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) SISTER THERESA LAMETTEREY........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(2) KEVIN MURPHY........................................................................ BOARD OF DIRECTOR	2.0 .......................50.0	X		0	323,816	49,695
(3) ERIC MORENO........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(4) DIANA CARLONI O'MALLEY........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(5) VODUR REDDY MD........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		24,000	0	0
(6) BROTHER IGNATIUS SUDOL........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(7) ROB TURNER........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(8) DAVID VARGAS MD........................................................................ BOARD OF DIRECTOR (PART YEAR)	2.0 .......................0.0	X		600	0	0
(9) ZOHEIR EL-HAJJAOUI MD........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(10) SISTER CLAUDETTE DES FORGES........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(11) VENKAT DEVINENI MD........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		57,035	0	0
(12) BRUCE FAY........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(13) ALAN H GARRETT........................................................................ PRESIDENT/CEO	50.0 .......................2.0	X	X	0	590,309	48,352
(14) VIRGIL BARNES........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(15) ROSELLA BERNAL........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(16) BROTHER STEPHEN DE LA ROSA........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X		0	0	0
(17) SISTER MARTHA ANN FITZPATRICK........................................................................ BOARD OF DIRECTOR	2.0 .......................2.0	X		0	0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) HENRY GONZALEZ MD........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X					0	0	0
(19) JOHN HULTERSTROM........................................................................ BOARD OF DIRECTOR	2.0 .......................0.0	X					0	0	0
(20) TARA COWELL........................................................................ SECRETARY	2.0 .......................52.0		X				0	314,087	39,671
(21) KELLY LINDEN........................................................................ COO	50.0 .......................0.0		X				344,921	0	22,923
(22) TRACY FERNANDEZ........................................................................ SVP/CFO	50.0 .......................0.0		X				296,271	0	25,384
(23) MARILYN DRONE........................................................................ CHIEF NURSING OFFICER	50.0 .......................0.0			X			274,181	0	27,314
(24) RANDY BEVILACQUA........................................................................ VP STRATEGIC SERVICES	50.0 .......................0.0			X			223,953	0	27,755
(25) DENNIS HAGHIGHAT MD........................................................................ VP MEDICAL AFFAIRS	50.0 .......................0.0			X			353,578	12,013	23,315
(26) VANBOTRA HUANG........................................................................ DIRECTOR OF PHARMACY	50.0 .......................0.0				X		190,025	0	23,006
(27) LAURIE ROBERTS........................................................................ DIRECTOR COMMUNITY HEALTH	50.0 .......................0.0				X		182,287	0	22,941
(28) KATHERINE FREEMAN........................................................................ STAFF RN	36.0 .......................0.0				X		174,023	0	13,923
(29) MARILYN PLATT........................................................................ MANAGER OB CLINIC	50.0 .......................0.0				X		170,534	0	21,382
(30) SHARON KIDD........................................................................ STAFF RN	36.0 .......................0.0				X		164,903	0	37,359
(31) DAVID O'BRIEN........................................................................ COO (FORMER KEY EMPLOYEE)	0.0 .......................52.0					X	203,450	261,161	12,702
(32) JAMES KYLE........................................................................ VP MED AFFAIRS (FMR KEY EMPL)	0.0 .......................50.0					X	0	451,523	34,727

(A) Name and business address	(B) Description of services	(C) Compensation
EXECUTIVE HEALTH RESOURCES, PO BOX 822688PHILADELPHIACA19182	CASE MANAGEMENT	1,071,556
HIGH DESERT PRIMARY MEDICAL GROUP, 17095 MAIN STREETHESPERIACA92345	MEDICAL SERVICES	703,151
HIGH DESERT SPECIALITY GROUP, 12550 HESPERIA RD SU 100VICTORVILLECA92395	SPECIALTY CARE SVCS	390,079
MS ILBEIGI AND ASSOC, 18300 HIGHWAY 18APPLE VALLEYCA92307	ANESTHESIA SERVICES	609,709
PRECYSE SOLUTIONS LLC, PO BOX 11407BIRMINGHAMIL35246	TRANSCRIPTION SVCS	237,744
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 19

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	133,400	133,400
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,679,719		1,679,719	0
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	0	0	0
7	Other salaries and wages	100,467,322	95,792,800	4,301,814	372,708
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	5,821,530	5,325,763	473,929	21,838
9	Other employee benefits .......	30,715,040	29,454,394	1,145,319	115,327
10	Payroll taxes ...........	7,907,093	7,453,715	423,938	29,440
11	Fees for services (non-employees):
a	Management ......	33,889,880	26,851,164	6,979,662	59,054
b	Legal .........	2,364,920	0	2,364,920	0
c	Accounting ...........	12,500	0	12,500	0
d	Lobbying ...........	35,488	35,488	0	0
e	Professional fundraising services. See Part IV, line 17	205			205
f	Investment management fees ......	378,528	0	378,528	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	21,008,919	20,116,833	715,160	176,926
12	Advertising and promotion ....	51,680		51,680	0
13	Office expenses .......	439,808	408,134	24,128	7,546
14	Information technology ......	392,847	382,986	9,831	30
15	Royalties ..	0	0	0	0
16	Occupancy ...........	5,277,529	5,054,294	217,248	5,987
17	Travel ............	162,307	91,092	62,315	8,900
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0	0	0	0
19	Conferences, conventions, and meetings ....	51,721	39,016	9,104	3,601
20	Interest ...........	2,814,806	2,814,806	0	0
21	Payments to affiliates .......	0		0	0
22	Depreciation, depletion, and amortization .....	10,446,897	9,906,379	537,197	3,321
23	Insurance ..............	2,159,463	0	2,159,463	0
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	MEDICAL SUPPLIES	42,195,184	42,147,884	42,833	4,467
b	PHYSICIAN LOAN FORGIVENES	882,620	0	882,620	0
c	CHFT PLEDGE	563,666	0	563,666	0
d	EMPLOYEE RECRUITMENT	155,817	0	155,817	0
e	All other expenses	1,556,550	1,276,252	260,962	19,336
25	Total functional expenses. Add lines 1 through 24e	271,565,439	247,284,400	23,452,353	828,686
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).	0

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	6,809,133	1	-7,702,497
2	Savings and temporary cash investments .........	38,630,826	2	65,053,455
3	Pledges and grants receivable, net ...........	952,900	3	952,900
4	Accounts receivable, net .............	47,734,801	4	48,136,708
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 .............	730,665	7	720,991
8	Inventories for sale or use ..............	3,577,975	8	3,967,158
9	Prepaid expenses and deferred charges ..........	308,997	9	13,874,903
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	250,641,281
b	Less: accumulated depreciation .....	10b	112,605,369	135,577,253	10c	138,035,912
11	Investments—publicly traded securities ..........	21,823,124	11	25,099,967
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 ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	15,203,746	15	2,635,357
16	Total assets. Add lines 1 through 15 (must equal line 34)......	271,349,420	16	290,774,854
	17	Accounts payable and accrued expenses .........	28,635,630	17	25,180,088
18	Grants payable .................	0	18	0
19	Deferred revenue ................	462,730	19	1,578,624
20	Tax-exempt bond liabilities .............	0	20	954,440
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	59,645,424	25	74,626,651
26	Total liabilities. Add lines 17 through 25.........	88,743,784	26	102,339,803
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	177,161,203	27	183,193,560
28	Temporarily restricted net assets ...........	5,444,433	28	5,241,491
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	182,605,636	33	188,435,051
34	Total liabilities and net assets/fund balances ........	271,349,420	34	290,774,854

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

See separate instructions.
right arrow

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

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

ST MARY MEDICAL CENTER

Employer identification number

95-1914489

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

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

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

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

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

Yes

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

11g(i)

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

11g(ii)

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

11g(iii)

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

Page 2

Part II

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

Section A. Public Support

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

Section B. Total Support

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

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

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

Section C. Computation of Public Support Percentage

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

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

16a

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

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

17a

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

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

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

Schedule A (Form 990 or 990-EZ) 2013

Page 3

Part III

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

Section A. Public Support

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

Section B. Total Support

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

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

Section C. Computation of Public Support Percentage

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

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

Section D. Computation of Investment Income Percentage

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

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

19a

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

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

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

Schedule A (Form 990 or 990-EZ) 2013

Page 4

Part IV

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

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2013

Name of the organization

ST MARY MEDICAL CENTER

Employer identification number

95-1914489

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 MARY MEDICAL CENTER

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 MARY MEDICAL CENTER

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 MARY MEDICAL CENTER

Employer identification number

95-1914489

Part III

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

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

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

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

See separate instructions. SchCMd Bullet

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

OMB No. 1545-0047

2013

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

ST MARY MEDICAL CENTER

Employer identification number

95-1914489

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

35,488

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

35,488

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 1I	LOBBYING A PORTION OF THE DUES PAID TO HOSPITAL ASSOCIATIONS ARE FOR LOBBYING ACTIVITIES. DURING THIS PAST YEAR, THE ST. JOSEPH HEALTH SYSTEM HAS CONDUCTED AN ADVOCACY EFFORT WHICH INCLUDED SOME LOBBYING ACTIVITY. THESE INCLUDED MEETINGS WITH LOCAL, STATE,AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS; AND COMMUNICATIONS TO LEGISLATORS ADVOCATING POSITIONS ON LEGISLATION.

Schedule C (Form 990 or 990EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990. SchDMd Bullet

See separate instructions. SchDMd Bullet

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

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST MARY MEDICAL CENTER

Employer identification number

95-1914489

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 ....	566,823	549,770	530,889	473,913	420,803
b	Contributions ........
c	Net investment earnings, gains, and losses	70,417	20,053	21,881	59,976	56,110
d	Grants or scholarships .....	3,000	3,000	3,000	3,000	3,000
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......	634,240	566,823	549,770	530,889	473,913

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

100.000 %

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

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

Yes

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

3a(i)

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

3a(ii)

Yes

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

Yes

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

Part VI

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

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	30,153,187		30,153,187
b	Buildings ................	107,135,872	55,311,093	51,824,779
c	Leasehold improvements ............	328,078	205,307	122,771
d	Equipment ................	70,921,032	55,529,615	15,391,417
e	Other .................	42,103,112	1,559,354	40,543,758
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				138,035,912

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
INTERCOMPANY W/HEALTH SYSTEM BONDS		61,019,735
DUE TO 3RD PARTY PAYORS		11,492,950
CAPITAL LEASE		1,383,318
ANNUITY AND TRUST PAYABLE		650,136
457F LIABILITY		74,819
SECURITY DEPOSIT		5,693



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		74,626,651
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 V, LINE 4	ENDOWMENT FUNDS USE ENDOWMENT FUNDS WERE DESIGNATED TO PROVIDE SCHOLARSHIP FUNDS FOR NURSING STUDENTS.
SCHEDULE D, PART X, LINE 2	FIN 48 (ASC 740) FOOTNOTE ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2014 OR 2013.

Return Reference

Explanation

SCHEDULE D, PART V, LINE 4

ENDOWMENT FUNDS USE ENDOWMENT FUNDS WERE DESIGNATED TO PROVIDE SCHOLARSHIP FUNDS FOR NURSING STUDENTS.

SCHEDULE D, PART X, LINE 2

FIN 48 (ASC 740) FOOTNOTE ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2014 OR 2013.

Schedule D (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

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

See separate instructions.
right arrow

Information about Schedule G (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 MARY MEDICAL CENTER

Employer identification number

95-1914489

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2013

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 ANNUAL GALA (event type)	(b) Event #2 MEN WHO COOK (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . .	211,625	38,115	249,740
2	Less: Contributions . .	19,320	12,320	31,640
3	Gross income (line 1 minus line 2) . . .	192,305	25,795	218,100
4	Cash prizes . . .
5	Noncash prizes . .	3,150	181	3,331
6	Rent/facility costs . .	54,261	2,304	56,565
7	Food and beverages .	48,316	0	48,316
8	Entertainment . . .	35,000	0	35,000
9	Other direct expenses .	17,093	414	17,507
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........			160,719
11	Net income summary. Subtract line 10 from line 3, column (d)...........			57,381

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (add col.(a) through col.(c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2013

Page 3

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ..........................

YesNo

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

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

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST MARY MEDICAL CENTER

Employer identification number

95-1914489

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 500 %

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	6,203,860		6,203,860	2.290 %
b	Medicaid (from Worksheet 3, column a) ....	64,945,939	52,305,722	12,640,217	4.660 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	71,149,799	52,305,722	18,844,077	6.950 %
Other Benefits		701,124	196,357	504,767	0.190 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	701,124	196,357	504,767	0.190 %
f	Health professions education (from Worksheet 5) ..	419,384		419,384	0.150 %
g	Subsidized health services (from Worksheet 6) ..	5,682,198	926,061	4,756,137	1.750 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	148,993		148,993	0.050 %
j	Total. Other Benefits ..	6,951,699	1,122,418	5,829,281	2.140 %
k	Total. Add lines 7d and 7j .	78,101,498	53,428,140	24,673,358	9.090 %

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.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	1,419		1,419	0 %
3	Community support	2,228		2,228	0 %
4	Environmental improvements	4,989	4,989	0
5	Leadership development and training for community members	4,989	4,989	0
6	Coalition building	4,989	4,989	0
7	Community health improvement advocacy	21,773	21,158	615	0 %
8	Workforce development	383	0	383	0 %
9	Other	0	0	0	0 %
10	Total	40,770	36,125	4,645	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

2,922,691

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

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

Section B. Medicare

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

54,572,613

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

64,326,855

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

-9,754,242

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 2013

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number
1	ST MARY MEDICAL CENTER 18300 HIGHWAY 18 APPLE VALLEY,CA92307 www.stmaryapplevalley.com 240000207	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 MARY MEDICAL CENTER
Name of hospital facility or facility reporting group

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

Yes

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The health needs of the community

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

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

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

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

Other (describe in Part VI)

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

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): SEE SCHEDULE H, PART V, SECTION C

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: 500.% 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, SECTION B, LINE 3	THE HOSPITAL PLACES ON ITS INTERNET SITE ALL COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS, COMMUNITY BENEFIT PLANS AND ANNUAL COMMUNITY BENEFIT REPORTS. THE HOSPITAL OPERATES A HEALTHY COMMUNITY DEPARTMENT WORKING WITH NUMEROUS COMMUNITY PARTNERS AND RESIDENTS WHO PROVIDE INPUT ON HEALTH AND SOCIAL NEEDS THROUGHOUT THE YEAR. ADDITIONALLY, THE HOSPITAL OPERATES TWO FIXED COMMUNITY CLINICS AND A MOBILE MEDICAL UNIT. THE HOSPITAL'S COMMUNITY CLINICS SERVE POOR PATIENTS IN THE COMMUNITIES OF ADELANTO, APPLE VALLEY, HESPERIA AND VICTORVILLE. THE PRIMARY CARE SERVICES THAT ARE PROVIDED TO THIS POPULATION PROVIDES FEEDBACK THAT LOW COST SPECIALTY CARE SERVICES ARE NEEDED. FEEDBACK TO THE HOSPITAL'S HEALTHY COMMUNITIES TEAM IS ALWAYS FOCUSED ON THE NEED FOR ADDITIONAL SERVICES PROVIDED IN LOW INCOME COMMUNITIES. THIS INCLUDES: THE NEED FOR LOW COST ACCESS TO HEALTHY FOODS, ADDITIONAL HEALTH PROVIDERS LOCATED IN POOR NEIGHBORHOODS, AN IMPROVED TRANSPORTATION SYSTEM THAT PROVIDING IMPROVED SERVICE FOR LOW INCOME PERSONS, THE DEVELOPMENT OF ADDITIONAL BEHAVIORAL HEALTH SERVICES INCLUDING AN INPATIENT PSYCHIATRIC PROGRAM, CREATION OF A FOOD BANK, IMPROVED JOB TRAINING AND EMPLOYMENT OPPORTUNITIES AND INCREASED AFFORDABLE HOUSING FOR THE HOMELESS. THE HOSPITAL RECEIVES FEEDBACK FROM TWO PARTNERS USING HOSPITAL GRANTS TO SERVE THE POOR WITH FOOD, HOUSING AND UTILITY ASSISTANCE. THEIR QUARTERLY REPORTS CITE A DEMAND OF SERVICES EXCEEDING THE SUPPLY OF FOOD OR FUNDS. THE REGION SUFFERS FROM AN UNEMPLOYMENT RATE THAT IS TYPICALLY ONE TO TWO PERCENTAGE POINTS HIGHER THAN THE STATEWIDE AVERAGE. THAT PERCENTAGE IS 8.9% FOR DECEMBER 2013. THE HOSPITAL RECEIVES FEEDBACK FROM SAN BERNARDINO COUNTY PUBLIC HEALTH THAT COLLABORATIVE EFFORTS WILL SPEED THE OPENING OF LOCAL COMMUNITY CLINICS SERVING THE POOR. SAN BERNARDINO COUNTY EXPERIENCES AN ACUTE PHYSICIAN SHORTAGE TO SERVE ITS POPULATION. THE HOSPITAL JOINED A COUNTY-WIDE COMMUNITY CLINIC COLLABORATIVE AND HAS ASSISTED IN THE OPENING OF FOUR (4) LOCAL COMMUNITY CLINICS SERVING LOW INCOME PERSONS. THE HOSPITAL WORKED CLOSELY WITH KAISER FONTANA WHO PROVIDED TECHNICAL ASSISTANCE AND START-UP GRANTS FOR CLINIC EXPANSION. ADDITIONALLY, THE HOSPITAL WORKED WITH THE NEWLY FORMED COMMUNITY CLINIC ASSOCIATION TO STREAMLINE THE REFERRAL OF POOR PATIENTS OBTAINING SPECIALTY CARE AT THE COUNTY HOSPITAL. THE HOSPITAL RECEIVED FEEDBACK FROM RESIDENTS AND LEADERS THAT COMMUNITIES NEED ADDITIONAL HEALTH CLINICS. THIS FEEDBACK RESULTED IN THE HOSPITAL RECRUITING MOLINA HEALTH TO OPEN ITS FIRST CLINIC IN THE VICTOR REGION. IN 2013 MOLINA OPENED A SECOND CLINIC IN THE CITY OF VICTORVILLE. THE HOSPITAL RECEIVED FEEDBACK FROM THE COUNTY'S HEALTHY COMMUNITIES PROGRAM THAT COORDINATING RESOURCES AND ADVOCACY COULD HELP "PUSH" LOCAL CITY LEADERS TO PRIORITIZE PARK AND RECREATION AND IMPROVED STREET PROGRAMS (PROVIDING SIDEWALKS, WALKING TRAILS AND BICYCLE LANES). THIS ADVOCACY RESULTED IN THE HOSPITAL'S CONTINUED WORK SUPPORTING/MANAGING FOUR (4) HEALTHY CITY CAMPAIGNS WHICH ALSO PROVIDES THE HOSPITAL FEEDBACK ABOUT THE LOCAL RESIDENT'S NEED FOR INCREASED ACCESS TO HEALTHY FOODS, SAFER STREETS, PARK AND RECREATION, THE NEED FOR MORE MEDICAL CARE, MORE EMPLOYMENT AND CAREER DEVELOPMENT PROGRAMS. THE HOSPITAL'S WORK IS NOW REGIONAL WITH MULTIPLE CITIES ENGAGED. FEEDBACK FROM THE COUNTY'S INLAND EMPIRE CHILDREN'S HEALTH INITIATIVE URGED THE HOSPITAL TO ASSIST IN DEVELOPING ENROLLMENT CAMPAIGNS TARGETING HISPANIC FAMILIES TRADITIONALLY NOT ENROLLING INTO HEALTH INSURANCE. THE HOSPITAL IS THE ONLY VICTOR VALLEY REPRESENTATIVE ON THIS COUNTY LEVEL COLLABORATIVE. HEALTH INSURANCE RESEARCH ESTIMATES THAT THE VICTOR VALLEY HAS 67,000 UNINSURED RESIDENTS AND AN ESTIMATED 32,000 OF THEM ELIGIBLE FOR MEDI-CAL. IN RESPONSE, THE HOSPITAL DEVELOPED A LOCAL NETWORK OF BILINGUAL HEALTH INSURANCE ENROLLERS. THE HOSPITAL ALSO IDENTIFIED SCHOOLS WHERE LARGE NUMBERS OF HISPANIC FAMILIES MEET TO DISCUSS THEIR CHILDREN'S EDUCATION. THESE MEETINGS SERVE AS EDUCATION OPPORTUNITIES TO DISCUSS COMMUNITY BARRIERS TO SERVICES, HEALTH CONDITIONS AND HEALTH INSURANCE. FEEDBACK FROM SAN BERNARDINO COUNTY'S ONLY FOOD BANK URGED THE HOSPITAL PARTICIPATE DEVELOPING A COUNTY-WIDE FOOD POLICY INCLUDING DEVELOPMENT OF A TRANSPORTATION SERVICE WHEREBY LARGER QUANTITIES OF FOOD COULD BE DELIVERED TO LOCAL FOOD PANTRIES. IN RESPONSE, THE HOSPITAL IDENTIFIED FOUR PROGRAMS AND SECURED GRANT FUNDS TO BEGIN A COLLABORATIVE FOOD TRANSPORT SERVICE. THE LONG TERM GOAL OF THIS PROJECT COULD LEAD TO THE DEVELOPMENT OF THE HIGH DESERT'S FIRST FOOD BANK. THE NEED FOR A VICTOR-BARSTOW FOOD BANK HAS BEEN IDENTIFIED AS A NEED BY PARTNERS SERVING THE POOR.
SCHEDULE H, PART V, SECTION B, LINE 5	CHNA WEBSITE ADDRESS HTTP://WWW.STMARYAPPLEVALLEY.COM/DOCUMENTS/COMMUNITY-BENEFIT/2014-COMMUNIT Y-HEALTH-NEEDS-ASSESMENT-REPORT.PDF
SCHEDULE H, PART V, SECTION B, LINE 7	AS THE REGION'S ONLY NON-PROFIT HOSPITAL, ST. MARY COMPLETES A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENTS INCLUDING INPUT FROM RESIDENTS, COMMUNITY PARTNERS AND COUNTY AGENCIES INCLUDING SAN BERNARDINO COUNTY PUBLIC HEALTH. A HEALTH SURVEY WAS CONDUCTED LOCALLY TO OBTAIN PRIMARY HEALTH DATA BY INTERVIEWING 700 RANDOMLY SELECTED HOUSEHOLDS REPRESENTING THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. COLLECTION OF THIS PRIMARY HEALTH DATA WAS THEN CROSS-REFERENCED WITH HEALTH BENCHMARKS ESTABLISHED AT THE COUNTY, STATE OF CALIFORNIA AND NATIONAL LEVEL (HEALTHY PEOPLE 2020. THE HOSPITAL WORKS IN A COMMUNITY BENEFIT COLLABORATIVE OF SIX (6) NONPROFIT HOSPITALS TO DISCUSS RESULTS OF EACH HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT. DISCUSSIONS INCLUDE COMMON APPROACHES ADDRESSING SIGNIFICANT HEALTH AND SOCIAL NEEDS REGIONALLY. THE COLLABORATIVE HAS IDENTIFIED: (1) ACCESS TO CARE AND (2) HEART DISEASE AS REGIONAL ISSUES WITH CROSS-CUTTING THEMES OF OBESITY, AND POOR PHYSICAL ENVIRONMENTS PROMOTING HEALTH. A RESULT OF THE HOSPITAL'S 2012 COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED 16 HEALTH/DISEASE OR POPULATION BEHAVIOR RISKS HIGHER THAN STATE AND NATIONAL BENCHMARKS. IN FY14 THE HOSPITAL CONTINUED TO IMPLEMENT PROGRAMS ADDRESSING THE PRIORITY ISSUES: (1) ACCESS TO CARE, (2) CHILD/FAMILY OBESITY, (3) BREASTFEEDING AND (4) DIABETES. THE HOSPITAL'S SUCCESS WITH ACCESS TO CARE INCLUDES ENROLLING 963 PERSONS INTO HEALTH INSURANCE, AND THE OPENING OF TWO ADDITIONAL COMMUNITY CLINICS SERVING THE AREA'S POOR. THE TWO CLINICS PROVIDE PRIMARY CARE AND MENTAL HEALTH SERVICES TO LOW INCOME PERSONS. THE HOSPITAL'S FAMILY OBESITY PROGRAM WORKS IN 9 SCHOOLS AND 13 CLASSROOMS. THE PROGRAM HAS BEEN ADOPTED BY PARTNERS COUNTY-WIDE AT FEDERALLY FUNDED HEAD STARTS. THE PROGRAM ASSISTED 17% OF OVERWEIGHT OR OBESE CHILDREN (AGES 3-6 YEARS) TO DROP ONE WEIGHT CLASSIFICATION AS A RESULT OF FAMILY CHANGES IN EATING AND PLAYTIME. THE HOSPITAL'S COMPREHENSIVE DIABETES PROGRAM FOR THE UNINSURED IS THE ONLY ONE OF ITS KIND IN THE REGION. THE PROGRAM REPORTS THAT 80% OF PATIENTS REPORT MAINTAINING HGA1C LEVELS LESS THAN 7 AND 90% HAVE COMPLIED WITH ACCESSING ANNUAL EYE AND FOOT EXAMS. THE HOSPITAL CONTINUED TO IMPLEMENT ITS BREASTFEEDING WORK AS AN ELEMENT OF ITS BABY FRIENDLY DESIGNATION. THE HOSPITAL'S COMMUNITY HEALTH DEPARTMENT TRACKS THE NUMBER OF MOMS PROVIDING BREAST MILK AT ONE, THREE AND SIX MONTH INTERVALS AS WELL AS PROVIDING PATIENTS LACTATION AND BREAST PUMP ASSISTANCE. THE PROGRAM IS CONSIDERED A BEST PRACTICE BY THE COUNTY WIC AGENCY. A DETAILED DISCUSSION OF THE HOSPITAL ADDRESSING HEALTH NEEDS FOLLOWS. HOSPITAL RESPONSE TO IDENTIFIED HEALTH NEEDS THE HOSPITAL'S HEALTH ASSESSMENT IDENTIFIED 16 HEALTH AND SOCIAL CONDITIONS AT LEVELS GREATER THAN STATE OR NATIONAL BENCHMARKS. THESE CONDITIONS ARE: CHILD ASTHMA, CANCER, DIABETES, STROKE, HYPERTENSION AND HIGH CHOLESTEROL, DEPRESSION AND LOW SELF-RATED MENTAL HEALTH, ARTHRITIS AND ACTIVITY LIMITATION, FAIR AND POOR SELF-RATED HEALTH, OBESITY, ACCESS TO GROCERY STORES, HIGH USE OF ALCOHOL AND TOBACCO, POOR DENTAL CARE, UNINSURED AND HIGH BARRIERS TO ACCESS TO HEALTH SERVICES. DURING THE HOSPITAL'S ASSESSMENT OF FINDINGS AND FEEDBACK SESSIONS WITH RESIDENTS AND PARTNERS, THE HOSPITAL PRIORITIZED FOUR HEALTH ISSUES THAT WERE NOT BEING ADDRESSED AT ALL OR NEEDED INCREASED HOSPITAL SUPPORT. THESE ISSUES ARE: ACCESS TO CARE, DIABETES, OBESITY AND MENTAL HEALTH. THE HOSPITAL IDENTIFIED PUBLIC HEALTH PROVIDING PROGRAMS ADDRESSING CHILD ASTHMA AND MENTAL HEALTH INCLUDING CRISIS SERVICES. THE HOSPITAL PARTNERS WITH A COMMUNITY ORGANIZATION PROVIDING DENTAL CARE TO LOW INCOME AND THE UNINSURED. THE HOSPITAL PRIORITIZATION OF ACCESS TO CARE AND DIABETES WAS ALSO IDENTIFIED REGIONALLY. THE HOSPITAL NOTED THE EXPERTISE OF THE AMERICAN HEART ASSOCIATION AND THE COUNTY'S 211 PROGRAM TO EDUCATE ON THE RISKS OF HEART DISEASE AND SIGNS OF STROKE. THE HOSPITAL RECOGNIZED THAT IT IS THE COMMUNITY'S ONLY PROVIDER OF COMPREHENSIVE SERVICES ADDRESSING OBESITY AND DIABETES. THE HOSPITAL PARTNERS WITH COMMUNITY CLINICS TO ASSIST IN EXPANDING ACCESS TO CARE. THE HOSPITAL CONTINUES ENROLLMENT OF UNINSURED INTO HEALTH INSURANCE. THE HOSPITAL PARTNER'S WITH THE COUNTY'S LARGEST MEDI-CAL PROVIDER TO NAVIGATE ON FREQUENT USERS OF ACUTE CARE HEALTH SERVICES. THE HOSPITAL'S OBESITY PROGRAM INCLUDES STRATEGIES ADDRESSING TOBACCO, ALCOHOL AND ACCESS TO HEALTHY FOODS. THE HOSPITAL IS ADDRESSING THESE ISSUES IN PARTNERSHIP WITH CITY HEALTH CAMPAIGNS AND COUNTY PUBLIC HEALTH. RESIDENT FEEDBACK INCLUDED THE NEED FOR MORE LOCAL GROCERY STORES AND PARKS. RESIDENTS IN ADELANTO WANT THE HOSPITAL TO BRING MORE HEALTH SERVICES TO THEIR COMMUNITY INCLUDING AN URGENT CARE CENTER, MENTAL HEALTH PROVIDERS AND DIABETES EDUCATION AND LOW COST SERVICES TO EQUIPMENT, TEST STRIPS AND MEDICATION. THE HOSPITAL, AS PREVIOUSLY MENTIONED, HELPED MOLINA HEALTH TO OPEN A CLINIC IN ADELANTO IN 2012. FEEDBACK FROM NON-PROFIT AGENCIES WAS A LOW COST TRANSPORTATION SERVICE WAS NEEDED TO CONNECT THE POOR WITH THEIR HEALTH HAND SOCIAL SERVICE NEEDS. THE HOSPITAL IS ASSESSING THE DEVELOPMENT OF TRANSPORTATION PROGRAMS WITH THE TECHNICAL ASSISTANCE OF VICTOR VALLEY TRANSIT AUTHORITY. FEEDBACK FROM HOMELESS PERSONS ADVOCATE FOR GREATER ACCESS TO FOOD, EMPLOYMENT AND HOUSING AS WELL AS ACCESS TO HEALTH INSURANCE AND EYE GLASSES.
SCHEDULE H, PART V, SECTION B, LINE 12I	BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS: THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT.
SCHEDULE H, PART V, SECTION B, LINE 14G	MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA. PROVIDED UPON INQUIRY.
SCHEDULE H, PART V, SECTION B, LINE 18E	THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA.
SCHEDULE H, PART V, SECTION B, LINE 20D	AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: FOR PATIENTS WITH A FAMILY INCOME BETWEEN 201% AND 350% OF FEDERAL POVERTY GUIDELINES (FPG), THE HOSPITAL FACILITY USES MEDICARE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. FOR PATIENTS WITH A FAMILY INCOME BETWEEN 351% AND 500% OF FPG, THE AVERAGE OF NEGOTIATED COMMERCIAL INSURANCE RATES IS USED TO DETERMINE THE MAXIMUM AMOUNT THAT CAN BE CHARGED.

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?5
Name and address		Type of Facility (describe)
1	OUTPATIENT SURGERY PAVILLION 18122 HIGHWAY 18 APPLE VALLEY,CA92307	AMBULATORY SURGERY CENTER
2	WOUND CARE CENTER 16077 KAMANA ROAD APPLE VALLEY,CA92307	WOUND CARE
3	HEALTHY BEGINNINGS CLINIC 18977 S OUTER HWY 18 A APPLE VALLEY,CA92307	CLINIC
4	ADELANTO CLINIC 11424 CHAMBERLAIN WAY STE 89 ADELANTO,CA92301	CLINIC
5	HESPERIA CLINIC 17091 MAIN STREET STE 100 HESPERIA,CA92345	CLINIC
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, SECTION B, LINE 3	THE HOSPITAL PLACES ON ITS INTERNET SITE ALL COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS, COMMUNITY BENEFIT PLANS AND ANNUAL COMMUNITY BENEFIT REPORTS. THE HOSPITAL OPERATES A HEALTHY COMMUNITY DEPARTMENT WORKING WITH NUMEROUS COMMUNITY PARTNERS AND RESIDENTS WHO PROVIDE INPUT ON HEALTH AND SOCIAL NEEDS THROUGHOUT THE YEAR. ADDITIONALLY, THE HOSPITAL OPERATES TWO FIXED COMMUNITY CLINICS AND A MOBILE MEDICAL UNIT. THE HOSPITAL'S COMMUNITY CLINICS SERVE POOR PATIENTS IN THE COMMUNITIES OF ADELANTO, APPLE VALLEY, HESPERIA AND VICTORVILLE. THE PRIMARY CARE SERVICES THAT ARE PROVIDED TO THIS POPULATION PROVIDES FEEDBACK THAT LOW COST SPECIALTY CARE SERVICES ARE NEEDED. FEEDBACK TO THE HOSPITAL'S HEALTHY COMMUNITIES TEAM IS ALWAYS FOCUSED ON THE NEED FOR ADDITIONAL SERVICES PROVIDED IN LOW INCOME COMMUNITIES. THIS INCLUDES: THE NEED FOR LOW COST ACCESS TO HEALTHY FOODS, ADDITIONAL HEALTH PROVIDERS LOCATED IN POOR NEIGHBORHOODS, AN IMPROVED TRANSPORTATION SYSTEM THAT PROVIDING IMPROVED SERVICE FOR LOW INCOME PERSONS, THE DEVELOPMENT OF ADDITIONAL BEHAVIORAL HEALTH SERVICES INCLUDING AN INPATIENT PSYCHIATRIC PROGRAM, CREATION OF A FOOD BANK, IMPROVED JOB TRAINING AND EMPLOYMENT OPPORTUNITIES AND INCREASED AFFORDABLE HOUSING FOR THE HOMELESS. THE HOSPITAL RECEIVES FEEDBACK FROM TWO PARTNERS USING HOSPITAL GRANTS TO SERVE THE POOR WITH FOOD, HOUSING AND UTILITY ASSISTANCE. THEIR QUARTERLY REPORTS CITE A DEMAND OF SERVICES EXCEEDING THE SUPPLY OF FOOD OR FUNDS. THE REGION SUFFERS FROM AN UNEMPLOYMENT RATE THAT IS TYPICALLY ONE TO TWO PERCENTAGE POINTS HIGHER THAN THE STATEWIDE AVERAGE. THAT PERCENTAGE IS 8.9% FOR DECEMBER 2013. THE HOSPITAL RECEIVES FEEDBACK FROM SAN BERNARDINO COUNTY PUBLIC HEALTH THAT COLLABORATIVE EFFORTS WILL SPEED THE OPENING OF LOCAL COMMUNITY CLINICS SERVING THE POOR. SAN BERNARDINO COUNTY EXPERIENCES AN ACUTE PHYSICIAN SHORTAGE TO SERVE ITS POPULATION. THE HOSPITAL JOINED A COUNTY-WIDE COMMUNITY CLINIC COLLABORATIVE AND HAS ASSISTED IN THE OPENING OF FOUR (4) LOCAL COMMUNITY CLINICS SERVING LOW INCOME PERSONS. THE HOSPITAL WORKED CLOSELY WITH KAISER FONTANA WHO PROVIDED TECHNICAL ASSISTANCE AND START-UP GRANTS FOR CLINIC EXPANSION. ADDITIONALLY, THE HOSPITAL WORKED WITH THE NEWLY FORMED COMMUNITY CLINIC ASSOCIATION TO STREAMLINE THE REFERRAL OF POOR PATIENTS OBTAINING SPECIALTY CARE AT THE COUNTY HOSPITAL. THE HOSPITAL RECEIVED FEEDBACK FROM RESIDENTS AND LEADERS THAT COMMUNITIES NEED ADDITIONAL HEALTH CLINICS. THIS FEEDBACK RESULTED IN THE HOSPITAL RECRUITING MOLINA HEALTH TO OPEN ITS FIRST CLINIC IN THE VICTOR REGION. IN 2013 MOLINA OPENED A SECOND CLINIC IN THE CITY OF VICTORVILLE. THE HOSPITAL RECEIVED FEEDBACK FROM THE COUNTY'S HEALTHY COMMUNITIES PROGRAM THAT COORDINATING RESOURCES AND ADVOCACY COULD HELP "PUSH" LOCAL CITY LEADERS TO PRIORITIZE PARK AND RECREATION AND IMPROVED STREET PROGRAMS (PROVIDING SIDEWALKS, WALKING TRAILS AND BICYCLE LANES). THIS ADVOCACY RESULTED IN THE HOSPITAL'S CONTINUED WORK SUPPORTING/MANAGING FOUR (4) HEALTHY CITY CAMPAIGNS WHICH ALSO PROVIDES THE HOSPITAL FEEDBACK ABOUT THE LOCAL RESIDENT'S NEED FOR INCREASED ACCESS TO HEALTHY FOODS, SAFER STREETS, PARK AND RECREATION, THE NEED FOR MORE MEDICAL CARE, MORE EMPLOYMENT AND CAREER DEVELOPMENT PROGRAMS. THE HOSPITAL'S WORK IS NOW REGIONAL WITH MULTIPLE CITIES ENGAGED. FEEDBACK FROM THE COUNTY'S INLAND EMPIRE CHILDREN'S HEALTH INITIATIVE URGED THE HOSPITAL TO ASSIST IN DEVELOPING ENROLLMENT CAMPAIGNS TARGETING HISPANIC FAMILIES TRADITIONALLY NOT ENROLLING INTO HEALTH INSURANCE. THE HOSPITAL IS THE ONLY VICTOR VALLEY REPRESENTATIVE ON THIS COUNTY LEVEL COLLABORATIVE. HEALTH INSURANCE RESEARCH ESTIMATES THAT THE VICTOR VALLEY HAS 67,000 UNINSURED RESIDENTS AND AN ESTIMATED 32,000 OF THEM ELIGIBLE FOR MEDI-CAL. IN RESPONSE, THE HOSPITAL DEVELOPED A LOCAL NETWORK OF BILINGUAL HEALTH INSURANCE ENROLLERS. THE HOSPITAL ALSO IDENTIFIED SCHOOLS WHERE LARGE NUMBERS OF HISPANIC FAMILIES MEET TO DISCUSS THEIR CHILDREN'S EDUCATION. THESE MEETINGS SERVE AS EDUCATION OPPORTUNITIES TO DISCUSS COMMUNITY BARRIERS TO SERVICES, HEALTH CONDITIONS AND HEALTH INSURANCE. FEEDBACK FROM SAN BERNARDINO COUNTY'S ONLY FOOD BANK URGED THE HOSPITAL PARTICIPATE DEVELOPING A COUNTY-WIDE FOOD POLICY INCLUDING DEVELOPMENT OF A TRANSPORTATION SERVICE WHEREBY LARGER QUANTITIES OF FOOD COULD BE DELIVERED TO LOCAL FOOD PANTRIES. IN RESPONSE, THE HOSPITAL IDENTIFIED FOUR PROGRAMS AND SECURED GRANT FUNDS TO BEGIN A COLLABORATIVE FOOD TRANSPORT SERVICE. THE LONG TERM GOAL OF THIS PROJECT COULD LEAD TO THE DEVELOPMENT OF THE HIGH DESERT'S FIRST FOOD BANK. THE NEED FOR A VICTOR-BARSTOW FOOD BANK HAS BEEN IDENTIFIED AS A NEED BY PARTNERS SERVING THE POOR.
SCHEDULE H, PART V, SECTION B, LINE 5	CHNA WEBSITE ADDRESS HTTP://WWW.STMARYAPPLEVALLEY.COM/DOCUMENTS/COMMUNITY-BENEFIT/2014-COMMUNIT Y-HEALTH-NEEDS-ASSESMENT-REPORT.PDF
SCHEDULE H, PART V, SECTION B, LINE 7	AS THE REGION'S ONLY NON-PROFIT HOSPITAL, ST. MARY COMPLETES A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENTS INCLUDING INPUT FROM RESIDENTS, COMMUNITY PARTNERS AND COUNTY AGENCIES INCLUDING SAN BERNARDINO COUNTY PUBLIC HEALTH. A HEALTH SURVEY WAS CONDUCTED LOCALLY TO OBTAIN PRIMARY HEALTH DATA BY INTERVIEWING 700 RANDOMLY SELECTED HOUSEHOLDS REPRESENTING THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. COLLECTION OF THIS PRIMARY HEALTH DATA WAS THEN CROSS-REFERENCED WITH HEALTH BENCHMARKS ESTABLISHED AT THE COUNTY, STATE OF CALIFORNIA AND NATIONAL LEVEL (HEALTHY PEOPLE 2020. THE HOSPITAL WORKS IN A COMMUNITY BENEFIT COLLABORATIVE OF SIX (6) NONPROFIT HOSPITALS TO DISCUSS RESULTS OF EACH HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT. DISCUSSIONS INCLUDE COMMON APPROACHES ADDRESSING SIGNIFICANT HEALTH AND SOCIAL NEEDS REGIONALLY. THE COLLABORATIVE HAS IDENTIFIED: (1) ACCESS TO CARE AND (2) HEART DISEASE AS REGIONAL ISSUES WITH CROSS-CUTTING THEMES OF OBESITY, AND POOR PHYSICAL ENVIRONMENTS PROMOTING HEALTH. A RESULT OF THE HOSPITAL'S 2012 COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED 16 HEALTH/DISEASE OR POPULATION BEHAVIOR RISKS HIGHER THAN STATE AND NATIONAL BENCHMARKS. IN FY14 THE HOSPITAL CONTINUED TO IMPLEMENT PROGRAMS ADDRESSING THE PRIORITY ISSUES: (1) ACCESS TO CARE, (2) CHILD/FAMILY OBESITY, (3) BREASTFEEDING AND (4) DIABETES. THE HOSPITAL'S SUCCESS WITH ACCESS TO CARE INCLUDES ENROLLING 963 PERSONS INTO HEALTH INSURANCE, AND THE OPENING OF TWO ADDITIONAL COMMUNITY CLINICS SERVING THE AREA'S POOR. THE TWO CLINICS PROVIDE PRIMARY CARE AND MENTAL HEALTH SERVICES TO LOW INCOME PERSONS. THE HOSPITAL'S FAMILY OBESITY PROGRAM WORKS IN 9 SCHOOLS AND 13 CLASSROOMS. THE PROGRAM HAS BEEN ADOPTED BY PARTNERS COUNTY-WIDE AT FEDERALLY FUNDED HEAD STARTS. THE PROGRAM ASSISTED 17% OF OVERWEIGHT OR OBESE CHILDREN (AGES 3-6 YEARS) TO DROP ONE WEIGHT CLASSIFICATION AS A RESULT OF FAMILY CHANGES IN EATING AND PLAYTIME. THE HOSPITAL'S COMPREHENSIVE DIABETES PROGRAM FOR THE UNINSURED IS THE ONLY ONE OF ITS KIND IN THE REGION. THE PROGRAM REPORTS THAT 80% OF PATIENTS REPORT MAINTAINING HGA1C LEVELS LESS THAN 7 AND 90% HAVE COMPLIED WITH ACCESSING ANNUAL EYE AND FOOT EXAMS. THE HOSPITAL CONTINUED TO IMPLEMENT ITS BREASTFEEDING WORK AS AN ELEMENT OF ITS BABY FRIENDLY DESIGNATION. THE HOSPITAL'S COMMUNITY HEALTH DEPARTMENT TRACKS THE NUMBER OF MOMS PROVIDING BREAST MILK AT ONE, THREE AND SIX MONTH INTERVALS AS WELL AS PROVIDING PATIENTS LACTATION AND BREAST PUMP ASSISTANCE. THE PROGRAM IS CONSIDERED A BEST PRACTICE BY THE COUNTY WIC AGENCY. A DETAILED DISCUSSION OF THE HOSPITAL ADDRESSING HEALTH NEEDS FOLLOWS. HOSPITAL RESPONSE TO IDENTIFIED HEALTH NEEDS THE HOSPITAL'S HEALTH ASSESSMENT IDENTIFIED 16 HEALTH AND SOCIAL CONDITIONS AT LEVELS GREATER THAN STATE OR NATIONAL BENCHMARKS. THESE CONDITIONS ARE: CHILD ASTHMA, CANCER, DIABETES, STROKE, HYPERTENSION AND HIGH CHOLESTEROL, DEPRESSION AND LOW SELF-RATED MENTAL HEALTH, ARTHRITIS AND ACTIVITY LIMITATION, FAIR AND POOR SELF-RATED HEALTH, OBESITY, ACCESS TO GROCERY STORES, HIGH USE OF ALCOHOL AND TOBACCO, POOR DENTAL CARE, UNINSURED AND HIGH BARRIERS TO ACCESS TO HEALTH SERVICES. DURING THE HOSPITAL'S ASSESSMENT OF FINDINGS AND FEEDBACK SESSIONS WITH RESIDENTS AND PARTNERS, THE HOSPITAL PRIORITIZED FOUR HEALTH ISSUES THAT WERE NOT BEING ADDRESSED AT ALL OR NEEDED INCREASED HOSPITAL SUPPORT. THESE ISSUES ARE: ACCESS TO CARE, DIABETES, OBESITY AND MENTAL HEALTH. THE HOSPITAL IDENTIFIED PUBLIC HEALTH PROVIDING PROGRAMS ADDRESSING CHILD ASTHMA AND MENTAL HEALTH INCLUDING CRISIS SERVICES. THE HOSPITAL PARTNERS WITH A COMMUNITY ORGANIZATION PROVIDING DENTAL CARE TO LOW INCOME AND THE UNINSURED. THE HOSPITAL PRIORITIZATION OF ACCESS TO CARE AND DIABETES WAS ALSO IDENTIFIED REGIONALLY. THE HOSPITAL NOTED THE EXPERTISE OF THE AMERICAN HEART ASSOCIATION AND THE COUNTY'S 211 PROGRAM TO EDUCATE ON THE RISKS OF HEART DISEASE AND SIGNS OF STROKE. THE HOSPITAL RECOGNIZED THAT IT IS THE COMMUNITY'S ONLY PROVIDER OF COMPREHENSIVE SERVICES ADDRESSING OBESITY AND DIABETES. THE HOSPITAL PARTNERS WITH COMMUNITY CLINICS TO ASSIST IN EXPANDING ACCESS TO CARE. THE HOSPITAL CONTINUES ENROLLMENT OF UNINSURED INTO HEALTH INSURANCE. THE HOSPITAL PARTNER'S WITH THE COUNTY'S LARGEST MEDI-CAL PROVIDER TO NAVIGATE ON FREQUENT USERS OF ACUTE CARE HEALTH SERVICES. THE HOSPITAL'S OBESITY PROGRAM INCLUDES STRATEGIES ADDRESSING TOBACCO, ALCOHOL AND ACCESS TO HEALTHY FOODS. THE HOSPITAL IS ADDRESSING THESE ISSUES IN PARTNERSHIP WITH CITY HEALTH CAMPAIGNS AND COUNTY PUBLIC HEALTH. RESIDENT FEEDBACK INCLUDED THE NEED FOR MORE LOCAL GROCERY STORES AND PARKS. RESIDENTS IN ADELANTO WANT THE HOSPITAL TO BRING MORE HEALTH SERVICES TO THEIR COMMUNITY INCLUDING AN URGENT CARE CENTER, MENTAL HEALTH PROVIDERS AND DIABETES EDUCATION AND LOW COST SERVICES TO EQUIPMENT, TEST STRIPS AND MEDICATION. THE HOSPITAL, AS PREVIOUSLY MENTIONED, HELPED MOLINA HEALTH TO OPEN A CLINIC IN ADELANTO IN 2012. FEEDBACK FROM NON-PROFIT AGENCIES WAS A LOW COST TRANSPORTATION SERVICE WAS NEEDED TO CONNECT THE POOR WITH THEIR HEALTH HAND SOCIAL SERVICE NEEDS. THE HOSPITAL IS ASSESSING THE DEVELOPMENT OF TRANSPORTATION PROGRAMS WITH THE TECHNICAL ASSISTANCE OF VICTOR VALLEY TRANSIT AUTHORITY. FEEDBACK FROM HOMELESS PERSONS ADVOCATE FOR GREATER ACCESS TO FOOD, EMPLOYMENT AND HOUSING AS WELL AS ACCESS TO HEALTH INSURANCE AND EYE GLASSES.
SCHEDULE H, PART V, SECTION B, LINE 12I	BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS: THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT.
SCHEDULE H, PART V, SECTION B, LINE 14G	MEASURES USED TO PUBLICIZE THE FACILITY'S FINANCIAL ASSISTANCE POLICY: THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA. PROVIDED UPON INQUIRY.
SCHEDULE H, PART V, SECTION B, LINE 18E	THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA.
SCHEDULE H, PART V, SECTION B, LINE 20D	AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: FOR PATIENTS WITH A FAMILY INCOME BETWEEN 201% AND 350% OF FEDERAL POVERTY GUIDELINES (FPG), THE HOSPITAL FACILITY USES MEDICARE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. FOR PATIENTS WITH A FAMILY INCOME BETWEEN 351% AND 500% OF FPG, THE AVERAGE OF NEGOTIATED COMMERCIAL INSURANCE RATES IS USED TO DETERMINE THE MAXIMUM AMOUNT THAT CAN BE CHARGED.

Schedule H (Form 990) 2013

Additional Data

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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 MARY MEDICAL CENTER

Employer identification number
95-1914489

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) CATHOLIC CHARITIES 1450 N D STREET SAN BERNARDINO,CA92405	95-3516461	501(c)(3)	30,000	PROGRAM SUPPORT
(2) ST JOHN OF GOD 13333 PALMDALE RD VICTORVILLE,CA92392	95-3806996	501(c)(3)	48,000	PROGRAM SUPPORT
(3) ST JOSEPH HEALTH SYSTEM FOUNDATION 3345 Michelson Dr STE 100 Irvine,CA92612	33-0143024	501(c)(3)	55,400	PROGRAM SUPPORT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2013

Page 2

Part III

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

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

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	DESCR OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS COMMUNITY BENEFIT COMMITTEE OVERSEES/MONITORS GRANT USAGE ON A MONTHLY BASIS.

Schedule I (Form 990) 2013

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

Complete if the organization answered "Yes" to Form 990, Part IV, 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 MARY MEDICAL CENTER

Employer identification number

95-1914489

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2013

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)KEVIN MURPHYBOARD OF DIRECTOR	(i) (ii)	0 236,899	0 55,060	0 31,857	0 17,205	0 32,490	0 373,511	0 0
(2)MARILYN DRONECHIEF NURSING OFFICER	(i) (ii)	219,231 0	30,934 0	24,016 0	10,801 0	16,513 0	301,495 0	0 0
(3)RANDY BEVILACQUAVP STRATEGIC SERVICES	(i) (ii)	174,070 0	24,599 0	25,284 0	12,113 0	15,642 0	251,708 0	0 0
(4)VANBOTRA HUANGDIRECTOR OF PHARMACY	(i) (ii)	193,202 0	0 0	-3,177 0	7,494 0	15,512 0	213,031 0	0 0
(5)TARA COWELLSECRETARY	(i) (ii)	0 230,892	0 53,574	0 29,621	0 16,482	0 23,189	0 353,758	0 0
(6)DENNIS HAGHIGHAT MDVP MEDICAL AFFAIRS	(i) (ii)	260,569 0	61,131 0	31,878 12,013	12,244 506	10,143 422	375,965 12,941	0 0
(7)KELLY LINDENCOO	(i) (ii)	237,722 0	81,299 0	25,900 0	0 0	22,923 0	367,844 0	0 0
(8)LAURIE ROBERTSDIRECTOR COMMUNITY HEALTH	(i) (ii)	153,298 0	22,310 0	6,679 0	13,578 0	9,363 0	205,228 0	0 0
(9)KATHERINE FREEMANSTAFF RN	(i) (ii)	173,273 0	750 0	0 0	4,444 0	9,479 0	187,946 0	0 0
(10)MARILYN PLATTMANAGER OB CLINIC	(i) (ii)	147,778 0	15,000 0	7,756 0	13,433 0	7,949 0	191,916 0	0 0
(11)SHARON KIDDSTAFF RN	(i) (ii)	164,866 0	0 0	37 0	11,916 0	25,443 0	202,262 0	0 0
(12)ALAN H GARRETTPRESIDENT/CEO	(i) (ii)	0 454,940	0 65,252	0 70,117	0 22,950	0 25,402	0 638,661	0 0
(13)TRACY FERNANDEZSVP/CFO	(i) (ii)	240,392 0	32,779 0	23,100 0	0 0	25,384 0	321,655 0	0 0
(14)DAVID O'BRIENCOO (FORMER KEY EMPLOYEE)	(i) (ii)	168,723 151,918	16,878 83,943	17,849 25,300	8,439 380	436 3,447	212,325 264,988	0 0
(15)JAMES KYLEVP MED AFFAIRS (FMR KEY EMPL)	(i) (ii)	0 311,235	0 101,428	0 38,860	0 10,200	0 24,527	0 486,250	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	SUPPLEMENTAL COMPENSATION INFORMATION DISCRETIONARY SPENDING ACCOUNT EXECUTIVES RECEIVE A PERCENTAGE OF BASE COMPENSATION FOR DISCRETIONARY SPENDING. THESE AMOUNTS ARE INCLUDED IN OTHER REPORTABLE COMPENSATION. TAX INDEMNIFICATIONS AND GROSS-UP PAYMENTS GIFT CARDS PROVIDED TO EMPLOYEES DURING CHRISTMAS AND THROUGHOUT THE YEAR FOR REWARD AND RECOGNITION ARE GROSSED UP AND TAXES ARE PAID BY THE MINISTRY.
SCHEDULE J, PART I, LINE 3	THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS THAT IS COMPLETED BY THE ST. JOSEPH HEALTH SYSTEM.
SCHEDULE J, PART I, LINE 4B	EXECUTIVES COULD PARTICIPATE IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN UNDER INTERNAL REVENUE CODE 457(F). THE PLAN WAS FROZEN EFFECTIVE DECEMBER 31, 2007 AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED TO THE PLAN. THIS PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF THE PLAN.
SCHEDULE J, PART I, LINE 7	A PORTION OF EXECUTIVE SALARIES ARE PLACED "AT-RISK" AND ARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE OUR STRATEGIC OBJECTIVES OF PERFECT CARE, SACRED ENCOUNTERS, AND HEALTHIEST COMMUNITIES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY.

Schedule J (Form 990) 2013

Additional Data

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.
MediumBullet

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

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST MARY MEDICAL CENTER

Employer identification number

95-1914489

Part I

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

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

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

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

Part II

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

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






Total ...... $

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2013

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) UPLAND ANESTHESIA	SEE PART V	1,197,672	ANESTHESIA SERVICES		No

Part V

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

Return Reference	Explanation
SCHEDULE L, PART IV	RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION HENRY GONZALEZ, M.D. SERVES ON THE BOARD OF ST. MARY MEDICAL CENTER AND IS ALSO A BOARD MEMBER AND PARTNER OF UPLAND ANESTHESIA.

Schedule L (Form 990 or 990-EZ) 2013

Additional Data

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Software Version:

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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 MARY MEDICAL CENTER

Employer identification number

95-1914489

Return Reference	Explanation
FORM 990, PART I, LINE 1	ORGANIZATION'S MISSION WE ARE COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE.
FORM 990, PART III, LINE 4A	PROGRAM SERVICE ACCOMPLISHMENTS REALIZING OUR MISSION ST. MARY MEDICAL CENTER HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE LOCAL COMMUNITY FOR OVER 58 YEARS. SERVING THE COMMUNITIES OF THE HIGH DESERT, ST. MARY MEDICAL CENTER IS AN ACUTE CARE HOSPITAL THAT PROVIDES QUALITY CARE IN THE AREAS OF 24-HOUR EMERGENCY SERVICES, COMPREHENSIVE CARDIAC SERVICES, AN OUTPATIENT SURGERY PAVILION, MOBILE HEALTH SERVICES, DIABETES EDUCATION, LEVEL II NEONATAL INTENSIVE CARE, A ROBOTIC-ASSISTED SURGERY PROGRAM AND A CENTER FOR WOUND CARE & HYPERBARIC MEDICINE. THE HOSPITAL IS DESIGNATED AS A STEMI RECEIVING CENTER BY INLAND COUNTIES EMERGENCY MEDICAL AGENCY AND RECEIVED THE BABY FRIENDLY DESIGNATION BY THE WORLD HEALTH ORGANIZATION. SJH ST. MARY IS THE COMMUNITY'S LARGEST PROVIDER OF ACUTE CARE SERVICES, THE HIGH DESERT'S ONLY NONPROFIT HOSPITAL AND EMPLOYS OVER 1850 EMPLOYEES COMMITTED TO REALIZING THIS MISSION. AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM, ST. MARY MEDICAL CENTER IS COMMITTED TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. THE SISTERS OF ST. JOSEPH OF ORANGE TRACE THEIR ROOTS BACK TO 17TH CENTURY FRANCE AND THE UNIQUE VISION OF A JESUIT PRIEST NAMED JEAN-PIERRE MEDAILLE. HE SOUGHT TO ORGANIZE AN ORDER OF RELIGIOUS WOMEN WHO, RATHER THAN REMAINING SAFELY CLOISTERED IN A CONVENT, VENTURED OUT INTO THE COMMUNITY TO SEEK OUT "THE DEAR NEIGHBORS" AND MINISTER TO THEIR NEEDS. THE CONGREGATION MANAGED TO SURVIVE THE TURBULENCE OF THE FRENCH REVOLUTION AND EVENTUALLY EXPANDED, NOT ONLY THROUGHOUT FRANCE, BUT THROUGHOUT THE WORLD. IN 1912 A SMALL GROUP OF SISTERS OF ST. JOSEPH WENT TO EUREKA, CALIFORNIA, AT THE INVITATION OF THE LOCAL BISHOP, TO ESTABLISH A SCHOOL. A FEW YEARS LATER, THE GREAT INFLUENZA EPIDEMIC OF 1918 CAUSED THE SISTERS TO TEMPORARILY SET ASIDE THEIR EDUCATION EFFORTS TO CARE FOR THE ILL. THEY REALIZED IMMEDIATELY THAT THE SMALL COMMUNITY DESPERATELY NEEDED A HOSPITAL. THROUGH BOLD FAITH, FORESIGHT, AND FLEXIBLITY IN 1920, THE SISTERS OPENED THE 28-BED ST. JOSEPH HOSPITAL OF EUREKA, THE FIRST ST. JOSEPH HEALTH SYSTEM MINISTRY. THREE MISSION OUTCOMES STRATEGICALLY GUIDE OUR MINISTRY WORK ST. MARY MEDICAL CENTER IS COMMITTED TO THREE SYSTEMWIDE MISSION OUTCOMES: EVERY INTERACTION WILL BE EXPERIENCED AS A SACRED ENCOUNTER. THE GOAL OF SACRED ENCOUNTER HAS A DIRECT CONNECTION TO THE OVERALL MISSION. OUR VALUE OF DIGNITY CALLS FOR US TO RESPECT EACH PERSON AS AN INHERENTLY VALUABLE MEMBER OF THE HUMAN COMMUNITY AND AS A UNIQUE EXPRESSION OF LIFE. WE STRIVE TO DO THIS BY KEEPING AT THE FOREFRONT OF OUR MINDS THE UNDERSTANDING OF THE IMPACT WE CAN HAVE ON ONE ANOTHER WITH EVERY ACTION WE TAKE. - STARTED A HOMELESS CARE PROGRAM ASSISTING WITH ACCESS TO HOUSING, MEDICAL SUPPLIES, OUTPATIENT CARE, MEDICATION AND TRANSPORTATION RESOURCES. THE HOSPITAL'S PROGRAM ALSO IS COORDINATING WORK CONDUCTED WITH A NEW COUNTY HOMELESS PROGRAM (NAMED HOPE) WHERE THE HOMELESS ARE CASE MANAGED AND RECEIVE BEHAVIORAL HEALTH AND HOUSING ASSISTANCE. - DONATIONS OF THREE VEHICLES (RETIRED BY THE HOSPITAL) THAT HAVE BEEN PLACED INTO SERVICE BY COMMUNITY PARTNERS TO: (1) PROVIDE A MOBILE EMERGENCY COMMAND CENTER TO A LOCAL FIRE DEPARTMENT, (2) A MOBILE HEALTH CLINIC SERVING CHURCHES MINISTERING TO THE POOR, (3) A TRANSPORTATION SHUTTLE SERVING LOW INCOME SENIORS AND THE DISABLED TO ACCESS MEDICAL CARE, SOCIAL SERVICES AND FOOD. ALL PATIENTS WILL RECEIVE PERFECT CARE. IT IS OUR ATTENTION TO DETAIL AND THE SMALLEST IMPERFECTIONS OF EACH PATIENT'S EXPERIENCE THAT DRIVES A DEEPER UNDERSTANDING AND ULTIMATELY A SUSTAINABLE APPROACH TO THE ACHIEVEMENT OF PERFECT CARE. - IMPLEMENTING FOUR INITIATIVES ADDRESSING (1) ACCESS TO CARE BARRIERS IN POOR NEIGHBORHOODS, (2) INCREASING THE ADOPTION OF BREASTFEEDING PRACTICES, (3) REDUCING CHILD OBESITY IN SCHOOLS, AND (4) TEACHING DIABETES EDUCATION AND SELF-CARE TO THE POOR. EACH OF THESE FOUR PROGRAMS ACHIEVED ITS TARGETED GOAL. HOWEVER ACCESS TO CARE ISSUES REMAIN SIGNIFICANT AND THE PREVALENCE OF ADULT OBESITY AND DIABETES HAS INCREASED FROM RESULTS OBTAINED IN THE 2011 CHNA. - WHEN PATIENTS REQUIRE TRANSPORTATION SERVICES AFTER BEING RELEASED, THIS SERVICE ALLOWS THEM TO CONTINUE RECEIVING MEDICALLY NECESSARY CARE. ST. MARY PROVIDED 2,134 TRIPS CONNECTING PATIENTS TO FOLLOW-UP SERVICES ENSURING THE CONTINUITY OF PERFECT CARE. THE COMMUNITIES WE SERVE WILL BE AMONG THE HEALTHIEST IN OUR NATION. WE SEEK TO DEVELOP COMMUNITY HEALTH INITIATIVES THAT IMPACT LONG-TERM HEALTH ACROSS THE ENTIRE COMMUNITY. - ORGANIZING FOUR HEALTHY CITY CAMPAIGNS IN COLLABORATION WITH SAN BERNARDINO COUNTY PUBLIC HEALTH AND THE COMMUNITIES OF ADELANTO, APPLE VALLEY, HESPERIA AND VICTORVILLE. EACH CAMPAIGN IS MAKING IMPROVEMENTS TO THEIR COMMUNITY'S FOOD AND PHYSICAL ENVIRONMENT. THE PHYSICAL AND FOOD ENVIRONMENTS OF SAN BERNARDINO COUNTY ARE RANKED 45TH OUT OF 57 CALIFORNIA COUNTIES IN PROMOTING HEALTH (COUNTY HEALTH RANKINGS PUBLISHED BY THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE WWW.COUNTYHEALTHRANKINGS.ORG). - ST. MARY'S CHILDHOOD OBESITY PROGRAM IS RECOGNIZED IN THE COUNTY AS A BEST PRACTICE IN COLLABORATION WITH FIRST 5 OF SAN BERNARDINO AND LOCAL SCHOOL DISTRICTS. FY14 OUTCOMES INCLUDED 17% OF AT-RISK CHILDREN DROPPING ONE WEIGHT CLASSIFICATION BY YEAR END AND ADDITIONALLY 36% OF FAMILIES SELF-REPORTING, ADOPTED HEALTHIER EATING HABITS. PROGRAM SERVICE ACCOMPLISHMENTS FINANCIAL ASSISTANCE PROGRAM WE BELIEVE NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY ST. MARY MEDICAL CENTER, HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND/OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. FACTORS USED IN DETERMINING ELIGIBILITY FOR PATIENT FINANCIAL ASSISTANCE INCLUDE INCOME LEVEL, ASSET LEVEL, AND MEDICAL INDIGENCE. TOTAL COMMUNITY BENEFIT COST OF $6,203,860. SUBSIDIZED HEALTH SERVICES IMPROVING ACCESS TO CARE THROUGH THE OPERATION OF THREE HEALTH CLINICS AND A MOBILE MEDICAL PROGRAM SERVING LOW INCOME NEIGHBORHOODS IN ADELANTO, APPLE VALLEY, HESPERIA AND VICTORVILLE. THESE CLINIC RESOURCES SERVED 47,192 PATIENT ENCOUNTERS PROVIDING PRIMARY CARE, CANCER SCREENINGS, IMMUNIZATIONS, DIABETES AND BREASTFEEDING EDUCATION AS WELL AS MIDWIFERY CARE AND HEALTH INSURANCE ENROLLMENT ASSISTANCE. THE CLINIC'S EXPERTISE IN MATERNAL CARE IS NOTEWORTHY ESPECIALLY SINCE 90% OF PATIENTS ARE LOW INCOME. IN FY14 THE CLINIC'S BIRTH OUTCOMES AGAIN SURPASSED NATIONAL PATIENT QUALITY RANKINGS IN PRIMARY CESAREAN SECTION (11.7% VS. 23% NATIONALLY), PRE-TERM DELIVERY (5.67% VS. 11.55% NATIONALLY) AND LOW BIRTH RATE (4.61% VS. 7.99% NATIONALLY). THE HOSPITAL ALSO SUPPORTED TWO PARTNERS EACH OF WHOM OPENED COMMUNITY HEALTH CLINICS SERVING THE POOR - ONE IN NORTH ADELANTO AND THE SECOND IN OLD TOWN VICTORVILLE. THESE NEW CLINICS BRING EXPANDED HEALTH SERVICES TO THESE LOW INCOME POPULATIONS. TOTAL COMMUNITY BENEFIT COST OF $4,756,137. SUBSIDIZED: EMERGENCY & TRAUMA CARE HEALTH INSURANCE ACCESSIBILITY SHOULD NOT PREVENT ANYONE FROM RECEIVING MEDICALLY NECESSARY CARE; ST. MARY MEDICAL CENTER HELPS ON A CASE BY CASE BASIS REGARDLESS OF THE ABILITY TO PAY. OUR MISSION TO PARTNER WITH LIKE MINDED ORGAINIZATIONS ENABLES US TO ACHIEVE SUCCESSFUL MEDICAL OUTCOMES FOR THE MOST VULNERABLE POPULATIONS - UNINSURED AND HOMELESS IN OUR COMMUNITY. 496 LETTERS OF AGREEMENT WERE EXECUTED BY OUR CARE MANAGEMENT DEPARTMENT PROVIDING FOLLOW-UP MEDICAL SUPPORT. OUR DEAR NEIGHBORS THAT DO NOT QUALIFY FOR HEALTH INSURANCE COVERAGE ARE PROVIDED ENROLLMENT ASSISTANCE AT OUR HOSPITAL AND IN THE COMMUNITY. TOTAL COMMUNITY BENEFIT EXPENSE: $1,519,957. FOR MORE INFORMATION ABOUT ST. MARY MEDICAL CENTER, PLEASE VISIT WWW.STMARYAPPLEVALLEY.COM. FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH SYSTEM, PLEASE VISIT WWW.STJHS.ORG.
FORM 990, PART VI, LINE 6	DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS ST JOSEPH HEALTH SYSTEM AND COVENANT HEALTH NETWORK, INC. ARE THE CORPORATE MEMBERS OF ST. MARY MEDICAL CENTER.
FORM 990, PART VI, LINE 7A	DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ST. MARY MEDICAL CENTER HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE ST. MARY MEDICAL CENTER BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE ST. MARY MEDICAL CENTER BOARD AS NOMINATIONS MUST BE APPROVED BY ST. JOSEPH HEALTH SYSTEM, AS A CORPORATE MEMBER, AND ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. THE TRUSTEES ARE THEN APPROVED AND ELECTED BY THE COVENANT HEALTH NETWORK, INC. BOARD.
FORM 990, PART VI, LINE 7B	DESCR CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS.
FORM 990, PART VI, LINE 11B	DESCR THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 WAS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AS APPLICABLE. THE FORM 990 WAS THEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE APRIL 2015 MEETING. DURING THE FINANCE COMMITTEE MEETING, MANAGEMENT PRESENTED AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE FINANCE COMMITTEE CHAIR THEN PROVIDED A SUMMARY AT THE FULL BOARD MEETING.
FORM 990, PART VI, LINE 12C	CONFLICT OF INTEREST POLICY OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN CONNECTION WITH THAT INDIVIDUAL SATISFYING THEIR FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WITH GUIDANCE FROM THE ST. JOSEPH HEALTH SYSTEM CHIEF COMPLIANCE OFFICER (CCO), THE CHIEF EXECUTIVE AND/OR THE GOVERNING BOARD CHAIRPERSON, AS APPROPRIATE, CONSIDERS THE MATTER INITIALLY. IF THE MATTER CANNOT BE RESOLVED AT THAT LEVEL, THE MATTER IS ESCALATED TO THE CCO. THE CCO, IN CONSULTATION WITH THE ST. JOSEPH HEALTH SYSTEM GENERAL COUNSEL, REVIEWS THE MATTER AND PRESENTS RECOMMENDATIONS TO THE GOVERNING BOARD AND/OR BOARD COMMITTEE, AS APPROPRIATE, FOR DISCUSSION AND VOTE. THE INDIVIDUAL WHOSE POTENTIAL CONFLICT IS BEING REVIEWED MAY BE REQUESTED TO BE PRESENT DURING ANY MEETING IN WHICH THE BOARD OR BOARD COMMITTEE CONDUCTS ITS EVALUATION BUT SHALL BE EXCUSED FOR ANY DISCUSSION OR VOTE.
FORM 990, PART VI, LINE 15A & 15B	PROCESS USED TO DETERMINE COMPENSATION EXECUTIVE COMPENSATION IS APPROVED BY THE ST. MARY MEDICAL CENTER COMPENSATION AND BENEFITS COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE REVIEWS COMPARABILITY DATA PREPARED FOR AND COMPILED BY THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE, A COMMITTEE OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES COMPRISED OF INDEPENDENT MEMBERS. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE ACTS IN ACCORDANCE WITH A COMMITTEE CHARTER APPROVED BY THE ST. JOSEPH HEATLH SYSTEM BOARD OF TRUSTEES AND AN EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER DIRECTS THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND TO APPROVE PROGRAM CHANGES, AS NECESSARY, TO ENSURE ALIGNMENT WITH THE STATED PHILOSOPHY AND ENSURE CONTINUED COMPLIANCE WITH FEDERAL AND STATE REGULATIONS ON BEHALF OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS RETENTION OF KEY MANAGEMENT TALENT. THE EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF FOR PROFIT AND NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. ST. JOSEPH HEALTH SYSTEM PROVIDES COMPENSATION TO ITS EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO ENSURE COMPENSATION PHILOSOPHY ADHERENCE AND GENERAL FAIR MARKET VALUE COMPENSATION, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA AND ENGAGES LEGAL COUNSEL AND CONSULTING SUPPORT, AS NEEDED. THEY USE THIS INFORMATION TO SUPPORT ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE MEETS AT LEAST 3 TIMES A YEAR AND TAKES ACTION IN EXECUTIVE SESSION. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. A FULL COMPENSATION REVIEW IS CONDUCTED ON A BIENNIAL BASIS AND THE LAST REVIEW WAS PERFORMED IN JUNE 2013. DURING THE YEAR, THE ST. MARY MEDICAL CENTER COMPENSATION AND BENEFITS COMMITTEE REVIEWED AND APPROVED ANY CHANGES IN COMPENSATION FOR KEY EXECUTIVES PREDICATED ON THE ANALYSIS AND RECOMMENDATION BY AN INDEPENDENT THIRD PARTY CONSULTING FIRM WITH EXPERTISE IN HEALTHCARE EXECUTIVE COMPENSATION. IN ADDITION, ANNUAL INCENTIVE AWARDS ARE REVIEWED AND APPROVED PRIOR TO PAYMENT CONSISTENT WITH THE MOST RECENT COMPENSATION BIENNIAL REVIEW AND IN ACCORDANCE WITH THE PLAN DOCUMENT. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES WHICH ARE SUBSEQUENTLY APPROVED AT THE COMMITTEE MEETING.
FORM 990, PART VI, LINE 19	AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY & FIN STMTS TO GEN PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE. AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990.
FORM 990, PART XI, LINE 9	CHANGES IN NET ASSETS OR FUND BALANCE SJHH-AV EQUITY TRANSFER ($ 726,376) SJHS EQUITY TRANSFER ($ 9,211,877) -------------- TOTAL ($ 9,938,253)

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

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

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

ST MARY MEDICAL CENTER

Employer identification number

95-1914489

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

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) COVENANT HEALTH NETWORK INC 3345 MICHELSON DRIVE STE 100 IRVINE,CA92612 46-1259908	HEALTHCARE	CA	501(C)(3)	11, III	SJHS	Yes
(2) COVENANT HEALTH PARTNERS 3615 19TH STREET LUBBOCK,TX79410 61-1573313	HEALTHCARE	TX	501(C)(3)	11,I	CHS	Yes
(3) COVENANT HEALTH SYSTEM 3615 19TH STREET LUBBOCK,TX79410 75-2765566	HEALTHCARE	TX	501(C)(3)	3	SJHS	Yes
(4) COVENANT HEALTH SYSTEM FOUNDATION 4000 24TH STREET LUBBOCK,TX79410 75-2897026	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes
(5) COVENANT MEDICAL GROUP 3420 22ND PLACE LUBBOCK,TX79410 75-2743883	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(6) COVENANT PHYSICIAN PARTNERS 3615 19TH STREET LUBBOCK,TX79410 46-3516417	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(7) HOAG CHARITY SPORTS 3920 BIRCH STREET SUITE 105 NEWPORT BEACH,CA92660 45-2982422	SUPPORT	CA	501(C)(3)	7	HHF	Yes
(8) HOAG HOSPITAL FOUNDATION 1 HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92663 95-3222343	FUNDRAISING	CA	501(C)(3)	7	HMHP	Yes
(9) HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92663 95-1643327	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(10) HOME CARE PARTNERS 1165 MONTGOMERY DR SANTA ROSA,CA95405 68-0318656	INACTIVE	CA	501(C)(3)	3	SRMH	Yes
(11) HOSPICE OF LUBBOCK 1102 SLIDE ROAD LUBBOCK,TX79414 75-2133781	HEALTHCARE	TX	501(C)(3)	9	CHS	Yes
(12) LUBBOCK METHODIST HOSPITAL FOUNDATION 3615 19TH STREET LUBBOCK,TX79410 75-2220963	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes
(13) METHODIST CHILDREN'S HOSPITAL 3610 21ST STREET LUBBOCK,TX79410 75-2428911	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(14) METHODIST HOSPITAL LEVELLAND 1900 COLLEGE AVENUE LEVELLAND,TX79336 75-2246348	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(15) METHODIST HOSPITAL PLAINVIEW 2601 DIMMITT ROAD PLAINVIEW,TX79072 75-2426010	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes
(16) MISSION HOSPITAL REGIONAL MEDICAL CTR 27700 MEDICAL CENTER ROAD MISSION VIEJO,CA92691 95-1643360	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(17) QUEEN OF THE VALLEY MEDICAL CENTER 1000 TRANCAS STREET NAPA,CA94558 94-1243669	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(18) REDWOOD MEMORIAL FOUNDATION 3300 RENNER DRIVE FORTUNA,CA95540 94-2779313	HEALTHCARE	CA	501(C)(3)	7	RMH	Yes
(19) REDWOOD MEMORIAL HOSPITAL 3300 RENNER DRIVE FORTUNA,CA95540 94-1384665	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(20) SANTA ROSA MEMORIAL HOSPITAL 1165 MONTGOMERY DR SANTA ROSA,CA95405 94-1231005	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(21) SISTERS OF ST JOSEPH OF ORANGE 480 S BATAVIA ORANGE,CA92868 95-1643383	RELIGIOUS ORG	CA	501(C)(3)	1	NA		No
(22) SRM ALLIANCE HOSPITAL SERVICES 400 NORTH MCDOWELL BLVD PETALUMA,CA94954 68-0395200	HEALTHCARE	CA	501(C)(3)	3	SRMH	Yes
(23) ST JOSEPH HEALTH MINISTRY 3345 MICHELSON DRIVE STE 100 IRVINE,CA92612 27-1666576	RELIGIOUS ORG	CA	501(C)(3)	1	SSJO		No
(24) ST JOSEPH HEALTH SYSTEM 3345 MICHELSON DRIVE STE 100 IRVINE,CA92612 95-3589356	HEALTHCARE	CA	501(C)(3)	11, I	SJHM		No
(25) ST JOSEPH HEALTH SYSTEM FOUNDATION 3345 MICHELSON DRIVE STE 100 IRVINE,CA92612 33-0143024	HEALTHCARE	CA	501(C)(3)	7	SJHS	Yes
(26) ST JOSEPH HOME CARE NETWORK 170 PROFESSIONAL CENTER DR B ROHNERT PARK,CA94928 68-0331084	HEALTHCARE	CA	501(C)(3)	9	SJHS	Yes
(27) ST JOSEPH HOSPITAL OF EUREKA 2700 DOLBEER STREET EUREKA,CA95501 94-1156596	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(28) ST JOSEPH HOSPITAL OF ORANGE 1100 WEST STEWART DRIVE ORANGE,CA92868 95-1643359	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(29) ST JUDE HOSPITAL YORBA LINDA 500 S MAIN STREET STE 1000 ORANGE,CA92868 33-0185031	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes
(30) ST JUDE HOSPITAL INC 101 EAST VALENCIA MESA DRIVE FULLERTON,CA92635 95-1643324	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(31) ST MARY MEDICAL CENTER 18300 HIGHWAY 18 APPLE VALLEY,CA92307 95-1914489	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes
(32) ST MARY OF THE PLAINS HOSPITAL FDN 4000 24TH STREET LUBBOCK,TX79410 75-1653181	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes
(33) TALLER SAN JOSE 801 NORTH BROADWAY SANTA ANA,CA92701 59-3816355	WORKFORCE DEV	CA	501(C)(3)	2	SSJO	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?
(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) ST JOSEPH HLTH SYS HOME HLTH	HOME HEALTH	CA	NA	N/A
(2) ST JOSEPH HLTH SYS HOME CARE 33-0307672	HOME HEALTH	CA	NA	N/A
(3) METHODIST DIAGNOSTIC IMAGING 75-2343261	HEALTHCARE SVCS	TX	NA	N/A
(4) SHA LLC 75-2569094	INSURANCE	TX	NA	N/A
(5) LUBBOCK SURGERY CENTER LTD 75-2177401	HEALTHCARE SVCS	TX	NA	N/A
(6) COVENANT LONG-TERM CARE LP 20-5033419	HEALTHCARE SVCS	TX	NA	N/A
(7) HERITAGE INVESTMENT GROUP	INVESTMENTS	CA	NA	N/A
(8) MISSION AMBULATORY SURGICENTER 33-0355575	HEALTHCARE SVCS	CA	NA	N/A
(9) COMPREHENSIVE IMAGING PARTNERS 26-4591502	HEALTHCARE SVCS	CA	NA	N/A
(10) ST JOSEPH PHYSICIAN VENTURES	REAL ESTATE	CA	NA	N/A
(11) ADVANCED SURGERY INSTITUTE LLC	HEALTHCARE SVCS	CA	NA	N/A
(12) HOAG OUTPATIENT CENTERS	HEALTHCARE SVCS	CA	NA	N/A
(13) NEWPORT IMAGING CENTER	HEALTHCARE SVCS	CA	NA	N/A
(14) HOAG ORTHOPEDIC INSTITUTE	HEALTHCARE SVCS	CA	NA	N/A
(15) MAIN ST SPECIALTY SURGERY CNTR SEE PART VII SANTA ROSA,CA95404 26-2299255	HEALTHCARE SVCS	CA	NA	N/A
(16) ORTHOPEDIC SURGERY CNTR OF OC	HEALTHCARE SVCS	CA	NA	N/A
(17) THE INSTITUTE FOR INNOVATION	HEALTHCARE SVCS	DE	NA	N/A
(18) HEALTHCARE DESIGN & CONSTRUCT	REAL ESTATE	DE	NA	N/A
(19) NORTH BAY ENDOSCOPY CENTER	HEALTHCARE SVCS	CA	NA	N/A

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) ST JOSEPH PROF SVCS ENTERPRISES INC 3345 MICHELSON DRIVE SUITE 100 IRVINE,CA92612 33-0155323	HEALTHCARE SVCS	CA	NA	C-CORP
(2) AMERICAN UNITY GROUP LTD 58 PAR-LA-VILLE ROAD HAMILTON,HMHX BD	CAPTIVE INSURANCE	BD	NA	C-CORP
(3) ALLIANCE PHYSICIAN SERVICES	INACTIVE	CA	NA	C-CORP
(4) MISSION VIEJO MEDICAL VENTURES 27800 MEDICAL CENTER RD 354 MISSION VIEJO,CA92691 33-0212905	HEALTHCARE SVCS	CA	NA	C-CORP
(5) ST JOSEPH YORBA PARK	INACTIVE	CA	NA	C-CORP
(6) LUBBOCK METHODIST HOSPITAL SVCS PO BOX 1201 LUBBOCK,TX79410 75-2118585	HEALTHCARE SVCS	TX	NA	C-CORP
(7) LUBBOCK METHODIST HOSP PRACTICE MGMT 2107 OXFORD STREET STE 300 LUBBOCK,TX79410 75-2578995	INACTIVE	TX	NA	C-CORP
(8) HOAG MANAGEMENT SERVICES INC 1 HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92658 33-0731587	HEALTHCARE SVCS	CA	NA	C-CORP
(9) COASTAL MANAGEMENT SERVICES ORGANIZATION 1 HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92658 33-0676831	HEALTHCARE SVCS	CA	NA	C-CORP
(10) HMTS INC FKA HOAG MEDICAL FOUNDATION 1 HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92658 45-3583707	HEALTHCARE SVCS	CA	NA	C-CORP
(11) ST JOSEPH HEALTH SOURCE INC 3345 MICHELSON DRIVE SUITE 100 IRVINE,CA92612 46-1900168	HEALTHCARE SVCS	CA	NA	C-CORP
(12) DATU HEALTH INC 16150 MAIN CIRCLE DR SUITE 250 CHESTERFIELD,MO63017 46-3070062	IT SVCS	MO	NA	C-CORP
(13) ST JOSEPH HEALTH 3345 MICHELSON DR SUITE 100 IRVINE,CA92612 46-2340232	HOLDING COMPANY	CA	NA	C-CORP

Schedule R (Form 990) 2013

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ST JUDE HOSPITAL YORBA LINDA	B	215,324	CASH
(2) ST JOSEPH HEALTH SYSTEM FOUNDATION	C	840,177	ACCRUAL
(3) ST JOSEPH HEALTH SYSTEM FOUNDATION	B	55,400	ACCRUAL
(4) ST JUDE HOSPITAL YORBA LINDA	Q	82,267	CASH

Schedule R (Form 990) 2013

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

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

Return Reference

Explanation

SCHEDULE R, PART III

IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP ST. JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE. 200 ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE. 100, ORANGE, CA 92868-2012 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 2301 QUAKER, LUBBOCK, TX 79410 COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 3345 MICHELSON DRIVE, STE. 100, IRVINE, CA 92612 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE. 362, MISSION VIEJO, CA 92691 COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY, LLC EIN: 26-4591502 ADDRESS: ONE CITY BOULEVARD WEST, SUITE 1100, ORANGE, CA 92868 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 ADVANCED SURGERY INSTITUTE, LLC EIN: 26-2299255 ADDRESS: 1739 4TH STREET, SANTA ROSA, CA 95404 HOAG OUTPATIENT CENTERS EIN: 45-3587572 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SAN MIGUEL, NEWPORT BEACH, CA 92660 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 MAIN ST SPECIALTY SURGERY CENTER EIN: 95-4813223 ADDRESS: 280 MAIN STREET, STE 100, ORANGE, CA 92868 ORTHOPEDIC SURGERY CENTER OF OC, LLC EIN: 33-0841806 ADDRESS: 22 CORPORATE PLAZA, NEWPORT BEACH, CA 92660 THE INSTITUTE FOR INNOVATION, LLC EIN: 90-0745066 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 HEALTHCARE DESIGN AND CONSTRUCTION EIN: 46-2611662 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 NORTH BAY ENDOSCOPY CENTER, LLC EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD SUITE 110A, PETALUMA, CA 94954

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	18
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	1,863
6	Total number of volunteers (estimate if necessary) .............	6	213
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,835,121	2,309,993
9	Program service revenue (Part VIII, line 2g) .........	274,185,520	276,738,669
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	7,941,415	3,985,468
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	99,826	7,475
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	288,061,882	283,041,605
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	99,750	133,400
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)	135,859,970	146,590,704
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	47,317	205
b	Total fundraising expenses (Part IX, column (D), line 25) 828,686
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	132,383,707	124,841,130
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	268,390,744	271,565,439
19	Revenue less expenses. Subtract line 18 from line 12.......	19,671,138	11,476,166
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	271,349,420	290,774,854
21	Total liabilities (Part X, line 26).............	88,743,784	102,339,803
22	Net assets or fund balances. Subtract line 21 from line 20.....	182,605,636	188,435,051

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 247,284,400 including grants of $ 133,400 ) (Revenue $ 276,680,599 )
	SEE SCHEDULE O

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses247,284,400

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,659,761	1,952,909	430,449

				(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		31,640
d	Related organizations...1d		940,177
e	Government grants (contributions)1e		959,641

f	All other contributions, gifts, grants, and similar amounts not included above1f		378,535

g	Noncash contributions included in lines 1a-1f:$		0
h	Total. Add lines 1a-1f.......			2,309,993
			Business Code
2a	NET PATIENT REVENUE		622110	255,041,808	255,041,808	0	0
b	CAPITATION PREMIUM REVENUE		622110	20,892,518	20,892,518	0	0
c	CAFETERIA REVENUE		722110	433,315	433,315	0	0
d	FINANCE CHARGES REVENUE		900099	173,726	173,726	0	0
e	FEE REVENUE		900099	114,399	114,399	0	0
f	All other program service revenue .			82,903	82,903	0	0
g	Total. Add lines 2a–2f........			276,738,669
3	Investment income (including dividends, interest, and other similar amounts).......			3,981,716			3,981,716
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	46,377
b	Less: rental expenses	38,213
c	Rental income or (loss)	8,164	0
d	Net rental income or (loss).......			8,164			8,164
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		3,752
b	Less: cost or other basis and sales expenses
c	Gain or (loss)		3,752
d	Net gain or (loss)..........			3,752			3,752
8a	Gross income from fundraising events (not including $ 31,640 of contributions reported on line 1c). See Part IV, line 18 ..
	a		218,100
b	Less: direct expenses ...b		160,719
c	Net income or (loss) from fundraising events..			57,381			57,381
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		293,986
b	Less: cost of goods sold ..b		352,056
c	Net income or (loss) from sales of inventory..			-58,070	-58,070
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			283,041,605	276,680,599	0	4,051,013


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			6,809,133	1	-7,702,497
2	Savings and temporary cash investments .........			38,630,826	2	65,053,455
3	Pledges and grants receivable, net ...........			952,900	3	952,900
4	Accounts receivable, net .............			47,734,801	4	48,136,708
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 .............			730,665	7	720,991
8	Inventories for sale or use ..............			3,577,975	8	3,967,158
9	Prepaid expenses and deferred charges ..........			308,997	9	13,874,903
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	250,641,281
b	Less: accumulated depreciation .....	10b	112,605,369	135,577,253	10c	138,035,912
11	Investments—publicly traded securities ..........			21,823,124	11	25,099,967
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 ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			15,203,746	15	2,635,357
16	Total assets. Add lines 1 through 15 (must equal line 34)......			271,349,420	16	290,774,854
17	Accounts payable and accrued expenses .........			28,635,630	17	25,180,088
18	Grants payable .................			0	18	0
19	Deferred revenue ................			462,730	19	1,578,624
20	Tax-exempt bond liabilities .............			0	20	954,440
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			59,645,424	25	74,626,651
26	Total liabilities. Add lines 17 through 25.........			88,743,784	26	102,339,803
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			177,161,203	27	183,193,560
28	Temporarily restricted net assets ...........			5,444,433	28	5,241,491
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			182,605,636	33	188,435,051
34	Total liabilities and net assets/fund balances ........			271,349,420	34	290,774,854