identification number

37-0661238

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2013

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)ROBERT RITZFORMER PRESIDENT & CEO	(i) (ii)	0 308,684	0 0	0 279,929	0 51,520	0 14,758	0 654,891	0 210,511
(2)LAWRENCE SCHUMACHERINTERIM PRESIDENT	(i) (ii)	0 658,748	0 185,209	0 390,861	0 178,777	0 25,741	0 1,439,336	0 332,388
(3)ANN M CARRTREASURER	(i) (ii)	0 223,926	0 38,138	0 56,891	0 236,713	0 18,355	0 574,023	0 24,602
(4)LARRY J RAGELCHIEF FINANCIAL OFFICER	(i) (ii)	290,797 0	62,273 0	44 0	67,000 0	21,518 0	441,632 0	0 0
(5)DAVID OLEJNICZAKCHIEF OPERATING OFFICER	(i) (ii)	386,853 0	16,444 0	44 0	67,541 0	21,715 0	492,597 0	0 0
(6)SHERRI A GREENWOODCHIEF NURSING OFFICER	(i) (ii)	223,850 0	6,174 0	44 0	40,406 0	21,332 0	291,806 0	0 0
(7)PATRICIA SCHULZCHIEF PEOPLE OFFICER	(i) (ii)	133,473 0	0 0	109,736 0	38,566 0	12,806 0	294,581 0	0 0
(8)EVERT J KUIPERCENTRAL ILLINOIS DIVISION CEO	(i) (ii)	0 2,250	0 100,000	0 55,959	0 0	0 0	0 158,209	0 0
(9)MARGARET L CURTINASST ADMINISTRATOR OF CHILDREN	(i) (ii)	213,717 0	50 0	44 0	55,919 0	8,648 0	278,378 0	0 0
(10)JIANXIN WANGMANAGER	(i) (ii)	189,288 0	50 0	44 0	36,052 0	19,881 0	245,315 0	0 0
(11)ANN DERRICKEXEC DIR OF CONTINUUM OF CARE	(i) (ii)	196,980 0	50 0	44 0	115,124 0	9,982 0	322,180 0	0 0
(12)AMY K BULPITTDIRECTOR OF LEGAL SERVICES	(i) (ii)	230,610 0	50 0	44 0	17,724 0	1,081 0	249,509 0	0 0
(13)TOMMY A IBRAHIMMEDICAL DIRECTOR	(i) (ii)	391,715 0	18,031 0	12,044 0	17,189 0	9,599 0	448,578 0	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
Schedule J, Part I, Line 1a, Tax indemnification and gross-up payments	TAX GROSS-UPS WERE TO DAVID OLEJNICZAK FOR $44, TO LARRY RAGEL FOR $44, TO SHERRI GREENWOOD FOR $44, TO REBECCA PUCLIK FOR $48, TO TOMMY IBRAHIM FOR $44, TO AMY BULPITT FOR $44, TO JIANXIN WANG FOR $44, TO ANN DERRICK FOR $44, AND TO MARGARET CURTIN FOR $44 DURING THE YEAR. THE FAIR VALUE OF THESE WERE INCLUDED IN THEIR ANNUAL REPORTED INCOME.
Schedule J, Part I, Line 3, Arrangement used to establish the top management official's compensation	PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O.
Schedule J, Part I, Line 4a, Severance or change-of-control payment	PER THE TERMS OF PATRICIA SCHULZ'S EMPLOYMENT AGREEMENT, SHE WAS TO RECEIVE SEVERANCE PAYMENTS THROUGH 08/30/2014. DURING CALENDARE YEAR 2013, PATRICIA RECEIVED SEVERANCE PAYMENTS TOTALING $81,850.
Schedule J, Part I, Line 4b, Supplemental nonqualified retirement plan	HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2013; THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). ANN M. CARR -- $28,503 LAWRENCE SCHUMACHER -- $121,580 DAVID OLEJNICZAK -- $20,617 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2013; THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. ANN M. CARR -- $24,602 LAWRENCE SCHUMACHER -- $332,388 ROBERT RITZ -- $210,511

Schedule J (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

ST JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

Employer identification number

37-0661238

Return Reference	Explanation
FORM 990, PART III, LINE 4A, PROGRAM SERVICE REVENUE - CARDIOVASCULAR	ST. JOHN'S HOSPITAL IS ONE OF THE LARGEST HEART PROGRAMS IN ILLINOIS. WE HAVE DEVELOPED A REPUTATION AS ONE OF THE PREMIER CARDIOVASCULAR PROGRAMS IN THE COUNTRY, BUT IT'S OUR DEDICATION TO PROVIDING COMPASSIONATE CARE TO PATIENTS AND THEIR FAMILIES THAT MAKES US UNIQUE. IN FISCAL YEAR 2014, EIGHT CARDIOLOGISTS AT THE PRAIRIE HEART INSTITUTE AT ST. JOHN'S HOSPITAL APPEARED ON THE BEST DOCTORS IN AMERICA LIST. RECEIVED THE PLATINUM PERFORMANCE ACHIEVEMENT AWARD FROM THE NATIONAL CARDIOVASCULAR DATA REGISTRY FOR MEETING 11 KEY QUALITY AND TREATMENT MEASURES AT LEAST 90% OF THE TIME FOR EIGHT CONSECUTIVE QUARTERS. IN ADDITION, ST. JOHN'S CARDIAC PROGRAMS HAVE RECEIVED THE FOLLOWING AWARDS, DESIGNATIONS AND ACCOMPLISHMENTS: - CARDIAC INSTITUTE OF QUALITY DESIGNATION BY AETNA INSURANCE COMPANY. - ST. JOHN'S WAS DESIGNATED A BLUE DISTINCTION CENTER FOR CARDIAC CARE BY BLUECROSS AND BLUESHIELD OF ILLINOIS. - A CIRCLE OF EXCELLENCE AWARD FROM COMPARION MEDICAL ANALYTICS FOR BEING RANKED IN THE TOP 10% OF HOSPITALS IN THE U.S. FOR CARDIAC CARE, CANCER CARE AND TRAUMA CARE. - PRAIRIE HEART EARNED FOR THE AMERICAN HEART ASSOCIATION'S MISSION: LIFELINE GOLD PERFORMANCE ACHIEVEMENT AWARD FOR ITS CARE OF HEART ATTACK PATIENTS. - PRAIRIE HEART INSTITUTE AT ST. JOHN'S HOSPITAL WAS RECOGNIZED AS ONE OF HEALTHGRADES 100 BEST HOSPITALS FOR CARDIAC SURGERY (2013, 2012 & 2011) - PRAIRIE HEART IS A HEALTHGRADES FIVE-STAR RECIPIENT FOR CARDIAC SURGERY (2013 & 2012); CORONARY BYPASS SURGERY (2013, 2012 & 2011); VALVE SURGERY (2013, 2012, 2011 & 2010); AND FOR TREATMENT OF HEART FAILURE (2013, 2012 & 2011). - BECKER'S HOSPITAL REVIEW NAMED ST. JOHN'S ONE OF THE "100 HOSPITALS FOR GREAT HEART PROGRAMS." - TRUVEN HEALTH ANALYTICS NAMED THE PRAIRIE HEART INSTITUTE AT ST. JOHN'S HOSPITAL ONE OF THE NATION'S 50 TOP CARDIOVASCULAR HOSPITALS. THE NEW INNOVATIONS BEING UTILIZED BY ST. JOHN'S HOSPITAL'S CARDIOVASCULAR SERVICES INCLUDE: - WATCHMEN PROCEDURE - USED TO REPLACE BLOOD THINNERS FOR PATIENTS WITH ATRIAL FIBRILLATION. - LARIAT DEVICE - PERCUTANEOUS LEFT ATRAIL APPENDAGE SUTURE LIGATION, USING THE LARIAT DEVIDE IN PATIENTS WITH ATRIAL FIBRILLATION WHO CANNOT TOLERATE OR ARE NOT CANDIDATES FOR ANTICOAGULATION. - TAVR DEVICES - SMALLER, MORE EASILY DELIVERED CARDIAC VALVES IMPLANTED WITHOUT THE NEED FOR OPEN HEART SURGERY. - REPRISE III - FULLY REPOSITIONABLE TAVR VALVES. - MITRA CLIP - MIMIMALLY INVASIVE REPAIR OF THE MITRAL VALVE. - PRAIRIE CARDIOVASCULAR CARDIOLOGISTS AT ST. JOHN'S HOSPITAL WERE THE FIRST TO ENROLL PATIENTS INTO LUTONIX'S LEVANT 2. THIS IS A GLOBAL RANDOMIZED TRIAL TO EVALUATE THE SAFETY AND EFFICIANCY OF THE MOXY DRUG COATED BALLOON COMPARTED TO A STANDARD ANGIOPLASTY BALLOON FOR THE TREATMENT OF PERIPHERAL ATERIAL DISEASE. - CREST 2 - RANDOMIZED TRIAL COMPARING CAROTID SURGERY TO CAROTID STENTING. - ALLSTAR - THE USE OF CARDIAC DERIVED CELLS IN HOPES TO REGENERATE AND IMPROVE CARDIAC FUNCTION AFTER A HEART ATTACK. - PARACHUTE - IMPLANTABLE DEVICE USED TO RESHAPE THE LEFT VENTRICLE THUS IMPROVING THE HEART FUNCTION. - EVERA - UPDATED IDC TECHNOLOGY ALLOWING PATIENTS TO SAFELY UNDERGO MRI SCAN. IN ADDITION TO THE LIST OF CATHETERIZATION, SURGICAL AND NON-INVASIVE PROCEDURES BELOW, ST. JOHN'S OFFERS A CARDIAC REHABILITATION PROGRAM, AND OTHER STRESS-REDUCTION SERVICES THROUGH THE ST. JOHN'S CENTER FOR LIVING. CATHETERIZATION LABORATORY PROCEDURES: -ABDOMINAL AORTIC ANEURYSM GRAPHS -ABLATION OF COMPLEX ARRHYTHMIAS -ANGIOPLASTY WITH STENTING -ATRIALFIBRILLATION ABLATIONS -BALLOON ANGIOPLASTY -CAROTID STENTS -DEFIBRILLATOR IMPLANTATION -DIAGNOSTIC CARDIAC CATHETERIZATION -DRUG-ELUTING STENTS -ELECTRO PHYSIOLOGIC EVALUATION OF COMPLEX ARRHYTHMIAS -EVALUATION OF CARDIAC VALVES -EVALUATION OF CONGENITAL HEART DISEASE -NEUROLOGICAL INTERVENTIONS -PACEMAKER IMPLANTATION -PERIPHERAL VASCULAR STENTS -PERCUTANEOUS TRANSLUMINA MYOCARDIAL REVASCULARIZATION -RENAL STENTS -COATED STENTS SURGICAL PROCEDURES: -BEATING HEART BYPASS SURGERY -CORONARY ARTERY BYPASS GRAFT SURGERY -GENERAL THORACIC SURGERY -HEART VALVE REPLACEMENT AND REPAIR -LASER PACEMAKER LEAD EXTRACTION -MINIMALLY INVASIVE ATRIAL ABLATION SURGERY -MINIMALLY INVASIVE VALVE REPLACEMENT REPAIR SURGERY -PACEMAKER AND DEFIBRILLATOR IMPLANTATION -VASCULAR SURGERY (AORTIC, CEREBROVASCULAR, RENAL, AND PERIPHERAL) NONINVASIVE CARDIOVASCULAR DIAGNOSTIC PROCEDURES: -AUDICOR TESTING -A-V OPTIMIZATION -BIO-Z -CARDIAC CT'S -CARDIAC AND VASCULAR ULTRASOUND -CARDIOVERSIONS -DOPPLER EXAMS -ECHOCARDIOGRAPHY -ELECTROCARDIOGRAMS -HOLTER MONITORING/ARRHYTHMIA MONITORING/PACEMAKER CHECKS -NUCLEAR STRESS TESTING -PEDIATRIC CARDIOLOGY CLINIC -PREADMISSION TESTING (CHEST X-RAYS AND BLOOD TESTS) -STRESS ECHOCARDIOGRAPHY -TRAN ESOPHAGEAL ECHOCARDIOGRAPHY -T-WAVE ALTERNANS
FORM 990, PART III, LINE 4B, PROGRAM SERVICE REVENUE - ORTHOPEDICS	ORTHOPEDIC SERVICES AT ST. JOHN'S HOSPITAL INCLUDE MUSCULOSKELETAL INJURIES TO THE BONES, JOINTS, MUSCLES, LIGAMENTS OR TENDONS, AND CONDITIONS SUCH AS ARTHRITIS AND OSTEOPOROSIS. SPORTS INJURIES, TRAUMA, SPINE, FRACTURES, CHRONIC PAIN AND TOTAL JOINT REPLACEMENTS ARE THE MAIN REASONS WHY PATIENTS NEED ORTHOPEDIC CARE. - THE SERVICE LINE AVERAGES 3,100 SURGICAL AND 6,300 NON-SURGICAL PROCEDURES ANNUALLY. - SURGICAL CASE VOLUME IN FY14 (JULY '13 - JUNE '14) WAS 3,094 CASES. - OF THE TOP 10 SURGEONS IN VOLUME, 4 ARE ORTHOPEDIC (1 PEDIATRIC ORTHO). - OF THE TOP 10 PROCEDURES PERFORMED AT SJS, 4 OF THOSE ARE ORTHOPEDIC. - ORTHOPEDICS IS NUMBER 1 IN CASE PERCENTAGE OF TOTAL VOLUME FOR SJS MAIN OR AND OUTPATIENT SURGERY CLINIC AT 23.7% OF CASES PERFORMED; 3,050 OF THESE CASES WERE PERFORMED IN MAIN OR, PUTTING ORTHOPEDICS AGAIN AT NUMBER 1 FOR CASE VOLUME AT 36.9% OF TOTAL CASE VOLUME IN MAIN OR. - ADMISSION TYPE: 57.2% OUTPATIENT; 19.0% AM ADMISSION; 20.7% INPATIENT; 3.1% 23-HOUR OBSERVATION - CASE TYPE: 81.6% ELECTIVE; 15.5% ELECTIVE ON-CALL; 2.2% EMERGENT THE SERVICE LINE OFFERS MORE THAN 20 EDUCATIONAL EVENTS/LECTURES ANNUALLY TO THE GENERAL PUBLIC ON ORTHOPEDIC PROCEDURES AND CARE. THE SPECIFIC SERVICES INCLUDE: SURGICAL: INPATIENT & OUTPATIENT MAJOR ORTHOPEDIC PROCEDURES: -- KNEE & HIP ARTHROPLASTY/JOINT REPLACEMENTS (TOTALS, PARTIALS, REVISIONS): -748 IN FY14 -1458 IN LAST 2 FISCAL YEARS -38 USING MAKOPLASTY* -- SPINAL FUSION & DECOMPRESSION, LUMBAR & CERVICAL: -381 SPINE FUSION CASES IN FY 14 OTHER ORTHOPEDIC PROCEDURES: -- ARTHROSCOPY/ARTHROPLASTY/ARTHROTOMY: KNEE, HIP, SHOULDER, ELBOW, TOE, WRIST, ANKLE: -ROTATOR CUFF REPAIR -ARTHROSCOPIC ACL KNEE -CARPAL TUNNEL -FUSION: SPINE, FOOT, ANKLE, FINGER, TOE, WRIST, TIBIA -NAILING/RODDING TIBIA & FEMORAL -LAMINECTOMY, FACETECTOMY, DISKECTOMY, LAMINOTOMY, FORAMINOTOMY -ORIF: ACETABULUM, ANKLE, CALCANEUS, CLAVICLE, ELBOW, FEMUR, FINGER, FOOT, HIP, HUMERUS, PATELLA, PELVIS, RADIUS, SCAPULA, SHOULDER, TIBIA, TIBIAL PLATEAU, ULNA, WRIST -REPAIR OF TENDONS, LIGAMENTS, SOFT TISSUE AND CONDITIONS CAUSED BY ARTHRITIS AND REPETITIVE MOTION INJURIES NON-SURGICAL SERVICES: --PHYSICAL THERAPY: -SPORTS INJURIES -MUSCLE STRAINS AND SPRAINS -BACK AND NECK PAIN -HIP AND KNEE INJURIES -SHOULDER AND ELBOW INJURIES -ANKLE AND FOOT INJURIES -HAND AND UPPER EXTREMITY INJURIES -WORK-RELATED INJURIES -OVERUSE INJURIES, SUCH AS CARPAL TUNNEL SYNDROME -DIZZINESS AND BALANCE PROBLEMS --OCCUPATIONAL THERAPY: -BONE AND JOINT INJURIES/SURGERIES -CHRONIC PAIN -ARTHRITIS -WORK-RELATED INJURIES -HAND/WRIST INJURIES AND POST-SURGICAL CARE; SPLINTING -OVERUSE SYNDROMES, SUCH AS TENDONITIS AND CARPAL TUNNEL SYNDROME -STROKE -BRAIN AND SPINAL CORD INJURY -AMPUTATIONS --AQUATIC THERAPY: -ARTHRITIS -BACK INJURIES -GENERAL BONE AND JOINT INJURIES -JOINT REPLACEMENTS -NEUROLOGICAL CONDITIONS, SUCH AS STROKE; PARKINSON'S -SPORTS INJURIES --ATHLETIC TRAINING: -PREVENTION OF ATHLETIC INJURIES -IMMEDIATE CARE OF ATHLETIC INJURIES -REHABILITATION/RECONDITIONING OF ATHLETIC INJURIES -HEALTH CARE ADMINISTRATION -PROVIDING EDUCATION IN SCHOOLS -COMMUNITY EVENT COVERAGE
FORM 990, PART III, LINE 4C, PROGRAM SERVICE REVENUE - GASTROENTEROLOGY	GASTROENTEROLOGY SERVICES IS A SMALL, BUT TYPICALLY BUSY UNIT THAT SEES APPROXIMATELY 18-25 PATIENTS PER DAY. SEVENTY PERCENT ARE OUTPATIENTS AND 30% ARE INPATIENTS. BOTH DIAGNOSTIC AND THERAPEUTIC PROCEDURES ARE PERFORMED INCLUDING, BUT NOT LIMITED TO, COLONOSCOPY, EGD (ESOPHAGOGASTRODUODENOSCOPY), ERCP, PEG PLACEMENT, DILATATIONS, 24 HOUR PH AND MANOMETRICS. NURSING RESPONSIBILITIES FOR A ROUTINE OUTPATIENT INCLUDE COMPLETING A COMPREHENSIVE PATIENT ASSESSMENT; OBTAINING A WRITTEN CONSENT FOR TREATMENT; STARTING AN IV LINE; ADMINISTERING PRE-PROCEDURE ANTIBIOTICS IF ORDERED; TRANSPORTING THE PATIENT TO THE PROCEDURAL ROOM; ASSISTING THE PHYSICIAN WITH THE PROCEDURE; ADMINISTERING CONSCIOUS SEDATION IF ORDERED; ASSESSING AND TREATING DISCOMFORT; AND OVERALL PATIENT MONITORING. POST PROCEDURE, THE PATIENT SPENDS APPROXIMATELY ONE HOUR IN RECOVERY AND IS DISCHARGED TO A RESPONSIBLE PERSON AFTER DISCHARGE INSTRUCTIONS AND TEACHING IS COMPLETE. THE GIDA UNIT AT ST. JOHN'S HOSPITAL IS NOW OFFERING ENDOSCOPIC ULTRASOUND (EUS) SERVICES. THIS CUTTING-EDGE TECHNIQUE PROVIDES STAGING INFORMATION FOR CANCER AND CAN ALSO REDUCE SURGICAL RISK BY GIVING PHYSICIANS COMPREHENSIVE INFORMATION ABOUT THE LESION, THUS PREVENTING UNNECESSARY INVASIVE EXPLORATORY PROCEDURES. WE HAVE TWO OF THE MOST ADVANCED EUS INSTRUMENTS AVAILABLE IN THE U.S. WITH GI PHYSICIANS PERFORMING SOME OF THE MOST ADVANCED ENDOSCOPIC PROCEDURES, INCLUDING ENDOSCOPIC SUB-MUCOSAL DISSECTION. THIS PROCEDURE IN PARTICULAR, HAS THE ABILITY TO SAVE OUR PATIENTS FROM HAVING TO GO THROUGH AN OPEN SURGICAL PROCEDURE FOR REMOVAL OF CANCEROUS LESIONS. ST. JOHN'S IS THE ONLY HOSPITAL IN CENTRAL ILLINOIS PERFORMING THESE TYPES OF CASES.
FORM 990, PART IV, LINE 24A, TAX EXEMPT BONDS	ST. JOHN'S HOSPITAL HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990.
Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders	THE SENIOR GOVERNING BODY OF ST. JOHN'S HOSPITAL (THE CORPORATION) IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.
Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body	PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD, AND PRESIDENT.
Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders	RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. JOHN'S HOSPITAL SPRINGFIELD (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO, FROM TIME TO TIME, ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY, OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI.
Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body	THE HOSPITAL EMPLOYS CROWE HORWATH TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE HORWATH PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION, AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN, AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS.
Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy	A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN USED SINCE JANUARY, 2010 TO ESTABLISH THE PRACTICE OF MANAGING CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS, AND MEDICAL DEVICES, ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO, A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE, AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES.
FORM 990, PART VI, LINE 13, WHISTLEBLOWER POLICY	PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES.
Form 990, Part VI, Sec B, Line 15a, Process to establish compensation of top management official	THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES, AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING.
Form 990, Part VI, Sec B, Line 15b, Process to establish compensation of other employees	PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A.
FORM 990, PART VI, LINE 16B, JOINT VENTURES	HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. JOHN'S HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES SACRED HEART HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD SACRED HEART HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS.
Form 990, Part VI, Sec C, Line 19, Required documents available to the public	BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME.
Form 990, Part IX, Line 11g, Other Expenses	OTHER PURCHASED SERVICES - TOTAL EXPENSE: 27407683, PROGRAM SERVICE EXPENSE: 24879775, MANAGEMENT AND GENERAL EXPENSES: 2527908, FUNDRAISING EXPENSES: ; PROFESSIONAL FEES - TOTAL EXPENSE: 40754034, PROGRAM SERVICE EXPENSE: 34630754, MANAGEMENT AND GENERAL EXPENSES: 6123280, FUNDRAISING EXPENSES: ;
FORM 990, PART X, LINE 11, POOLED INVESTMENT ACCOUNT	ST. JOHN'S HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, AND EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS.
Form 990 , Part XI, Line 9, Other changes in net assets or fund balances	CHANGE IN FOUNDATION RESCRITED NET ASSETS - 2383916; CHANGE IN PENSION FUNDED STATUS - 14434286; TRANSFERS TO HSHS - -35003949; CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS - 975329; UNRESTRICTED NET ASSETS RELEASED FOR PURCHASE OF PPE - 2192; CHANGE IN FOUNDATION PERM RESTRICTED NET ASSETS - 110390; CHANGE IN COLLEGE OF NURSING TEMP RESTRICTED NET ASSETS - 4159;

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

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

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS

Employer identification number

37-0661238

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) SPRINGFIELD HEALTH PARTNERS LLC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1364419	HEALTHCARE (DISSOLVED 03/22/13)	IL	0	0	HSHS MG
(2) KIARA CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 26-1417684	HEALTHCARE	IL	-3,651,339	7,292,316	HSSI
(3) PHYSICIAN CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1668647	HEALTHCARE	IL	-779,271	1,233,121	KCIN

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) HOSPITAL SISTERS HEALTH SYSTEM 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1058692	HEALTHCARE	IL	501(C)(3)	11 - Type III - FI	NA		No
(2) HOSPITAL SISTERS OF ST FRANCIS FDTN 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1186514	HEALTHCARE	IL	501(C)(3)	9	HSHS	Yes
(3) HSHS HEALTHCARE PLAN TRUST FUND 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1137724	HEALTHCARE	IL	501(C)(9)	N/A	HSHS	Yes
(4) HSHS SELF INSURANCE TRUST 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1120626	INSURANCE	IL	501(C)(3)	11 - Type I	HSHS	Yes
(5) HOSPITAL SISTERS HEALTHCARE WEST INC 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS,WI54729 51-0157933	HEALTHCARE	WI	501(C)(3)	11 - Type III - FI	HSSI	Yes
(6) SACRED HEART HOSPITAL 990 WEST CLAIREMONT AVENUE EAU CLAIRE,WI54701 39-0807060	HEALTHCARE	WI	501(C)(3)	3	HSSI	Yes
(7) ST ANTHONY'S HOSPITAL 503 N MAPLE STREET EFFINGHAM,IL62401 37-0661233	HEALTHCARE	IL	501(C)(3)	3	HSSI	Yes
(8) ST ELIZABETH'S HOSPITAL 211 SOUTH THIRD STREET BELLEVILLE,IL62220 37-0663567	HEALTHCARE	IL	501(C)(3)	3	HSSI	Yes
(9) ST NICHOLAS HOSPITAL 3100 SUPERIOR AVENUE SHEBOYGAN,WI53081 39-0808480	HEALTHCARE	WI	501(C)(3)	3	HSSI	Yes
(10) ST JOSEPH'S HOSPITAL 9515 HOLY CROSS LANE BREESE,IL62230 37-1208459	HEALTHCARE	IL	501(C)(3)	3	HSSI	Yes
(11) ST JOSEPH'S HOSPITAL 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS,WI54729 39-0810545	HEALTHCARE	WI	501(C)(3)	3	HSSI	Yes
(12) ST MARY'S HOSPITAL 1800 E LAKE SHORE DRIVE DECATUR,IL62521 37-0661244	HEALTHCARE	IL	501(C)(3)	3	HSSI	Yes
(13) ST MARY'S HOSPITAL 111 SPRING STREET STREATOR,IL61364 36-2169181	HEALTHCARE	IL	501(C)(3)	3	HSSI	Yes
(14) ST MARY'S MEDICAL CENTER 1762 SHAWANO AVENUE GREEN BAY,WI54303 39-0818682	HEALTHCARE	WI	501(C)(3)	3	HSSI	Yes
(15) ST VINCENT HOSPITAL 835 S VAN BUREN GREEN BAY,WI51301 39-0817529	HEALTHCARE	WI	501(C)(3)	3	HSSI	Yes
(16) ST JOSEPH'S HOSPITAL 12866 TROXLER AVENUE HIGHLAND,IL62249 37-0663568	HEALTHCARE	IL	501(C)(3)	3	HSSI	Yes
(17) ST FRANCIS HOSPITAL 1215 FRANCISCAN DRIVE LITCHFIELD,IL62056 37-0661236	HEALTHCARE	IL	501(C)(3)	3	HSSI	Yes
(18) HOSPITAL SISTERS SERVICES INC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1163402	HEALTHCARE	IL	501(C)(3)	11 - Type III - FI	HSHS	Yes
(19) HSHS MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD,IL62703 26-3956318	HEALTHCARE	IL	501(C)(3)	11 - Type III - FI	HSSI	Yes
(20) HSHS WISCONSIN MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD,IL62703 26-4515959	HEALTHCARE	WI	501(C)(3)	11 - Type III - FI	HSSI	Yes
(21) ORANGE CROSS AMBULANCE INC 919 ASHLAND AVENUE SHEBOYGAN,WI53081 39-1860942	HEALTHCARE	WI	501(C)(3)	9	ST NICHOLAS	Yes
(22) WISCONSIN UPPER PENINSULA ONCOLOGY MGMT 835 S VAN BUREN GREEN BAY,WI54301 39-1677100	HEALTHCARE	WI	501(C)(3)	3	ST VINCENT	Yes
(23) UNITY LIMITED PARTNERSHIP 2366 OAK RIDGE CIRCLE DE PERE,WI54115 39-1750729	HEALTHCARE	WI	501(C)(3)	9	HSSI	Yes
(24) PRAIRIE EDUCATION & RESEARCH COOPERATIVE 317 NORTH 5TH STREET SPRINGFIELD,IL62701 37-1157915	HEALTHCARE	IL	501(C)(3)	4	HSSI	Yes
(25) COMMUNITY MEMORIAL HOSPITAL 855 S MAIN STREET OCONTO FALLS,WI54154 39-0848401	HEALTHCARE	WI	501(C)(3)	3	HSSI (SEE PART VII)	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	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) MEMORIAL AND ST ELIZABETH'S HEALTHCARE CANCER TREATMENT CENTER 4000 NORTH ILLINOIS STREET SWANSEA,IL62226 37-1312961	HEALTHCARE	IL	ST ELIZABETH'S	RELATED	599,299	4,931,271		No			No	0 %
(2) PRAIRIE HEART INSTITUTE ST JOHN'S 800 EAST CARPENTER STREET SPRINGFIELD,IL62769 37-1321197	HEALTHCARE	IL	HSHS	RELATED	-1,018	47,055		No			No	0 %
(3) NORTHEAST WISCONSIN RADIATION THERAPY SERVICES LLC 1726 SHAWANO AVE GREEN BAY,WI543079047 26-3749065	HEALTHCARE	WI	SMGB	RELATED	147,184	514,563		No		Yes		0 %
(4) PAIN CENTER OF WISCONSIN 4131 W LOOMIS ROAD SUITE 300 GREENFIELD,WI53221 26-3155343	HEALTHCARE	WI	ST VINCENT	RELATED	1,752,500	1,353,813		No			No	0 %
(5) SURGERY CENTER OF SHEBOYGAN LLC 3141 SAEMANN AVENUE SHEBOYGAN,WI53081 26-0822209	HEALTHCARE	WI	ST NICHOLAS (SOLD 1114)	RELATED	155,892	0		No			No	0 %
(6) CARPENTER STREET HOTEL LLC 525 NORTH SIXTH STREET SPRINGFIELD,IL62702 36-4128127	HOTEL	IL	LASANTE INC	N/A
(7) SPRINGFIELD URGENT CARE REAL ESTATE LLC PO BOX 19456 SPRINGFIELD,IL727949456 03-0413258	RENTAL REAL ESTATE	IL	LASANTE INC	N/A
(8) PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 26-1479945	MEDICAL	IL	HSHS	RELATED	-7,553	9,078		No		Yes		0 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(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) KIARA INC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1163401	HEALTHCARE	IL	HSHS	C CORPORATION	-23,279,067	45,045,072	0 %	Yes
(2) LASANTE WISCONSIN INC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 39-1572196	HEALTHCARE	IL	KIARA INC	C CORPORATION				Yes
(3) LASANTE INC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1163400	HEALTHCARE	IL	KIARA INC	C CORPORATION				Yes
(4) PRAIRIE CARDIOVASCULAR 619 EAST MASON SUITE 4P57 SPRINGFIELD,IL62701 37-1071858	HEALTHCARE	IL	KIARA INC	C CORPORATION				Yes
(5) PREVEA HEALTH SERVICES INC 2710 EXECUTIVE DRIVE GREEN BAY,WI54304 39-1839351	HEALTHCARE	WI	HSSI	C CORPORATION	2,912,268	45,322,060	0 %	Yes
(6) PREVEA CLINIC INC 2710 EXECUTVE DRIVE GREEN BAY,WI54304 39-1839349	HEALTHCARE	WI	PHSI	C CORPORATION				Yes
(7) RENAISSANCE QUALITY INSURANCE LTD PO BOX 1159 GRAND CAYMANKY1-1102 CJ 98-0669953	INSURANCE	CJ	HSSI	C CORPORATION	0	100,258,139	0 %	Yes
(8) OJV INC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 46-0873384	HEALTHCARE	IL	LASANTE INC	C CORPORATION				Yes
(9) STREATORLAND QUALITY CARE PHO LLC 111 SPRING STREET STREATOR,IL61364 36-4105007	HEALTHCARE	IL	ST MARY'S STREATOR	C CORPORATION	-3,136	20,601	0 %	Yes

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

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

Yes

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

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

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

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

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

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

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

Yes

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

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

Yes

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

Yes

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

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

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

PART II, COLUMN (F), DIRECT CONTROLLING ENTITY (CMH)

ON SEPTEMBER 1, 2014, HSSI BECAME THE SOLE CORPORATE MEMBER OF COMMUNITY MEMORIAL HOSPITAL (CMH) IN OCONTO FALLS, WISCONSIN. EFFECTIVE ON THE ACQUISITION DATE, CMH BECAME A CATHOLIC ENTITY AND THE HOSPITAL NAME WAS CHANGED TO ST. CLARE MEMORIAL HOSPITAL, INC. PREVIOUS TO THE ACQUISITION, TWO HSSI AFFILIATES HELD A COMBINED 24% MINORITY INTEREST IN CMH. REVISED GOVERNING DOCUMENTS ARE CONSISTENT WITH HSHS POLICIES APPLICABLE TO AFFILIATES. HSSI WILL RETAIN CERTAIN RESERVE POWERS OVER ST. CLARE MEMORIAL HOSPITAL, INC. CONSISTENT WITH OTHER HSSI SUBSIDIARIES.

PART V, LINE 2, TRANSACTIONS WITH RELATED ENTITIES

ANY TRANSACTIONS LISTED ON SCH R, PART V, LINE 1 AND NOT ON SCH R, PART V, R, PART V, LINE 2 ARE BETWEEN RELATED 501(C)(3) AND DO NOT REQUIRE REPORTING ON THIS SECTION.

Schedule R (Form 990) 2013

Additional Data

Software ID:	13000248
Software Version:	2013v3.1

1	Briefly describe the organization’s mission or most significant activities: ST. JOHN'S HOSPITAL PROVIDES A MINISTRY OF EXCEPTIONAL HEALTH CARE SERVICES TO THE PEOPLE OF CENTRAL ILLINOIS IN THE CATHOLIC TRADITION OF COMPASSION, JUSTICE AND REVERENCE FOR LIFE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	3,678
6	Total number of volunteers (estimate if necessary) .............	6	395
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,660,828
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) .........	9,413,052	6,742,381
9	Program service revenue (Part VIII, line 2g) .........	450,835,659	469,138,465
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	13,896,749	22,399,316
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,930,052	2,252,458
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	476,075,512	500,532,620
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	5,511	16,146
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)	188,974,015	188,859,520
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)....	284,876,634	300,914,466
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	473,856,160	489,790,132
19	Revenue less expenses. Subtract line 18 from line 12.......	2,219,352	10,742,488
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	792,569,828	829,352,834
21	Total liabilities (Part X, line 26).............	362,110,954	389,905,718
22	Net assets or fund balances. Subtract line 21 from line 20.....	430,458,874	439,447,116

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 109,641,078 including grants of $ ) (Revenue $ 143,820,560 )
	SEE SCHEDULE O - PROGRAM SERVICE REVENUE - CARDIOVASCULAR

4b	(Code: ) (Expenses $ 45,277,869 including grants of $ ) (Revenue $ 49,250,930 )
	SEE SCHEDULE O - PROGRAM SERVICE REVENUE - ORTHOPEDICS

4c	(Code: ) (Expenses $ 32,432,245 including grants of $ ) (Revenue $ 34,538,395 )
	SEE SCHEDULE O - PROGRAM SERVICE REVENUE - GASTROENTEROLOGY

	(Code: ) (Expenses $ 199,813,663 including grants of $ 16,146 ) (Revenue $ 241,528,580 )
	ST. JOHN'S OTHER SPECIALIZED SERVICES INCLUDE CANCER CARE, WOMEN'S SERVICES, A NEUROSCIENCES INSTITUTE, HOME HEALTH, HOSPICE, AN EMERGENCY DEPARTMENT THAT NEARLY 55,000 PEOPLE PER YEAR SEEK CARE IN AND THE ST. JOHN'S CHILDREN'S HOSPITAL. OUR CHILDREN'S HOSPITAL IS THE ONLY COMPREHENSIVE CHILD HEALTH CARE FACILITY IN SOUTH-CENTRAL ILLINOIS AND PROVIDES VITAL HEALTH CARE FOR THE REGION'S CHILDREN, FROM INFANCY THROUGH AGE 18. RECOGNIZED BY THE CHILDREN'S HOSPITAL ASSOCIATION AND A MEMBER OF THE ASSOCIATION OF ILLINOIS CHILDREN'S HOSPITALS, ST. JOHN'S CHILDREN'S HOSPITAL OFFERS A WIDE RANGE OF SERVICES FOR CHILDREN AND THEIR FAMILIES BOTH HERE AT OUR FACILITIES AND EXTENDING INTO THE HOME. SERVICES INCLUDE: - GENERAL PEDIATRIC BEDS, WITH PRIVATE BATH, SHOWER AND PARENTAL SLEEPING AREA - PEDIATRIC ICU - PEDIATRIC HEMATOLOGY/ONCOLOGY - LEVEL III NEONATAL ICU - PEDIATRIC EMERGENCY ROOM SERVICES - NEONATAL AND PEDIATRIC TRANSPORTATION - THE ONLY REGIONAL LEVEL III PERINATAL CARE CENTER IN THE AREA - CHILD AND FAMILY SUPPORT AND SERVICES THROUGH OUR CHILD LIFE SPECIALISTS AND SOCIAL AND SPIRITUAL SERVICES DEPARTMENTS. - COMPREHENSIVE OUTPATIENT SERVICES SUCH AS HOME HEALTH, CHILDREN'S REHABILITATION CENTER AND EARLY INTERVENTION PROGRAM - A RONALD MCDONALD HOUSE ON SITE

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 199,813,663 including grants of $ 16,146 ) (Revenue $ 241,528,580 )
4e	Total program service expenses387,164,855

(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) LARRY J RAGEL........................................................................ CHIEF FINANCIAL OFFICER	71.00 .......................3.75	X			353,114	0	88,518
(19) PATRICIA SCHULZ........................................................................ CHIEF PEOPLE OFFICER	75.00 .......................0	X			243,209	0	51,372
(20) REBECCA PUCLIK........................................................................ DIVISONAL CHIEF PEOPLE OFFICER	45.00 .......................30.00	X			78,965	0	32,766
(21) SHERRI A GREENWOOD........................................................................ CHIEF NURSING OFFICER	45.00 .......................15.00	X			230,068	0	61,738
(22) AMY K BULPITT........................................................................ DIRECTOR OF LEGAL SERVICES	40.00 .......................0		X		230,704	0	18,805
(23) ANN DERRICK........................................................................ EXEC DIR OF CONTINUUM OF CARE	40.00 .......................0		X		197,074	0	125,106
(24) JIANXIN WANG........................................................................ MANAGER	40.00 .......................0		X		189,382	0	55,933
(25) MARGARET L CURTIN........................................................................ ASST ADMINISTRATOR OF CHILDREN	40.00 .......................0		X		213,811	0	64,567
(26) TOMMY A IBRAHIM........................................................................ MEDICAL DIRECTOR	40.00 .......................0		X		421,790	0	26,788
(27) ROBERT RITZ........................................................................ FORMER PRESIDENT & CEO	0.00 .......................0.00			X	0	588,613	66,278

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,561,458	2,300,595	1,140,713

				(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		1,232,018
e	Government grants (contributions)1e		5,510,363

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

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			6,742,381
			Business Code
2a	NET PATIENT SERVICE REVENUE		900099	454,146,677	454,146,677
b	DEPARTMENTAL INCOME		900099	14,991,788	14,991,788
c				0
d				0
e				0
f	All other program service revenue .			0	0	0	0
g	Total. Add lines 2a–2f........			469,138,465
3	Investment income (including dividends, interest, and other similar amounts).......			6,342,889			6,342,889
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss).......			0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	16,215,187
b	Less: cost or other basis and sales expenses		158,760
c	Gain or (loss)	16,215,187	-158,760
d	Net gain or (loss)..........			16,056,427			16,056,427
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	DIETARY		541900	65,483			65,483
b	MEDICAL AND DIAGNOSTIC LAB		621500	1,493,213		1,493,213
c	GIFT SHOP		453220	439,833			439,833
d	All other revenue ....			253,929	0	167,615	86,314
e	Total. Add lines 11a–11d ......			2,252,458
12	Total revenue. See Instructions......			500,532,620	469,138,465	1,660,828	22,990,946


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			310,069	1	1,601,321
2	Savings and temporary cash investments .........			1,891,054	2	6,497,922
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			93,360,414	4	94,061,113
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			10,975,241	8	9,807,986
9	Prepaid expenses and deferred charges ..........			3,607,325	9	4,037,384
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	772,208,258
b	Less: accumulated depreciation .....	10b	387,231,576	331,112,423	10c	384,976,682
11	Investments—publicly traded securities ..........			346,456,301	11	317,018,617
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			4,857,001	15	11,351,809
16	Total assets. Add lines 1 through 15 (must equal line 34)......			792,569,828	16	829,352,834
17	Accounts payable and accrued expenses .........			46,907,910	17	41,306,373
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			228,054,515	20	277,435,412
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21	1,275,000
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			87,148,529	25	69,888,933
26	Total liabilities. Add lines 17 through 25.........			362,110,954	26	389,905,718
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			402,509,500	27	407,664,069
28	Temporarily restricted net assets ...........			25,457,798	28	29,181,080
29	Permanently restricted net assets ...........			2,491,576	29	2,601,967
	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 ...........			430,458,874	33	439,447,116
34	Total liabilities and net assets/fund balances ........			792,569,828	34	829,352,834