TY 2014 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) DENNIS MARCHI........................................................................ BOARD OF DIR	2.00 .......................2.00	X			1,932	0
(2) JOHN A LAYTON........................................................................ VICE CHAIR O	2.00 .......................4.00	X			1,766	0
(3) CLYDE NENNINGER........................................................................ CHAIR OF BOA	2.00 .......................4.00	X			0	0
(4) KEVIN GOVERO........................................................................ SECRETARY/TR	2.00 .......................4.00	X			0	0
(5) STEVEN C BJELICH........................................................................ PRESIDENT &	40.00 .......................6.00		X		2,771,477	31,513
(6) WILLIAM A BALSANO........................................................................ VP OF FINANC	40.00 .......................4.00		X		540,723	22,025
(7) JAMES A SCHELL MD........................................................................ VP MEDICAL A	40.00 .......................		X		529,101	31,648
(8) MARILYN K CURTIS........................................................................ VP OF PROF.	40.00 .......................		X		505,170	31,821
(9) BARBARA THOMPSON VP OF MARKET	20.00 .......................		X		438,171	0
(10) JEANNETTE K FADLER........................................................................ VP OF PATIEN	40.00 .......................		X		421,492	31,899
(11) THOMAS S DIEMER MD........................................................................ VP OF QUALIT	40.00 .......................		X		294,273	38,126
(12) STEVEN A OGBURN........................................................................ VP OF AMBULA	40.00 .......................		X		257,011	37,698
(13) MICHAEL FREEMANMD........................................................................ GASTRONENTER	40.00 .......................			X	1,241,035	36,952
(14) BRANDON SCOTT DO........................................................................ NEUROSURGEON	40.00 .......................			X	868,157	21,954
(15) EDWARD BENDERMD THORACIC AND........................................................................ CARDIOVASCUL	40.00 .......................			X	826,742	32,584
(16) WILLIAM K LAFOE MD........................................................................ INTERVEN. CA	40.00 .......................			X	773,456	30,724
(17) DUC T NGUYEN DO INTERVENTIONAL........................................................................ CARDIOLOGIST	40.00 .......................			X	773,306	37,462

(A) Name and business address	(B) Description of services	(C) Compensation
KIEFNER BROTHERS INC 1459 NORTH KINGSHIGHWAY STREET CAPE GIRARDEAU,MO63701	CONSTRUCTION	26,972,851
THE ROBERTS GROUP 730 NORTH GRAND AVENUE WAUKESKA,WI53186	ADVERTISING	8,078,294
EPIC SYSTEMS CORP PO BOX 88314 MILWAUKEE,WI532880314	EHR SYSTEM	7,381,896
CAPE ANESTHESIA GROUP INC PO BOX 1777 CAPE GIRARDEAU,MO637021777	ANESTHESIA SERV	7,362,238
INTERNAL MEDICINE ASSOC OF SE MO 225 PHYSICIANS PARK DRIVE SUITE 400 POPLAR BLUFF,MO63901	PHYSICIAN SRVCS	5,098,548
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 233

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 domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............
4	Benefits paid to or for members ....
5	Compensation of current officers, directors, trustees, and key employees ....	5,547,675	5,547,675
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages ....	157,051,685	157,051,685
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	5,273,977	5,273,977
9	Other employee benefits .......	20,942,189	20,942,189
10	Payroll taxes ...........	10,037,265	10,037,265
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	785,300	785,300
c	Accounting ...........	88,853	88,853
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	7,079,723	7,079,723
12	Advertising and promotion ....	10,067,574	10,067,574
13	Office expenses .......	50,586,808	50,586,808
14	Information technology ......	3,833,854	3,833,854
15	Royalties ..
16	Occupancy ...........	3,770,730	3,770,730
17	Travel ............	549,973	549,973
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........	3,938,278	3,938,278
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	28,310,392	28,310,392
23	Insurance ..............	3,710,500	3,710,500
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	41,643,716	41,643,716
b	DRUGS	25,577,105	25,577,105
c	FRA TAX	17,246,568	17,246,568
d	EQUIP. RENTAL & MAIN	8,596,858	8,596,858
e	All other expenses	7,047,467	7,047,467
25	Total functional expenses. Add lines 1 through 24e	411,686,490	411,686,490	0	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	70,663,829	1	90,185,958
2	Savings and temporary cash investments .........	18,345,988	2	5,590,311
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	62,074,548	4	61,048,824
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		479,789	5	491,623
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	10,611,836	8	11,015,861
9	Prepaid expenses and deferred charges ..........	9,403,091	9	10,091,826
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	526,770,156
b	Less: accumulated depreciation .....	10b	220,897,091	264,155,368	10c	305,873,065
11	Investments—publicly traded securities ..........	371,893,765	11	364,673,334
12	Investments—other securities. See Part IV, line 11 .....		12
13	Investments—program-related. See Part IV, line 11 .....		13
14	Intangible assets ...............	3,149,168	14	3,774,854
15	Other assets. See Part IV, line 11 ...........	2,213,100	15	1,855,289
16	Total assets. Add lines 1 through 15 (must equal line 34)......	812,990,482	16	854,600,945
	17	Accounts payable and accrued expenses .........	86,796,553	17	92,018,217
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	202,965,478	20	198,236,507
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................		25
26	Total liabilities. Add lines 17 through 25.........	289,762,031	26	290,254,724
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	523,228,451	27	564,346,221
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	523,228,451	33	564,346,221
34	Total liabilities and net assets/fund balances ........	812,990,482	34	854,600,945

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

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

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 in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

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

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.)..
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 section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. 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—2013. 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—2014. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. 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 VI 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) 2014

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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.) ..
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 section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. 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—2013. 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) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

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

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2014 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2014 distributable amount
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2014 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2014 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2015. Add lines 3j and 4c.
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......
e From 2014.......

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2014

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

2014

Name of the organization

SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

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, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) 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), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled 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 totaling $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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 2

Name of organization SAINT FRANCIS 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	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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 3

Name of organization SAINT FRANCIS 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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 4

Name of organization
SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

Part III

Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. 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) (2014)

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

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

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 value of contributions to (during year)
3	Aggregate value of 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)

Revenue 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:

Revenue 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) 2014

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, for escrow or custodial account liability?

Yes No

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

Part V

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

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

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	6,768,160		6,768,160
b	Buildings ................	158,811,634	69,525,138	89,286,496
c	Leasehold improvements ............
d	Equipment ................	238,767,457	145,242,433	93,525,024
e	Other .................	122,422,905	6,129,520	116,293,385
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				305,873,065

Schedule D (Form 990) 2014

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









Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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) 2014

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	452,804,260
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-19,140,435
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	9,642,189
e	Add lines 2a through 2d .....................			2e	-9,498,246
3	Subtract line 2e from line 1.....................			3	462,302,506
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	462,302,506

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	411,686,490
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	411,686,490
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	411,686,490

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, PAGE 3, PART X	THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY AT JUNE 30, 2015 OR 2014.
SCHEDULE D, PAGE 4, PART XI, LINE 2D	CHANGE IN INTEREST IN NET ASSETS OF SFF -357,811 TRANSFER FROM AFFILIATE SFHS 10,000,000
SCHEDULE D, PAGE 4, PART XIII	THE DIFFERENCE BETWEEN THE REVENUES AND THE NET ASSETS ON THE AUDITED FINANCIAL STATEMENTS AND THE REVENUES AND NET ASSETS REPORTED ON THE 990 REPRESENT THE NET GAIN FROM THE AUXILIARY OF 86,173 AND CASH OF 297,231.

Schedule D (Form 990) 2014

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

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

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization
SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

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) 2014

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 GOLF TOU (event type)	(b) Event #2 HAYDEN MEMORIAL (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . .	151,687	61,961	213,648
2	Less: Contributions . .	124,387	50,761	175,148
3	Gross income (line 1 minus line 2) . . .	27,300	11,200	38,500
4	Cash prizes . . .
5	Noncash prizes . .	5,780	3,920	9,700
6	Rent/facility costs . .	12,800	6,560	19,360
7	Food and beverages .	2,967	2,199	5,166
8	Entertainment . . .
9	Other direct expenses .		3,495	3,495
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........			37,721
11	Net income summary. Subtract line 10 from line 3, column (d)...........			779

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 conducts gaming activities:

Is the organization licensed to conduct 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) 2014

Page 3

Does the organization conduct 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 activities conducted 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 provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

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 300.0000000000 %

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

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

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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? ......

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) ..	14,184,020	6,676,474	7,507,546	1.820 %
b	Medicaid (from Worksheet 3, column a) ....	89,926,793	56,976,612	32,950,181	8.000 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .	104,110,813	63,653,086	40,457,727	9.830 %
Other Benefits		2,076,056		2,076,056	0.500 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	2,076,056		2,076,056	0.500 %
f	Health professions education (from Worksheet 5) ..	1,725,329		1,725,329	0.420 %
g	Subsidized health services (from Worksheet 6) ..	10,627,815	4,261,615	6,366,200	1.550 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	1,045,230		1,045,230	0.250 %
j	Total. Other Benefits ..	15,474,430	4,261,615	11,212,815	2.720 %
k	Total. Add lines 7d and 7j .	119,585,243	67,914,701	51,670,542	12.550 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014

Schedule H (Form 990) 2014

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	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	13,301	13,301
3	Community support	4,439	4,439
4	Environmental improvements
5	Leadership development and training for community members	43,069	43,069	0.010 %
6	Coalition building	34,266	34,266	0.010 %
7	Community health improvement advocacy
8	Workforce development	387,734	387,734	0.090 %
9	Other
10	Total	482,809	482,809	0.120 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

5,567,517

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. ......

2,946,330

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).....

136,742,768

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

183,834,583

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

-47,091,815

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) 2014

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 (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	SAINT FRANCIS MEDICAL CENTER 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU,MO63703	X	X	X

Schedule H (Form 990) 2014

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)

	SAINT FRANCIS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C..........

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 12....................

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 significant 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 Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

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

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

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

Yes

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

Hospital facility’s website (list url): WWW.SFMC.NET

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

If "Yes" (list url):

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)? ...........................

12a

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

If "Yes" to line 12b, 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) 2014

Page

Part VFacility Information (continued)

	SAINT FRANCIS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.000000000000%
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): WWWSFMCNET

The FAP application form was widely available on a website (list url): WWWSFMCNET

A plain language summary of the FAP was widely available on a website (list url):
WWWSFMCNET

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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 all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	SAINT FRANCIS MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other 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?.........

Yes

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (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)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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 Section C)

Other (describe in Section C)

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 Section C)

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 Section C.

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 Section C.

Schedule H (Form 990) 2014

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
FACILITY 1, SAINT FRANCIS MEDICAL CENTER - PART V, LINE 5	-SECTION B. FACILITY POLICIES AND PRACTICES INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF BOLLINGER, CAPE GIRARDEAU, SCOTT, AND STODDARD COUNTIES INCLUDED PEOPLE INVOLVED IN SOME OF THE FOLLOWING ORGANIZATIONS: PUBLIC HEALTH DEPARTMENTS RURAL HEALTH CLINICS LOCAL SCHOOL DISTRICTS LAW ENFORCEMENT EMERGENCY SERVICES PERSONNEL EIGHT FOCUS GROUPS WERE HELD IN THE FOUR DESIGNATED COUNTIES AND THE QUESTIONS ASKED CAN BE FOUND BELOW. 1. WHAT DO PEOPLE IN THIS COMMUNITY DO TO STAY HEALTHY? HOW DO PEOPLE GET INFORMATION ABOUT HEALTH? 2. IN THIS GROUP'S OPINION, WHAT ARE SERIOUS HEALTH PROBLEMS IN YOUR COMMUNITY? WHAT ARE SOME OF THE CAUSES OF THESE PROBLEMS? 3. WHAT KEEPS PEOPLE IN YOUR COMMUNITY FROM BEING HEALTHY? 4. WHAT COULD BE DONE TO SOLVE THESE PROBLEMS? 5. IS THERE ANY GROUP NOT RECEIVING ENOUGH HEALTH CARE? IF SO, WHY? 6. OF ALL THE ISSUES WE HAVE TALKED ABOUT TODAY, WHAT ISSUES DO YOU THINK ARE THE MOST IMPORTANT FOR YOUR COMMUNITY TO ADDRESS? 617 SURVEYS WERE COMPLETED BY RESIDENTS IN THE FOUR DESIGNATED COUNTIES. THE SURVEY WAS VERY EXTENSIVE AND CONSISTED OF FIVE DIFFERENT SECTIONS. THE SURVEY DEMOGRAPHICS WERE REPRESENTATIVE OF THE AREA'S POPULATION. 1. MULTIPLE CHOICE: QUESTIONS TO COLLECT INFORMATION ON DEMOGRAPHICS, HEALTH CARE ACCESS, HEALTH STATUS, AND INSURANCE. 2. HEALTH BEHAVIORS: QUESTIONS TO COLLECT HEALTH BEHAVIOR INFORMATION. 3. CHILDREN'S HEALTH BEHAVIORS: QUESTIONS TO COLLECT HEALTH BEHAVIOR INFORMATION ABOUT THE PARTICIPANTS' CHILDREN IF APPLICABLE. 4. HEALTH ISSUES: QUESTIONS THE PARTICIPANTS ABOUT HAVING PARTICULAR HEALTH ISSUES. 5. COMMUNITY HEALTH CONCERNS: QUESTIONS THE PARTICIPANTS TO CHOOSE HOW MUCH OF A PROBLEM THEY THINK PARTICULAR ISSUES ARE IN THEIR COMMUNITY.
FACILITY 1, SAINT FRANCIS MEDICAL CENTER - PART V, LINE 6A	-SECTION B. FACILITY POLICIES AND PRACTICES THE TWO NOT-FOR-PROFIT HOSPITALS IN THE CITY OF CAPE GIRARDEAU, MISSOURI, SAINT FRANCIS HEALTHCARE SYSTEM AND SOUTHEASTHEALTH WERE PARTNERS IN CONDUCTING THIS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA).
FACILITY 1, SAINT FRANCIS MEDICAL CENTER - PART V, LINE 7D	-SECTION B. FACILITY POLICIES AND PRACTICES THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS PLACED ON THE SAINT FRANCIS MEDICAL CENTER'S WEBSITE. THERE WERE NUMEROUS NEWS STORIES ON THE ASSESSMENT AND WHERE TO LOCATE THE INFORMATION. LOCAL HEALTH AND HUMAN SERVICES AGENCIES WERE INFORMED WHEN THE ASSESSMENT WAS COMPLETED AT LOCAL MEETINGS. HTTP://WWW.SFMC.NET/SAINT-FRANCIS-MEDICAL-CENTERS-COMMUNITY-HEALTH- NEEDS-ASSESSMENT/
FACILITY 1, SAINT FRANCIS MEDICAL CENTER - PART V, LINE 11	-SECTION B. FACILITY POLICIES AND PRACTICES WHILE TREATMENT FOR SUBSTANCE ABUSE AND MENTAL HEALTH CONDITIONS ARE A SIGNIFICANT COMMUNITY HEALTH NEED IDENTIFIED BY THIS ASSESSMENT, SAINT FRANCIS HEALTHCARE SYSTEM WILL NOT BE ADDRESSING THIS NEED AS PART OF ITS 2013-2016 CHNA IMPLEMENTATION PLAN FOR THE FOLLOWING REASONS: 1. CONSIDERABLE RESOURCES ARE ALREADY ALLOCATED TO ADDRESS THE OTHER TOP-PRIORITY HEALTH NEEDS IDENTIFIED BY THE 2012 CHNA; 2. SOUTHEASTHEALTH, THE OTHER COMMUNITY HOSPITAL IN CAPE GIRARDEAU, ALREADY OFFERS INPATIENT PSYCHIATRIC TREATMENT, AND DUPLICATION OF SUCH SERVICES IN THE SAME COMMUNITY IS NOT THE BEST USE OF SFMC RESOURCES; AND 3. THE SIGNIFICANT RESOURCE REQUIREMENTS THAT WOULD BE NECESSARY FOR SAINT FRANCIS HEALTHCARE SYSTEM TO DEVELOP ITS OWN OUTPATIENT SUBSTANCE ABUSE AND/OR MENTAL HEALTH TREATMENT PROGRAMS FROM THE GROUND UP IS NOT FEASIBLE AT THIS TIME. SAINT FRANCIS WILL INSTEAD CONTINUE TO WORK WITH OTHER COMMUNITY PARTNERS THAT OFFER SUCH SERVICE IN THE COMMUNITY BY MAKING APPROPRIATE PATIENT REFERRALS.
FACILITY 1, SAINT FRANCIS MEDICAL CENTER - PART V, LINE 13H	ALL UNINSURED PATIENTS RECEIVING SERVICES AT SAINT FRANCIS MEDICAL CENTER WILL RECEIVE A REDUCTION ON ALL CHARGES AT THE TIME OF BILLING (WITHOUT APPLICATION). THE DISCOUNT OF 50% IS COMPARABLE TO CONTRACTED PAYER DISCOUNTS. ALL SELF-PAY ACCOUNTS WILL BE PROCESSED THROUGH A PRESUMPTIVE SCORING PROGRAM TO DETERMINE IF THEY QUALIFY FOR ASSISTANCE. IF THE PATIENT MEETS THE QUALIFICATIONS, THE PATIENT'S ACCOUNT WILL BE REDUCED TO ZERO. IF THE QUALIFICATIONS ARE NOT MET, COLLECTIONS WILL BE ESCALATED.
FACILITY 1, SAINT FRANCIS MEDICAL CENTER - PART V, LINE 16I	ALL PATIENTS ARE PROVIDED PATIENT HANDBOOKS UPON ADMISSION THAT DETAIL THE FINANCIAL ASSISTANCE POLICY. ALL UNINSURED PATIENTS ARE PERSONALLY CONTACTED AFTER ADMISSION AND INFORMED OF THE FINANCIAL ASSISTANCE AVAILABLE THROUGH THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY.
FACILITY 1, SAINT FRANCIS MEDICAL CENTER - PART V, LINE 18D	REFERRAL TO A THIRD PARTY COLLECTION AGENCY IS ALSO PERMITTED UNDER THE COLLECTION POLICY.
FACILITY 1, SAINT FRANCIS MEDICAL CENTER - PART V, LINE 20E	THIRD PARTY REPRESENTATIVES WORK WITH UNINSURED PATIENTS TO HELP THEM QUALIFY FOR MEDICAID BENEFITS THROUGH THEIR STATE OF RESIDENCE. CHARITY CARE APPLICATIONS ARE OFFERED FOR THOSE THAT DO NOT QUALIFY FOR MEDICAID AND EXPRESS THE NEED AND THE INABILITY TO PAY FOR MEDICAL SERVICES.

Schedule H (Form 990) 2014

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?30
Name and address		Type of Facility (describe)
1	CAPE CARDIOLOGY GROUP 211 SAINT FRANCIS DRIVE SUITE 15 CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
2	PHYSICIANS PARK PRIMARY CARE 225 PHYSICIANS PARK DRIVE SUITE 40 POPLAR BLUFF,MO63901	PHYSICIAN PRACTICE
3	CAPE GASTROENTEROLGY SPECIALISTS 28 S MOUNT AUBURN RD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
4	CAPE CARE FOR WOMEN 150 S MT AUBURN ROAD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
5	CAPE PHYSICIAN ASSOCIATES 3250 GORDONVILLE ROAD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
6	CAPE ENT GROUP 150 S MT AUBURN ROAD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
7	CAPE THORACIC & CARDIOVASCULAR SURG 3250 GORDONVILLE ROAD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
8	CAPE MEDICAL ONCOLOGY 211 SAINT FRANCIS DR CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
9	SIKESTON RADIATION ONCOLOGY 1124 N MAIN STREET SIKESTON,MO63801	PHYSICIAN PRACTICE
10	FARMINGTON PHYSICIAN ASSOICATES 515 MAPLE VALLEY DRIVE FARMINGTON,MO63640	PHYSICIAN PRACTICE
11	CAPE SPINE AND NEUROSURGERY 150 S MT AUBURN ROAD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
12	CAPE PRIMARY CARE 1702 N KINGSHIGHWAY CAPE GIRARDEAU,MO63701	PHYSICIAN PRACTICE
13	IMMEDIATE CONVENIENT CARE - CAPE 1702 N KINGSHIGHWAY CAPE GIRARDEAU,MO63701	PHYSICIAN PRACTICE
14	CAPE NEUROLOGY SPECIALISTS 3004 GORDONVILLE ROAD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
15	CAPE DIABETES & ENDOCRINOLOGY 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
16	JACKSON PHYSCIAN ASSOCIATES 2130 E JACKSON BLVD JACKSON,MO63755	PHYSICIAN PRACTICE
17	CAPE PULMONOLOGY AND SLEEP MEDICINE 24 S MT AUBURN ROAD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
18	JACKSON FAMILY CARE 545 BROADRIDGE DRIVE JACKSON,MO63755	PHYSICIAN PRACTICE
19	CHARLESTON FAMILY CARE 400 S MAIN STREET CHARLESTON,MO63834	PHYSICIAN PRACTICE
20	PIEDMONT PHYSICIAN ASSOCIATES RT 4 BOX 4515 PIEDMONT,MO63957	PHYSICIAN PRACTICE
21	SAINT FRANCIS HOME HEALTH 14 DOCTORS PARK CAPE GIRARDEAU,MO63703	HOME HEALTH
22	FITNESS PLUS 150 S MT AUBURN ROAD CAPE GIRARDEAU,MO63703	FITNESS CENTER
23	CAPE PEDIATRIC GROUP 35 DOCTORS PARK CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
24	POPLAR BLUFF NEUROLOGY SPECIALISTS 2210 BARRON ROAD SUITE 112 POPLAR BLUFF,MO63901	PHYSICIAN PRACTICE
25	CAPE PERINATOLOGY SERVICES 150 S MT AUBURN ROAD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
26	CAPE GYNECOLOGIC ONCOLOGY 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
27	CAPE MEDICAL GROUP 150 S MT AUBURN ROAD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE
28	SIKESTON NEUROLOGY SPECIALISTS 807 N MAIN STREET SIKESTON,MO63801	PHYSICIAN PRACTICE
29	SAINT FRANCIS OUTPATIENT REHAB 150 S MT AUBURN ROAD CAPE GIRARDEAU,MO63703	OUTPATIENT REHAB
30	CAPE CEREBROVASCULAR & ENDOVASCULAR 150 S MT AUBURN ROAD CAPE GIRARDEAU,MO63703	PHYSICIAN PRACTICE

Schedule H (Form 990) 2014

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE	ALL UNINSURED PATIENTS RECEIVING SERVICES AT SAINT FRANCIS MEDICAL CENTER WILL RECEIVE A REDUCTION ON ALL CHARGES AT THE TIME OF BILLING (WITHOUT APPLICATION). THE DISCOUNT OF 50% IS COMPARABLE TO CONTRACTED PAYER DISCOUNTS. ALL SELF-PAY ACCOUNTS WILL BE PROCESSED THROUGH A PRESUMPTIVE SCORING PROGRAM TO DETERMINE IF THEY QUALIFY FOR ASSISTANCE. IF THE PATIENT MEETS THE QUALIFICATIONS, THE PATIENT'S ACCOUNT WILL BE REDUCED TO ZERO. IF THE QUALIFICATIONS ARE NOT MET, COLLECTIONS WILL BE ESCALATED.
PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION	COSTS FOR SUBSIDIZED HEALTH SERVICES INCLUDE COSTS ASSOCIATED WITH PROVIDING NEONATOLOGY, TRAUMA, HOSPITALIST AND PERINATOLOGY PHYSICIAN CLINICAL SERVICES WHERE OPERATIONS RESULT IN LOSSES. TOTAL EXPENSES IN THE AMOUNT OF 10,627,815 ARE INCLUDED.
PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE	BAD DEBTS WERE NOT EXCLUDED FROM THE CALCULATION IN COLUMN F.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION	A COST-TO-CHARGE RATIO WAS USED IN ACCORDANCE WITH THE CALCULATION IN WORKSHEET 2, "RATIO OF PATIENT CARE COST TO CHARGES."
PART II - COMMUNITY BUILDING ACTIVITIES	SAINT FRANCIS MEDICAL CENTER'S COMMUNITY BUILDING ACTIVITIES ARE TARGETED TO KEEP GOOD HEALTH IN THE FOREFRONT THROUGH NON-TRADITIONAL CHANNELS. THESE ACTIVITIES ARE USED TO DELIVER HEALTHCARE INFORMATION AND EDUCATION DIRECTLY TO CITIZENS OF THE COMMUNITY. COMMUNITY FORUMS OR MEETINGS ALLOW REPRESENTATIVES OF THE MEDICAL CENTER TO PRESENT POTENTIALLY LIFE-SAVING INFORMATION TO AN AUDIENCE NOT TYPICALLY REACHED BY COMMUNITY HEALTH AGENCIES OR SCREENINGS.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY	A COST-TO-CHARGE RATIO WAS USED IN ACCORDANCE WITH THE CALCULATION IN WORKSHEET 2, "RATIO OF PATIENT CARE COST TO CHARGES" TO DEVELOP COSTS ASSOCIATED WITH BAD DEBT EXPENSE. PATIENT PAYMENTS AND DISCOUNTS ARE APPLIED TO PATIENT'S ACCOUNT BEFORE BAD DEBT DETERMINATION IS MADE.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE	AN ESTIMATE OF BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE MEDICAL CENTER'S CHARITY CARE POLICY WAS CALCULATED BASED ON A STUDY OF POVERTY RATES IN THE MEDICAL CENTER'S SERVICE AREA. THE PERCENTAGE OF THE POPULATION WITH INCOME LEVELS AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES WAS OBTAINED FOR THE STATES REPRESENTED IN BAD DEBT EXPENSE. THAT PERCENTAGE WAS THEN APPLIED TO THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO EACH STATE TO OBTAIN THE ESTIMATED AMOUNT IN BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE CHARITY CARE POLICY. THE COST TO CHARGE RATIO WAS THEN APPLIED TO CONVERT TO COST. THE MEDICAL CENTER ESTIMATES THAT 2,946,330 AT COST IS CHARITY CARE ELIGIBLE AND IS INCLUDED IN BAD DEBT EXPENSE.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	THE MEDICAL CENTER ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE FOR PATIENTS WHICH IS NOT INCLUDED IN COMMUNITY BENEFIT EXPENSE, BUT IS REPORTED ON THE STATEMENT OF OPERATIONS AS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANY OF THOSE PATIENTS ARE UNINSURED OR UNDERINSURED, BUT DID NOT APPLY FOR OR QUALIFY FOR CHARITY CARE. DURING THE YEAR ENDED JUNE 30, 2015, THE MEDICAL CENTER REPORTED BAD DEBT EXPENSE; AT COST, OF 5,567,000.
PART III, LINE 8 - MEDICARE EXPLANATION	THE COSTING METHODOLOGY USED FOR PART III, LINE 6 IS A COST TO CHARGE RATIO DERIVED FROM THE PRIOR YEAR'S MEDICARE COST REPORT WHICH USES ONLY MEDICARE ALLOWABLE COSTS. IRS REV. RUL. 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. FOR-PROFIT SPECIALTY HOSPITALS HAVE BEEN CARVING OUT CERTAIN HIGH- MARGIN SERVICES (SUCH AS CARDIAC, ORTHOPEDICS, AND ONCOLOGY), LEAVING GENERAL ACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS INDICATES THAT MEDICARE LOSSES CAN BE A RESULT OF RENDERING THESE LOWER- MARGIN SERVICES (WHICH BENEFIT THE COMMUNITY) RATHER THAN INEFFICIENT OPERATIONS. IN SOME COMMUNITIES, MEDICARE IS THE LARGEST PAYER, AND HOSPITALS MUST ACCEPT THESE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SUCH SERVICES. IF THE MEDICARE PARTICIPATION IS PREMISED ON THIS FACT, THEN PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A COMMUNITY BENEFIT. THERE ARE A NUMBER OF LOW-INCOME CONSUMERS RECEIVING MEDICARE BENEFITS. THE ELDERLY ARE OFTEN AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE SERVICES, CMS WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY. MEDICARE PAYMENT ANOMALIES MAY BE PRESENT IN SOME STATES SO EVEN VERY EFFICIENT HOSPITALS ARE UNABLE TO AVOID LOSSES. THUS, LOSSES MAY NOT BE INDICATIVE OF INEFFICIENCY BUT RATHER PROVISION OF A COMMUNITY BENEFIT.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION	IF PATIENT EXPRESSES FINANCIAL INABILITY TO PAY, THE REPRESENTATIVE OF THE MEDICAL CENTER WILL OFFER AN ASSISTANCE APPLICATION TO THE PATIENT. THE PATIENT THEN RETURNS THE APPLICATION TO THE BUSINESS OFFICE FOR REVIEW. AFTER REVIEW THE BUSINESS OFFICE WILL NOTIFY THE PATIENT IN WRITING OF THE DECISION. IF APPROVED THE BUSINESS OFFICE WILL WRITE OFF REMAINING BALANCES. IF DENIED THE BUSINESS OFFICE WILL CONTACT THE PATIENT TO MAKE PAYMENT ARRANGEMENTS.
PART VI, LINE 2 - NEEDS ASSESSMENT	SAINT FRANCIS IS PROACTIVE IN ASSESSING THE HEALTHCARE NEEDS OF ITS SERVICE AREA THROUGH GATHERING INFORMATION OR STUDIES FROM COMMUNITY HEALTHCARE AGENCIES, DEVELOPING AND SUPPORTING COMMUNITY HEALTH EDUCATORS AND FOLLOWING UP ON INFORMATION FROM PATIENTS AND FAMILIES. SAINT FRANCIS IS REACTIVE IN ASSESSING THE HEALTHCARE NEEDS OF ITS SERVICE AREA BY PROVIDING SUPPORT AND ASSISTANCE THROUGH LOCAL AND NATIONAL AGENCIES, WHICH PROVIDE DIRECT HEALTHCARE SERVICES TO THE MEDICAL CENTER'S SERVICE AREA.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	HOSPITAL PERSONNEL, INCLUDING NURSES, PHYSICIANS, SOCIAL WORKERS AND OTHERS, MAY IDENTIFY AND REQUEST AN APPLICATION FOR A PATIENT WHEN DEEMED APPROPRIATE. PATIENTS AND PERSONS WHO MAY BE BILLED RECEIVE AN APPLICATION FOR ASSISTANCE WHEN A NEED IS EXPRESSED. REQUEST FOR ASSISTANCE IS USUALLY MADE WHEN THE PATIENT RECEIVES THE BILL, OR WHEN THE CUSTOMER SERVICE REPRESENTATIVE CONTACTS THE PATIENT FOR PAYMENT OF ACCOUNT. AT THE TIME NEED IS EXPRESSED, THE APPLICATION IS GIVEN PERSONALLY OR MAILED TO THE PATIENT. CUSTOMER SERVICE REPRESENTATIVES THEN WORK WITH THE PATIENT TO COMPLETE ASSISTANCE REQUEST AND FORWARD APPLICATION FOR APPROVAL. ANY PATIENTS WHO RETURN TO THE MEDICAL CENTER TO PAY A BILL HAVE ACCESS TO ASSISTANCE EDUCATION DOCUMENTATION AT THE BILLING OFFICE.
PART VI, LINE 4 - COMMUNITY INFORMATION	SAINT FRANCIS MEDICAL CENTER IS A LEADING TERTIARY CARE PROVIDER FOR A PORTION OF THE FIVE-STATE REGION OF MISSOURI, ARKANSAS, ILLINOIS, KENTUCKY AND TENNESSEE AND OFFERS SERVICES TO MORE THAN 650,000 PEOPLE. PRIMARY SERVICE AREA CONSISTS OF CAPE GIRARDEAU COUNTY WITH A POPULATION OF 78,043. ACCORDING TO THE MISSOURI OFFICE OF ADMINISTRATION, BUDGET AND PLANNING, CAPE GIRARDEAU COUNTY'S POPULATION IS EXPECTED TO INCREASE TO 84,612 BY 2030. SECONDARY SERVICE AREA HAS A TOTAL POPULATION OF ALMOST 176,206 AND INCLUDES THE COUNTIES OF ALEXANDER (7,499), PULASKI (5,815), JOHNSON (12,582) AND UNION (17,447) IN ILLINOIS; AND BOLLINGER (12,394), MISSISSIPPI (14,232), NEW MADRID (18,272), PERRY (19,202), SCOTT (38,903) AND STODDARD (29,867) IN MISSOURI. TERTIARY SERVICE AREA HAS A TOTAL POPULATION OF NEARLY 400,000 AND INCLUDES THE COUNTIES OF BUTLER (42,972), CARTER (6,258), DUNKLIN (31,344), IRON (10,267), MADISON (12,368), PEMISCOT (17,650), REYNOLDS (6,585), RIPLEY (13,969), ST. FRANCOIS (65,960), STE. GENEVIEVE (17,914) AND WAYNE (13,452) IN MISSOURI; AND JACKSON (59,677), RANDOLPH (32,869) AND WILLIAMSON (67,008) IN ILLINOIS. THE SOUTHEAST REGION OF MISSOURI IS GROWING SLOWLY AND HAS A HIGHER THAN AVERAGE PERCENTAGE OF RETIREE-AGED PEOPLE. OVER THE NEXT FIVE YEARS, THE POPULATION BETWEEN AGES 55 TO 75 IS PROJECTED TO HAVE THE LARGEST PERCENT GROWTH. CURRENTLY, THE LARGEST POPULATION AGE GROUP IS AGES 45-54. THIS REGION IS 87.5 PERCENT CAUCASIAN, 8.7 PERCENT BLACK AND 1.9 PERCENT HISPANIC. TOTAL PERSONAL INCOME FOR CAPE GIRARDEAU COUNTY FOR 2014 WAS 3,058,763,000 OR 39,560 PER CAPITA. TOTAL PERSONAL INCOME FOR THE SOUTHEAST REGION WAS 12.8 BILLION WITH AN AVERAGE PER CAPITA OF 34,980. OF THE ENTIRE SOUTHEAST REGION POPULATION AGE 25 AND OLDER, 13.5 PERCENT DID NOT OBTAIN A HIGH SCHOOL DIPLOMA. 79.5 PERCENT GRADUATED FROM HIGH SCHOOL, 17.3 PERCENT HAVE RECEIVED A COLLEGE DEGREE AND 6.5 PERCENT HAVE COMPLETED A GRADUATE DEGREE. ACCORDING TO EMPLOYMENT STATISTICS IN OCTOBER 2015, CAPE GIRARDEAU COUNTY HAD AN UNEMPLOYMENT RATE OF 3.9 PERCENT. THE SOUTHEAST REGION UNEMPLOYMENT RATE WAS 4.9 PERCENT. STATISTICS COURTESY OF THE MISSOURI ECONOMIC RESEARCH AND INFORMATION CENTER AND U.S. CENSUS BUREAU.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	SAINT FRANCIS MEDICAL CENTER FURTHERS ITS EXEMPT PURPOSE BY PROVIDING FOR AN OPEN MEDICAL STAFF COMPRISED OF PHYSICIANS IN ITS PRIMARY SERVICE AREA. THE BOARD OF DIRECTORS IS COMPRISED OF LOCAL COMMUNITY MEMBERS WITH A VESTED INTEREST IN PROMOTING AND IMPROVING THE HEALTH OF THE POPULATION SERVED BY SAINT FRANCIS MEDICAL CENTER. IN ADDITION, SURPLUS FUNDS GENERATED BY THE OPERATIONS OF THE MEDICAL CENTER ARE REINVESTED IN EQUIPMENT AND FACILITIES SO THAT SAINT FRANCIS MEDICAL CENTER CAN PROVIDE CUTTING EDGE HEALTHCARE TO THE RESIDENTS OF ITS COMMUNITY.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	SAINT FRANCIS HEALTHCARE SYSTEM, INC. IS A HOLDING COMPANY WHICH OWNS SAINT FRANCIS MEDICAL CENTER. SAINT FRANCIS MEDICAL CENTER OPERATES A 284-BED ACUTE CARE HOSPITAL LOCATED IN CAPE GIRARDEAU, MISSOURI. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. SAINT FRANCIS MEDICAL CENTER WAS ORGANIZED BY SAINT FRANCIS HEALTHCARE SYSTEM. SAINT FRANCIS HEALTH DEVELOPMENT SERVICES, INC. FORMED IN 2002, OWNS A 51% INTEREST IN PHYSICIANS ALLIANCE SURGERY CENTER, LLC, A 30% INTEREST IN POPLAR BLUFF MEDICAL PARTNERS, LLC, A 30% INTEREST IN LANDMARK HOSPITAL OF CAPE GIRARDEAU, LLC AND A 30% INTEREST IN DRX - FC MANAGEMENT 001, LLC WHICH OPERATES A DOCTORS EXPRESS URGENT CARE CENTER.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT	MISSOURI

Schedule H (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

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), 501(c)(4), and 501(c)(29) organizations 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? ...........................

Yes

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2014

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 in column(B) 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)
1STEVEN C BJELICHPRESIDENT & CEO	(i) (ii)	880,816 ...............................	1,859,856 ...............................	30,805 ...............................	11,375 ...............................	20,138 ...............................	2,802,990 ...............................	...............................
2WILLIAM A BALSANOVP OF FINANCE	(i) (ii)	466,722 ...............................	45,195 ...............................	28,806 ...............................	12,125 ...............................	9,900 ...............................	562,748 ...............................	...............................
3JAMES A SCHELL MDVP MEDICAL AFFAIRS	(i) (ii)	439,469 ...............................	45,195 ...............................	44,437 ...............................	12,125 ...............................	19,523 ...............................	560,749 ...............................	...............................
4MARILYN K CURTISVP OF PROF. SERVICE	(i) (ii)	365,280 ...............................	109,255 ...............................	30,635 ...............................	12,298 ...............................	19,523 ...............................	536,991 ...............................	...............................
5BARBARA THOMPSON VP OF MARKETING	(i) (ii)	438,171 ...............................	...............................	...............................	...............................	...............................	438,171 ...............................	...............................
6JEANNETTE K FADLERVP OF PATIENT CARE	(i) (ii)	293,327 ...............................	83,125 ...............................	45,040 ...............................	12,375 ...............................	19,524 ...............................	453,391 ...............................	...............................
7THOMAS S DIEMER MDVP OF QUALITY	(i) (ii)	251,550 ...............................	...............................	42,723 ...............................	12,043 ...............................	26,083 ...............................	332,399 ...............................	...............................
8STEVEN A OGBURNVP OF AMBULATORY SVC	(i) (ii)	217,190 ...............................	22,349 ...............................	17,472 ...............................	11,654 ...............................	26,044 ...............................	294,709 ...............................	...............................
9MICHAEL FREEMANMDGASTRONENTEROLOGIST	(i) (ii)	1,196,884 ...............................	...............................	44,151 ...............................	10,851 ...............................	26,101 ...............................	1,277,987 ...............................	...............................
10BRANDON SCOTT DONEUROSURGEON	(i) (ii)	716,435 ...............................	116,221 ...............................	35,501 ...............................	11,606 ...............................	10,348 ...............................	890,111 ...............................	...............................
11EDWARD BENDERMD THORACIC ANDCARDIOVASCULAR SURGE	(i) (ii)	780,074 ...............................	...............................	46,668 ...............................	11,462 ...............................	21,122 ...............................	859,326 ...............................	...............................
12WILLIAM K LAFOE MDINTERVEN. CARDIO.	(i) (ii)	771,045 ...............................	...............................	2,411 ...............................	4,623 ...............................	26,101 ...............................	804,180 ...............................	...............................
13DUC T NGUYEN DO INTERVENTIONALCARDIOLOGIST	(i) (ii)	737,747 ...............................	...............................	35,559 ...............................	13,615 ...............................	23,847 ...............................	810,768 ...............................	...............................

Schedule J (Form 990) 2014

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, PAGE 1, PART I, LINE 1A	EXECUTIVE AND BOARD MEMBERS RECEIVE TRAVEL FOR THEIR SPOUSES. SPOUSAL TRAVEL IS ADDED TO W-2'S FOR EXECUTIVES AND 1099'S ARE ISSUED TO BOARD MEMBERS. THE CEO RECEIVES COUNTRY CLUB DUES, WHICH IS INCLUDED ON THE W-2. SFMC WILL OCCASIONALLY CHARTER A FLIGHT FOR BUSINESS PURPOSES ONLY.
SCHEDULE J, PAGE 1, PART I, LINE 4	STEVEN A. OGBURN 0 15,555 0
SCHEDULE J, PAGE 1, PART I, LINE 6A	ALL EXECUTIVE BONUSES ARE BASED ON FINANCIAL PERFORMANCE.
SCHEDULE J, PART III	BARBARA THOMPSON, VP OF MARKETING IS NOT AN EMPLOYEE OF SAINT FRANCIS MEDICAL CENTER. SHE IS THE OWNER OF THE ROBERTS GROUP WHO PROVIDES ADVERTISING AND MARKETING SERVICES TO THE MEDICAL CENTER. HER COMPENSATION IS PAID BY THE ROBERTS GROUP.

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
SAINT FRANCIS MEDICAL CENTER

Employer identification number
23-7246265

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	IND DEV AUTH OF CAPE GIRARDEAUM	43-1193901	139404EH6	05-28-2009	49,238,638	CAPITAL EXPENDITURES	X			X		X
B	IND DEV AUTH OF CAPE GIRARDEAU	43-1193901	139404FJ1	05-01-2013	40,290,000	EXTINGUISH/DEFEASE OUTSTANDING BONDS		X		X		X
C	IND DEV AUTH OF CAPE GIRARDEAU	43-1193901	139404FH5	05-01-2013	131,833,295	CAPITAL EXPENDITURES		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	2,160,000		2,145,000		2,465,000
2 Amount of bonds legally defeased . . . . . . . . . . .	11,745,000
3 Total proceeds of issue . . . . . . . . . . . . . .	49,238,638		40,290,000		131,833,295
4 Gross proceeds in reserve funds . . . . . . . . . . . .	4,821,834				58,695,000
5 Capitalized interest from proceeds . . . . . . . . . . .	3,393,406				3,393,406
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	950,781				1,380,910
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	43,467,033				75,003,510
11 Other spent proceeds . . . . . . . . . . . . . .
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	2011		2013		2015
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X	X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X	X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2014

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .
6 Total of lines 4 and 5 . . . . . . . . . . . . .
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X		X		X
b Exception to rebate? . . . . . . . .		X		X		X
c No rebate due? . . . . . . . .		X		X		X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .		X	X			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2014

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X		X		X

Part VI

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

Return Reference	Explanation

Schedule K (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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
(1) STEVEN C BJELICH	PRESIDENT & CEO			X	479,162	491,623		No	Yes		Yes





Total ...... $						491,623

Part III

Grants or Assistance Benefiting 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
(1) DENNIS MARCHI	BOARD OF DIRECTORS	18,655	DISCOUNTED HEALTHCARE

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2014

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) B THOMPSON-OWNS THE ROBERTS GROUP	VP OF MARKETING	8,078,294	ADVERTISING FEES		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...	X	17	9,331	COST/SELLING PRICE/FMV
20 Drugs and medical supplies .	X	1	1,025	COST/SELLING PRICE/FMV
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( PRIZES )	X	72	28,507	COST/SELLING PRICE/FMV
26 Other ( PHOTOGRAPHY )	X	2	11,180	COST/SELLING PRICE/FMV
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that

it must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2014)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation

Schedule M (Form 990) (2014)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ 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

2014

Open to Public
Inspection

Name of the organization

SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

Return Reference	Explanation
FORM 990 - ORGANIZATION'S MISSION	SAINT FRANCIS MEDICAL CENTER IS A 284-BED FACILITY SERVING MORE THAN 650,000 PEOPLE THROUGHOUT MISSOURI, ILLINOIS, KENTUCKY, TENNESSEE, AND ARKANSAS. THE MEDICAL CENTER PROVIDES COMPREHENSIVE INPATIENT ACUTE CARE SERVICES FOR MEDICAL AND SURGICAL PATIENTS SPECIALIZING IN ORTHOPEDICS, NEUROSURGERY, CARDIOVASCULAR SERVICES, ONCOLOGY, DISEASE MANAGEMENT, GASTROENTEROLOGY, MATERNAL-CHILD HEALTH AND NEUROLOGY.
FORM 990, PAGE 2, PART III, LINE 4A	-CARE FOR PERSONS COVERED BY GOVERNMENTAL PROGRAMS THAT REIMBURSE BELOW ACTUAL COST. -HEALTH SCREENINGS AND EDUCATIONAL PROGRAMS TO SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITY. SFMC PROVIDES A VARIETY OF WELLNESS PROGRAMS, COMMUNITY HEALTH EDUCATION ACTIVITIES, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER-SERVED AND PARTICIPATES IN A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. SFMC SERVED 11,374 INPATIENTS, 34,770 EMERGENCY PATIENTS AND 156,042 OUTPATIENTS DURING THE FISCAL YEAR (FY) ENDING JUNE 30, 2015. DURING FY 2015, SFMC HAD A TOTAL OF 57,800 PATIENT DAYS IN ITS MEDICAL/SURGICAL, CRITICAL CARE, OBSTETRIC, AND REHABILITATION CARE UNITS. SFMC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, FOR WHICH IT IS REIMBURSED BELOW COST. RECOGNIZING ITS MISSION IN THE COMMUNITY, SFMC PROVIDES SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS IN EXCESS OF 80.0 MILLION IN FY 2015. CHARITY CARE IS PROVIDED IN THE FORM OF MANY REDUCED-PRICE AND FREE SERVICES OFFERED THROUGHOUT THE YEAR. SFMC STRONGLY BELIEVES THESE PROGRAMS AND SERVICES FILL A REAL NEED IN THE COMMUNITY. THESE PROGRAMS AND SERVICES INCLUDE THE FOLLOWING: -PARTICIPATION IN AND/OR SPONSORSHIP OF MANY COMMUNITY HEALTH FAIRS. THESE EVENTS RANGE FROM CHILDREN'S SPECIAL EVENTS TO SENIOR HEALTH FAIRS. TOTAL ATTENDANCE AT THESE ACTIVITIES EXCEEDED 8,300 DURING FY 2015. -SFMC SPONSORS THE REGIONAL ARTHRITIS CENTER, OFFERING INFORMATION AND ASSISTANCE TO PEOPLE THROUGHOUT SOUTHEAST MISSOURI. -FREE OR DISCOUNTED HEALTH SCREENINGS (CHOLESTEROL, BLOOD PRESSURE, GLAUCOMA, BLOOD SUGAR, ETC.) PROVIDED AT HEALTH FAIRS AND COMMUNITY HEALTH EDUCATION PROGRAMS, AS WELL AS OUR WEEKLY WEDNESDAY MORNING HEART HEALTH SCREENINGS. -COMMUNITY HEALTH FORUMS WERE OFFERED ON TOPICS SUCH AS ARTHRITIS, DIABETES, CARDIOVASCULAR FITNESS, CHILDREN'S HEALTH AND SAFETY, NUTRITION, BREAST CANCER AND OSTEOPOROSIS. OTHER WELLNESS PROGRAMS SUCH AS WEIGHT MANAGEMENT ARE SUBSIDIZED BY SFMC AND OFFERED FOR A NOMINAL FEE. -CHILDBIRTH, SIBLINGS, BREASTFEEDING AND INFANT CARE CLASSES ARE PROVIDED FREE OF CHARGE TO EXPECTANT MOTHERS AND YOUNG FAMILIES. -SFMC SPONSORS HEALTHCARE SPEAKERS FOR COMMUNITY EVENTS AND CIVIC MEETINGS. SFMC STAFF PRESENTS FREE PROGRAMS ON A VARIETY OF HEALTH AND WELLNESS TOPICS TO VARIOUS COMMUNITY, SCHOOL AND CHURCH GROUPS THROUGHOUT THE YEAR. -SEVERAL SFMC OUTPATIENT CLINICS ARE OFFERED AT REDUCED FEE OR NO COST TO PATIENTS AND THEIR FAMILIES. THE CLINICS ADDRESS DIABETIC FOOT CARE, GENETICS, ORTHOPEDICS AND SPORTS INJURIES. -SFMC PROVIDES FREE FIRST AID SERVICES AT THE WEEKLONG SEMO DISTRICT FAIR IN CAPE GIRARDEAU. MEDICAL CENTER PERSONNEL STAFF THE FIRST AID STATION AND PROVIDE MINOR MEDICAL SERVICES TO HUNDREDS OF PEOPLE DURING THE COURSE OF THE WEEK. SFMC ALSO PROVIDES STAFF AND FIRST AID MATERIALS FOR OTHER CIVIC FUNCTIONS DURING THE FISCAL YEAR. -SFMC PROVIDES FREE MEETING ROOM SPACE AND RELATED ASSISTANCE TO MANY HEALTHCARE SUPPORT GROUPS. SEVERAL HUNDRED PEOPLE REGULARLY PARTICIPATE IN THESE SUPPORT GROUPS FOR DISEASES AND DISORDERS INCLUDING BREAST CANCER, MUSCULAR DYSTROPHY, SLEEP DISTURBANCE, ALS, HEART SURGERY, DIGESTIVE DISEASES, ARTHRITIS, MULTIPLE SCLEROSIS AND STROKES. -SFMC PROVIDES FINANCIAL AND IN-KIND SUPPORT FOR ACTIVITIES OF LOCAL CHARITIES SUCH AS THE AMERICAN DIABETES ASSOCIATION, THE AMERICAN ARTHRITIS ASSOCIATION, THE MARCH OF DIMES, THE AMERICAN HEART ASSOCIATION, THE AMERICAN LUNG ASSOCIATION AND CATHOLIC CHARITIES. -SCHOLARSHIPS AND TUITION REIMBURSEMENT ARE AWARDED ANNUALLY BY SFMC TO UNDERGRADUATE AND GRADUATE STUDENTS ENROLLED IN VARIOUS HEALTHCARE CURRICULUMS. THE VALUE OF THIS INVESTMENT IN THE ADVANCEMENT OF EXISTING CARE PROVIDERS AND THE EDUCATION OF FUTURE CARE PROVIDERS WAS 272,002 IN FY 2015. -SFMC SPONSORS MEDICAL MINUTE. THESE WEEKLY EDUCATIONAL PROGRAMS, PRODUCED IN COOPERATION WITH MEMBERS OF THE MEDICAL COMMUNITY, PROVIDES INFORMATION ON NEW TECHNOLOGY AND PROCEDURES, TREATMENT FOR DISEASES AND DISORDERS, AND GENERAL MEDICAL EDUCATION TO AREA PATIENTS. -SFMC PROVIDES FREE INTERNET LIBRARY SEARCHES ON HEALTHCARE TOPICS TO AREA RESIDENTS WHO DO NOT HAVE OTHER ACCESS. -SFMC PROVIDES EMERGENCY CARE, CLOTHING AND PHARMACEUTICALS TO CHILDREN AND ADULTS IN NEED THROUGH THE SAINT FRANCIS FOUNDATION SISTER ESTHER FUND, PARENTS WITH HOPE FUND AND CANCER CARE FUND. -DURING FY 2015 SFMC VOLUNTEERS CONTRIBUTED APPROXIMATELY 42,363 HOURS OF SERVICE TO OUR PATIENTS, THEIR FAMILIES AND THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS ESTIMATED AT OVER 324,000 AND IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN PATIENT CARE SERVICES AND WELLNESS PROGRAMS SUCH AS THOSE DESCRIBED ELSEWHERE IN THIS DOCUMENT. -DURING FY 2015 SFMC PROVIDED 364 FREE MAMMOGRAMS AND ULTRASOUNDS TO AREA WOMEN WHO COULD NOT AFFORD THIS POTENTIALLY LIFESAVING SCREENING. THE VALUE OF THIS CONTRIBUTION IS ESTIMATED AT MORE THAN 42,108.
FORM 990, PAGE 6, PART VI, LINE 2	SAINT FRANCIS MEDICAL CENTER = SFMC SAINTFRANCISHEALTHDEVELOPMENT=SFHD S. BJELICH-OFFICER SFMC / DIR SFHD C.NENNINGER-DIRECTOR OF SFMC & SFHD BUSINESS RELATIONSHIP S. BJELICH-OFFICER SFMC / DIR SFHD K. GOVERO-DIRECTOR OF SFMC & SFHD BUSINESS RELATIONSHIP S. BJELICH-OFFICER SFMC / DIR SFHD J. LAYTON-DIRECTOR OF SFMC & SFHD BUSINESS RELATIONSHIP C.NENNINGER-DIRECTOR OF SFMC & SFHD K. GOVERO-DIRECTOR OF SFMC & SFHD BUSINESS RELATIONSHIP C.NENNINGER-DIRECTOR OF SFMC & SFHD J. LAYTON-DIRECTOR OF SFMC & SFHD BUSINESS RELATIONSHIP K. GOVERO-DIRECTOR OF SFMC & SFHD J. LAYTON-DIRECTOR OF SFMC & SFHD BUSINESS RELATIONSHIP
FORM 990, PAGE 6, PART VI, LINE 3	THE ROBERTS GROUP PROVIDES MARKETING AND ADVERTISING SERVICES FOR SAINT FRANCIS MEDICAL CENTER. BARBARA THOMPSON IS THE OWNER OF THE ROBERTS GROUP AND ALSO THE VICE PRESIDENT OF MARKETING AT SAINT FRANCIS MEDICAL CENTER. BARBARA THOMPSON IS NOT AN EMPLOYEE OF THE MEDICAL CENTER AND IS THEREFORE NOT PAID A DIRECT SALARY FROM THE MEDICAL CENTER.
FORM 990, PAGE 6, PART VI, LINE 6	SAINT FRANCIS HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE SAINT FRANCIS MEDICAL CENTER.
FORM 990, PAGE 6, PART VI, LINE 7A	SAINT FRANCIS HEALTHCARE SYSTEM, INC. AS THE SOLE MEMBER OF SAINT FRANCIS MEDICAL CENTER HAS THE POWER TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS, THE CHAIRMAN OF THE BOARD, THE VICE CHAIRMAN OF THE BOARD AND THE SECRETARY/TREASURER OF THE CORPORATION.
FORM 990, PAGE 6, PART VI, LINE 7B	DECISIONS ARE SUBJECT TO THE BISHOP'S APPROVAL.
FORM 990, PAGE 6, PART VI, LINE 11B	A COPY OF THE FORM 990 IS PROVIDED TO ALL THE MEMBERS OF THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO BEING FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PAGE 6, PART VI, LINE 12C	THE MEDICAL CENTER REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST STATEMENT EACH YEAR. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE EDUCATED EACH YEAR ON THE DEFINITION OF A CONFLICT OF INTEREST AND HOW TO AVOID THEM.
FORM 990, PAGE 6, PART VI, LINE 15A	AN OUTSIDE CONSULTANT IS ENGAGED TO PROVIDE BENCHMARK DATA FOR COMPARABLE POSITIONS IN COMPARABLY SIZED MEDICAL CENTERS. BASED ON THE DATA, THE CONSULTANT MAKES A RECOMMENDATION TO THE COMPENSATION COMMITTEE OF THE BOARD. THE BOARD DISCUSSES THE RECOMMENDATIONS AND MAKES A DECISION AS TO WHAT WILL BE PROVIDED FOR THE YEAR. THE PRESIDENT OF THE BOARD PROVIDES THE INFORMATION TO THE VP OF FINANCE TO IMPLEMENT.
FORM 990, PAGE 6, PART VI, LINE 15B	BASED ON DATA PROVIDED BY CONSULTANTS, THE BOARD OF DIRECTORS ESTABLISH PAY TARGETS FOR THE EXECUTIVE TEAM. THE PRESIDENT GRANTS THE VICE PRESIDENTS THEIR PAY INCREASES BASED ON PERFORMANCE IN THE PRECEEDING YEAR.
FORM 990, PAGE 6, PART VI, LINE 19	COPIES OF THE MEDICAL CENTERS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FEDERAL FORM 990 ARE AVAILABLE AT THE ADMINISTRATIVE OFFICE UPON REQUEST.
FORM 990, PART XI, LINE 9	CHANGE IN INTEREST IN NET ASSETS OF SFF -357,811 TRANSFER FROM AFFILIATE SFHS 10,000,000

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

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

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

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

SAINT FRANCIS MEDICAL CENTER

Employer identification number

23-7246265

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)	(f) Direct controlling entity
(1) MEDICAL PARTNERS OF CAPE GIRARDEAU 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU,MO63703 43-1869973	PHYS. PRAC	MO	SFMC

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) SAINT FRANCIS HEALTHCARE SYSTEM 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU,MO63703 43-0662499	HOLDING CO	MO	501C3	11B	NA		No
(2) SAINT FRANCIS FOUNDATION 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU,MO63703 43-1111276	FUND DEV.	MO	501C3	11B	NA		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2014

Page 2

Part III

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

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

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) SAINT FRANCIS HEALTH DEVELOP SRVC 211 SAINT FRANCIS DRIVE CAPE GIRARDEAU,MO63703 47-0849798	HOLDING CO	MO	SFHS	C CORP				No

Schedule R (Form 990) 2014

Page 3

Part V

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

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

Yes

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

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

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

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

Yes

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Schedule R (Form 990) 2014

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) 2014

Page 5

Part VII

Supplemental Information

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

Return Reference	Explanation

Schedule R (Form 990) 2014

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SAINT FRANCIS MEDICAL CENTER IS A 284-BED FACILITY SERVING MORE THAN 650,000 PEOPLE THROUGHOUT MISSOURI, ILLINOIS, KENTUCKY, TENNESSEE, AND ARKANSAS. THE MEDICAL CENTER PROVIDES COMPREHENSIVE INPATIENT ACUTE CARE SERVICES FOR MEDICAL AND SURGICAL PATIENTS SPECIALIZING IN ORTHOPEDICS, NEUROSURGERY, CARDIOVASCULAR SERVICES, ONCOLOGY, DISEASE MANAGEMENT, GASTROENTEROLOGY, MATERNAL-CHILD HEALTH AND NEUROLOGY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	4
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	4
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	2,881
6	Total number of volunteers (estimate if necessary) .............	6	291
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	5,693,462
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-139,289

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,156,980	1,556,054
9	Program service revenue (Part VIII, line 2g) .........	413,731,469	432,873,658
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	12,042,431	22,928,646
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	5,984,179	4,944,148
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	433,915,059	462,302,506
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	193,485,799	198,852,791
16a	Professional fundraising fees (Part IX, column (A), line 11e).....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	202,717,766	212,833,699
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	396,203,565	411,686,490
19	Revenue less expenses. Subtract line 18 from line 12.......	37,711,494	50,616,016
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	812,990,482	854,600,945
21	Total liabilities (Part X, line 26).............	289,762,031	290,254,724
22	Net assets or fund balances. Subtract line 21 from line 20.....	523,228,451	564,346,221

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 411,686,490 including grants of $ ) (Revenue $ 449,120,317 )
	SINCE ITS FOUNDING IN 1875, SAINT FRANCIS MEDICAL CENTER'S (SFMC) MISSION HAS BEEN TO PROVIDE HEALTH CARE SERVICES TO EVERYONE, REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF SFMC, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. IN FULFILLING OUR MISSION TO SERVE RESIDENTS OF CAPE GIRARDEAU AND THE SURROUNDING REGION, SFMC PROVIDES: -FREE AND/OR SUBSIDIZED CARE WHEN NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THIS PAST YEAR, SFMC PROVIDED OVER 63.0 MILLION IN FREE AND/OR SUBSIDIZED CARE. -CARE FOR PERSONS COVERED BY GOVERNMENTAL PROGRAMS THAT REIMBURSE BELOW ACTUAL COST. -HEALTH SCREENINGS AND EDUCATIONAL PROGRAMS TO SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITY. SFMC PROVIDES A VARIETY OF WELLNESS PROGRAMS, COMMUNITY HEALTH EDUCATION ACTIVITIES, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER-SERVED AND PARTICIPATES IN A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. SFMC SERVED 11,374 INPATIENTS, 34,770 EMERGENCY PATIENTS AND 156,042 OUTPATIENTS DURING THE FISCAL YEAR (FY) ENDING JUNE 30, 2015. DURING FY 2015, SFMC HAD A TOTAL OF 57,800 PATIENT DAYS IN ITS MEDICAL/SURGICAL, CRITICAL CARE, OBSTETRIC, AND REHABILITATION CARE UNITS. SFMC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, FOR WHICH IT IS REIMBURSED BELOW COST. RECOGNIZING ITS MISSION IN THE COMMUNITY, SFMC PROVIDES SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS IN EXCESS OF 80.0 MILLION IN FY 2015. CHARITY CARE IS PROVIDED IN THE FORM OF MANY REDUCED-PRICE AND FREE SERVICES OFFERED THROUGHOUT THE YEAR. SFMC STRONGLY BELIEVES THESE PROGRAMS AND SERVICES FILL A REAL NEED IN THE COMMUNITY. THESE PROGRAMS AND SERVICES INCLUDE THE FOLLOWING: -PARTICIPATION IN AND/OR SPONSORSHIP OF MANY COMMUNITY HEALTH FAIRS. THESE EVENTS RANGE FROM CHILDREN'S SPECIAL EVENTS TO SENIOR HEALTH FAIRS. TOTAL ATTENDANCE AT THESE ACTIVITIES EXCEEDED 8,300 DURING FY 2015. -SFMC SPONSORS THE REGIONAL ARTHRITIS CENTER, OFFERING INFORMATION AND ASSISTANCE TO PEOPLE THROUGHOUT SOUTHEAST MISSOURI. -FREE OR DISCOUNTED HEALTH SCREENINGS (CHOLESTEROL, BLOOD PRESSURE, GLAUCOMA, BLOOD SUGAR, ETC.) PROVIDED AT HEALTH FAIRS AND COMMUNITY HEALTH EDUCATION PROGRAMS, AS WELL AS OUR WEEKLY WEDNESDAY MORNING HEART HEALTH SCREENINGS. -COMMUNITY HEALTH FORUMS WERE OFFERED ON TOPICS SUCH AS ARTHRITIS, DIABETES, CARDIOVASCULAR FITNESS, CHILDREN'S HEALTH AND SAFETY, NUTRITION, BREAST CANCER AND OSTEOPOROSIS. OTHER WELLNESS PROGRAMS SUCH AS WEIGHT MANAGEMENT ARE SUBSIDIZED BY SFMC AND OFFERED FOR A NOMINAL FEE. -CHILDBIRTH, SIBLINGS, BREASTFEEDING AND INFANT CARE CLASSES ARE PROVIDED FREE OF CHARGE TO EXPECTANT MOTHERS AND YOUNG FAMILIES. -SFMC SPONSORS HEALTHCARE SPEAKERS FOR COMMUNITY EVENTS AND CIVIC MEETINGS. SFMC STAFF PRESENTS FREE PROGRAMS ON A VARIETY OF HEALTH AND WELLNESS TOPICS TO VARIOUS COMMUNITY, SCHOOL AND CHURCH GROUPS THROUGHOUT THE YEAR. -SEVERAL SFMC OUTPATIENT CLINICS ARE OFFERED AT REDUCED FEE OR NO COST TO PATIENTS AND THEIR FAMILIES. THE CLINICS ADDRESS DIABETIC FOOT CARE, GENETICS, ORTHOPEDICS AND SPORTS INJURIES. -SFMC PROVIDES FREE FIRST AID SERVICES AT THE WEEKLONG SEMO DISTRICT FAIR IN CAPE GIRARDEAU. MEDICAL CENTER PERSONNEL STAFF THE FIRST AID STATION AND PROVIDE MINOR MEDICAL SERVICES TO HUNDREDS OF PEOPLE DURING THE COURSE OF THE WEEK. SFMC ALSO PROVIDES STAFF AND FIRST AID MATERIALS FOR OTHER CIVIC FUNCTIONS DURING THE FISCAL YEAR. -SFMC PROVIDES FREE MEETING ROOM SPACE AND RELATED ASSISTANCE TO MANY HEALTHCARE SUPPORT GROUPS. SEVERAL HUNDRED PEOPLE REGULARLY PARTICIPATE IN THESE SUPPORT GROUPS FOR DISEASES AND DISORDERS INCLUDING BREAST CANCER, MUSCULAR DYSTROPHY, SLEEP DISTURBANCE, ALS, HEART SURGERY, DIGESTIVE DISEASES, ARTHRITIS, MULTIPLE SCLEROSIS AND STROKES. -SFMC PROVIDES FINANCIAL AND IN-KIND SUPPORT FOR ACTIVITIES OF LOCAL CHARITIES SUCH AS THE AMERICAN DIABETES ASSOCIATION, THE AMERICAN ARTHRITIS ASSOCIATION, THE MARCH OF DIMES, THE AMERICAN HEART ASSOCIATION, THE AMERICAN LUNG ASSOCIATION AND CATHOLIC CHARITIES. -SCHOLARSHIPS AND TUITION REIMBURSEMENT ARE AWARDED ANNUALLY BY SFMC TO UNDERGRADUATE AND GRADUATE STUDENTS ENROLLED IN VARIOUS HEALTHCARE CURRICULUMS. THE VALUE OF THIS INVESTMENT IN THE ADVANCEMENT OF EXISTING CARE PROVIDERS AND THE EDUCATION OF FUTURE CARE PROVIDERS WAS 272,002 IN FY 2015. -SFMC SPONSORS MEDICAL MINUTE. THESE WEEKLY EDUCATIONAL PROGRAMS, PRODUCED IN COOPERATION WITH MEMBERS OF THE MEDICAL COMMUNITY, PROVIDES INFORMATION ON NEW TECHNOLOGY AND PROCEDURES, TREATMENT FOR DISEASES AND DISORDERS, AND GENERAL MEDICAL EDUCATION TO AREA PATIENTS. -SFMC PROVIDES FREE INTERNET LIBRARY SEARCHES ON HEALTHCARE TOPICS TO AREA RESIDENTS WHO DO NOT HAVE OTHER ACCESS. -SFMC PROVIDES EMERGENCY CARE, CLOTHING AND PHARMACEUTICALS TO CHILDREN AND ADULTS IN NEED THROUGH THE SAINT FRANCIS FOUNDATION SISTER ESTHER FUND, PARENTS WITH HOPE FUND AND CANCER CARE FUND. -DURING FY 2015 SFMC VOLUNTEERS CONTRIBUTED APPROXIMATELY 42,363 HOURS OF SERVICE TO OUR PATIENTS, THEIR FAMILIES AND THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS ESTIMATED AT OVER 324,000 AND IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN PATIENT CARE SERVICES AND WELLNESS PROGRAMS SUCH AS THOSE DESCRIBED ELSEWHERE IN THIS DOCUMENT. -DURING FY 2015 SFMC PROVIDED 364 FREE MAMMOGRAMS AND ULTRASOUNDS TO AREA WOMEN WHO COULD NOT AFFORD THIS POTENTIALLY LIFESAVING SCREENING. THE VALUE OF THIS CONTRIBUTION IS ESTIMATED AT MORE THAN 42,108.

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 expenses411,686,490

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	10,243,812	384,406

				(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		175,148
d	Related organizations...1d		1,371,589
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		9,317

g	Noncash contributions included in lines 1a-1f:$		50,043
h	Total. Add lines 1a-1f.......			1,556,054
			Business Code
2a	PATIENT SERVICE REVENUE			423,847,357	423,847,357
b	PHARMACY		446110	5,154,090		5,154,090
c	FITNESS CENTER			2,042,156	2,042,156
d	WELLNESS PROGRAMS			923,605	923,605
e	LAB FEES		621500	360,291		360,291
f	All other program service revenue .			546,159	367,078	179,081
g	Total. Add lines 2a–2f........			432,873,658
3	Investment income (including dividends, interest, and other similar amounts).......			3,063,755	2,075,230		988,525
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	645,350
b	Less: rental expenses
c	Rental income or (loss)	645,350
d	Net rental income or (loss).......			645,350			645,350
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	102,061,730	24,126
b	Less: cost or other basis and sales expenses	81,909,936	311,029
c	Gain or (loss)	20,151,794	-286,903
d	Net gain or (loss)..........			19,864,891	19,864,891
8a	Gross income from fundraising events (not including $ 175,148 of contributions reported on line 1c). See Part IV, line 18 ..
	a		38,500
b	Less: direct expenses ...b		37,721
c	Net income or (loss) from fundraising events..			779
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	ELECTRONIC HEALTH RECORDS			2,768,702			2,768,702
b	CAFETERIA SALES			1,443,667			1,443,667
c	MISCELLANEOUS			76,049			76,049
d	All other revenue ....			9,601			9,601
e	Total. Add lines 11a–11d ......			4,298,019
12	Total revenue. See Instructions......			462,302,506	449,120,317	5,693,462	5,931,894


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			70,663,829	1	90,185,958
2	Savings and temporary cash investments .........			18,345,988	2	5,590,311
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			62,074,548	4	61,048,824
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				479,789	5	491,623
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			10,611,836	8	11,015,861
9	Prepaid expenses and deferred charges ..........			9,403,091	9	10,091,826
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	526,770,156
b	Less: accumulated depreciation .....	10b	220,897,091	264,155,368	10c	305,873,065
11	Investments—publicly traded securities ..........			371,893,765	11	364,673,334
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 .....				13
14	Intangible assets ...............			3,149,168	14	3,774,854
15	Other assets. See Part IV, line 11 ...........			2,213,100	15	1,855,289
16	Total assets. Add lines 1 through 15 (must equal line 34)......			812,990,482	16	854,600,945
17	Accounts payable and accrued expenses .........			86,796,553	17	92,018,217
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			202,965,478	20	198,236,507
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................				25
26	Total liabilities. Add lines 17 through 25.........			289,762,031	26	290,254,724
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			523,228,451	27	564,346,221
28	Temporarily restricted net assets ...........				28
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			523,228,451	33	564,346,221
34	Total liabilities and net assets/fund balances ........			812,990,482	34	854,600,945