TY 2015 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)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Sr Ann Leitao DC...................................................................... Board Chair through 12/2015	1.0 ................. 0.0	X	X		0	0	0
(2) Sr Marion Bill DC...................................................................... Board Member through 12/2015	1.0 ................. 7.0	X			0	0	0
(3) Sr Fran Ciluaga DC...................................................................... Secretary through 12/2015	1.0 ................. 1.0	X	X		0	0	0
(4) Sr Judith Schomisch DC...................................................................... Board Member through 12/2015	1.0 ................. 0.0	X			0	0	0
(5) Sr Arthur Gordon DC...................................................................... Board Member through 12/2015	1.0 ................. 0.0	X			0	0	0
(6) Robert Issai...................................................................... Board Member through 12/2015	1.0 ................. 46.0	X			0	3,832,601	282,571
(7) George Green MD...................................................................... Board Member through 12/2015	1.0 ................. 1.0	X			152,720	0	0
(8) Mitch Creem...................................................................... Board Member start 12/2015	1.0 ................. 45.0	X			0	0	0
(9) Mark Ahn MD...................................................................... Secretary	1.0 ................. 0.0	X			0	0	0
(10) Scott Benninghoven MD...................................................................... Board Member	1.0 ................. 0.0	X			17,300	0	0
(11) George Chiala...................................................................... Board Member	1.0 ................. 1.0	X			0	0	0
(12) Allen Hayes...................................................................... Vice Chair	1.0 ................. 0.0	X	X		0	0	0
(13) Sr Margaret Keaveney DC...................................................................... Int Pres & CEO through 12/2015	20.0 ................. 22.0		X		0	0	0
(14) Robert Minkin...................................................................... President & CEO start 12/2015	20.0 ................. 22.0		X		0	131,910	5,815
(15) Sandra Martin...................................................................... Interim VP/CFO through 03/2016	20.0 ................. 22.0		X		0	62,433	747
(16) Eric Hardy...................................................................... VP/CFO start 03/2016	20.0 ................. 22.0		X		0	0	0
(17) Carol Furgurson...................................................................... CAO through 02/2016	40.0 ................. 0.0			X	533,773	0	64,156

(A) Name and business address	(B) Description of services	(C) Compensation
Elite Anesthesia Medical Group Inc, 18535 Serra Avenida Dr MORGAN HILL,CA95037	Medical Services	874,117
California Emergency Physicians, 1601 Cummins Dr MODESTO,CA95358	Medical Services	508,311
Fritter Schulz, 9460 No Name Uno GILROY,CA95020	Medical Services	380,138
Learn Speech Pathology, 662 Hazel Dell Rd CARRALITOS,CA95076	Medical Services	371,148
Fastaff LLC, PO Box 911452 DENVER,CO80291	Registry Nursing	325,686
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 20

- 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.
right arrow

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

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Saint Louise Regional Hospital

Employer identification number

91-2154437

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 (Form 990 or 990-EZ))

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 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. 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—2014. 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—2015. 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—2014. 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) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. 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—2014. 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) 2015

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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

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

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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2015

Page 6

Part V

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

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

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) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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 2015 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-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

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) 2015

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

2015

Name of the organization

Saint Louise Regional Hospital

Employer identification number

91-2154437

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 other 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization Saint Louise Regional Hospital

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization Saint Louise Regional Hospital		Employer identification number 91-2154437

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization Saint Louise Regional Hospital			Employer identification number 91-2154437
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.) $ 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) (2015)

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," on 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

2015

Open to Public Inspection

Name of the organization

Saint Louise Regional Hospital

Employer identification number

91-2154437

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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 on 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 on 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) 2015

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(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 on 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" on 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' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	4,616,600		4,616,600
b	Buildings	14,630,090	9,907,118	4,722,972
c	Leasehold improvements	0	0	0
d	Equipment ...	30,989,808	28,885,556	2,104,252
e	Other ...	767,092	112,112	654,980
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				12,098,804

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1) DUE FROM RELATED ORGANIZATIONS				5,854,575
(2) DUE FROM GOVERNMENT AGENCIES				218,795
(3) OTHER RECEIVABLES				2,372,255
(4) DEPOSITS				17,181
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				8,462,806

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
DUE TO RELATED ORGANIZATIONS	83,071,969
PENSION OBLIGATIONS	6,959,254
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	90,031,223
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) 2015

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference	Explanation
Schedule D, Part X, Line 2:	Verity Health System of California, Inc. and its affiliates do not have a liability for uncertain tax positions under FIN 48 (ASC 740) on their consolidated financial statements for the year ended June 30, 2016. As such, there was no FIN 48 (ASC 740) disclosure in the footnotes to the consolidated financial statements of Verity Health System of California, Inc.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on 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

2015

Open to Public Inspection

Name of the organization

Saint Louise Regional Hospital

Employer identification number

91-2154437

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the 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		(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	295	621,796	0	621,796	0.630 %
b	Medicaid (from Worksheet 3, column a) . . . . .	18,469	33,414,154	20,331,944	13,082,210	13.160 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	18,764	34,035,950	20,331,944	13,704,006	13.790 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	3,851	259,376	15,500	243,876	0.250 %
f	Health professions education (from Worksheet 5) . . .	12	183,057	0	183,057	0.180 %
g	Subsidized health services (from Worksheet 6) . . . .	0	3,736	0	3,736	0.010 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	286	23,271	0	23,271	0.020 %
j	Total. Other Benefits . .	4,149	469,440	15,500	453,940	0.460 %
k	Total. Add lines 7d and 7j .	22,913	34,505,390	20,347,444	14,157,946	14.250 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

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

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other	248,326	0	248,326	0.250 %
10	Total	248,326	0	248,326	0.250 %

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. ......

2,088,267

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

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

Section B. Medicare

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

23,324,982

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

36,183,458

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

-12,858,476

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) 2015

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 Louise Regional Hospital 9400 No Name Uno Gilroy,CA95020 https://stlouise.verity.org/ 070000266	X	X	X

Schedule H (Form 990) 2015

Page 4

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 Louise Regional Hospital
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 15

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

6 a

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

Yes

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

Yes

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

Hospital facility’s website (list url): See Part V, Section C

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 16

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

Yes

If "Yes" (list url): See Part V, Section C

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

12b

If "Yes" on 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) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Saint Louise Regional Hospital
Name of hospital facility or letter of facility reporting group

Yes

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 200.% and FPG family income limit for eligibility for discounted care of 350.%

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

Yes

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):

See Part V, Section C

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

See Part V, Section C

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Section C

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) 2015

Page 6

Part VFacility Information (continued)

	Saint Louise Regional Hospital
Name of hospital facility or letter of facility reporting group

Yes

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

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 19. (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) 2015

Page 7

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
Part V, Section B, Lines 2, 3j, 7d, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c	21d, 22d, 23, and 24: N/A
Part V, Section B, Line 5:	See disclosure for Part VI, Question 2: Needs Assessment
Part V, Section B, Line 6a:	Saint Louise Regional Hospital's ("SLRH") Community Health Needs Assessment ("CHNA") was conducted in conjunction with the Santa Clara County Community Benefit Coalition, which includes seven nonprofit hospitals. The hospitals included in the Coalition are: Saint Louise Regional Hospital, El Camino Hospital, Kaiser Permanente South Bay (Santa Clara and San Jose Kaiser Foundation Hospitals), Lucile Packard Childrens Hospital at Stanford, OConnor Hospital, Stanford Health Care, and Sutter Health.
Part V, Section B, Line 6b:	The non-hospital organizations included in the Santa Clara County Community Benefit Coalition, which SLRH worked in conjunction with to complete its CHNA, include the Hospital Council of Northern & Southern California (a nonprofit multi-specialty medical group) and the Santa Clara County Public Health Department.
Part V, Section B, Line 7a:	The CHNA report is posted on SLRHs website at: https://stlouise.verity.org/about-us/community-benefit/
Part V, Section B, Line 10a:	SLRHs most recently adopted implementation strategy is posted on its website at: https://stlouise.verity.org/about-us/community-benefit/
Part V, Section B, Line 11:	The SLRH 2016 Community Benefit Advisory Committee (CBAC) met on April 27, 2016 and reviewed countywide health needs identified by the Santa Clara County Community Benefit Coalition CHNA. The CBAC is comprised of hospital representatives, including seven clinical directors, two non-clinical directors, and the Chief Nursing Executive. Following the collaborative review of the county-wide health needs, this group identified health needs to be prioritized for the community directly served by SLRH. The criteria used were: (i) the severity of the need, (ii) the magnitude/scale of the need, (iii) clear disparities or inequities, and (iv) the multiplier effect. The CBAC discussed all of the 17 county-wide health needs identified in the CHNA and determined through discussion and group consensus the five that were a priority to the SLRH community. Each member ranked their top seven, followed by each individual presenting their prioritization and their reasoning. This led to an engaging discussion. Some members of the group then re-prioritized their lists. The final lists were reviewed and the health needs ranked according to the votes they received. The following top five health needs, in order of priority, were deemed applicable to the community served by SLRH: 1. Obesity and Diabetes 2. Behavioral Health 3. Access to Healthcare 4. Violence & Abuse 5. Birth Outcomes Below are the actions SLRH plans to take to address the prioritized health needs for FY2017-FY2019. Some of these actions are a continuation of current programs and some are planned as new activities. Obesity and Diabetes is a health need as marked by relatively high rates of diabetes among adults in Santa Clara County. County-wide, diabetes prevalence is at 8% (no better than the state average), but for the countys Latino population (a population heavily served by SLRH) diabetes prevalence is 11%. A major driver of diabetes rate is obesity, directly linked to poor nutrition and lack of exercise, and physical environment such as availability of fresh food versus convenient, fast food. Obesity is a health need as indicated by high rates of obese youth (24%-31%) and adults (21%) in Santa Clara County, and high rates of overweight individuals as well (14% in youth and 36% in adults). SLRH has a goal of increasing the awareness of the dangers of diabetes and the direct link between diabetes and obesity. In doing so, SLRH plans to provide educational activities to targeted populations in different languages. By presenting information in a native language, SLRH hopes to reach a larger number of community members and enable them to make healthier choices when it comes to food and exercises. It is anticipated that education will improve the prevalence of diabetes and obesity over time. Education resources include: The Health Benefits Resource Center, which provides CalFresh and Brown Bag Program enrollment assistance; a monthly diabetes support group (to be reinstated); educational information and glucose screenings at health fairs provided throughout the year; and the reinstatement of the "Talking Health" program which will offer educational classes on a variety of topics, including weight management and diabetes. Behavioral Health is prioritized as a health need and includes mental health (including depression and anxiety) and substance abuse. Community input indicates high concern about stress and depression specifically and the rising rates of marijuana and binge drinking among youth. Primarily through our emergency department, SLRH encounters community members with behavioral health issues. SLRH has a goal of enhancing staff awareness of resources available to community members, as well as to increase collaboration with outside agencies. While overall, SLRH does not have the resources or expertise to address behavioral health issues, through referral services, SLRH can continue to assist with this health need. Such examples include participation in the New Directions Program and the sponsorship of the Medical Respite Program (programs which provide homeless clients with assistance in accessing substance abuse programs), both coordinated through the Hospital Council of Northern & Central California. Additionally, if there is an indication of a patient-need relating to mental health or substance abuse problems, the staff social worker will conduct an evaluation and work collaboratively with the case management team to determine appropriate referrals. Access to Healthcare services is a health need in Santa Clara County because socioeconomic conditions (poverty, low levels of education, lack of quality health insurance) as well as factors including language and transportation barriers all impact access to care, which negatively impacts health. With a goal of continuing to provide healthcare and the ability to access said healthcare through assistance with insurance, transportation, prescriptions, and health education, SLRH will continue to meet the communitys health care needs by providing charity care and caring for those with public insurance. In addition, health education programs offered by SLRH will expand to cover new topics and will be presented in languages other than English. SLRH will also continue to support programs that provide health professionals education opportunities to improve in overall health and well-being. It is also anticipated that through these actions, individuals will have increased access to health care services. Such programs include: coordinating transportation with OUTREACH for those community members who do not have transportation to SLRH; participation in the Hospital Council of Northern & Central Californias New Directions Programs which provides case management for the chronically homeless; regularly paying for taxi fares to patients without transportation; paying for prescriptions when patients are unable to do so; continuing to be a clinical teaching setting for nursing students, radiological technicians and clinical lab specialist; and continuing to offer pregnancy and parenting classes. Violence and Abuse is a rising health need. In addition to other indicators, the rate of youth homicide in Santa Clara County is higher than the Healthy People target and the county has seen an increase in homicides in recent years. Domestic violence and child abuse rates also miss the benchmark for some ethnic subgroups. Drivers of this health need include mental health and social determinants of health such as poverty and unemployment. SLRH has a goal of enhancing staff awareness of resources available to community members and increasing collaboration with outside agencies. While overall, SLRH does not have the resources or expertise to address issues of Violence and Abuse, through referral services, SLRH can continue to assist with this health need. An example of such includes participation in the aforementioned New Directions Program. Additionally, if there is an indication of a patient-need relating to mental health or substance abuse problems, the staff social worker will conduct an evaluation and work collaboratively with the case management team to determine appropriate referrals. Lastly, during the next three years, SLRH will increase collaborative efforts with other social services at local health fairs and other educational events. Birth Outcomes is a health need in Santa Clara County as marked by the percentage of low birth weight babies, which is no better than the state average, though below Health People 2020 targets. Ironically, in the community served by SLRH, high birth weights is also a concern. While low birth weight often accompany premature births, high birth weights are typically associated with health concerns for the pregnant woman, such as diabetes. With a goal of increasing the number of healthy birth weights while decreasing health issues for pregnant women and newborns, SLRH provides or undertakes the following: free childbirth preparation classes, which cover prenatal health, delivery and infant care; free pre- and post-natal yoga classes; distribution of educational information associated with the Maternal Child Health Services department of SLRH at multiple health fairs throughout the year; individualized lactation support; and a breast-feeding support group. In addition, SLRH is in the process of becoming Baby Friendly certified. While acknowledging the importance of all of the community needs identified through the CHNA, the limited resources and availability of expertise to the hospital result in the need to select the top needs to focus attention. The following needs are not specifically addressed by SLRH in its implementation plan, however, several needs are addressed through lesser methods. Alzheimer's Disease and Dementia is a health need because of the increasing proportion of Santa Clara County residents living with Alzheimers disease, and because it is one of the top ten leading causes of death in the county. This need
Part V, Section B, Lines 16a, 16b, and 16c:	The FAP, FAP application form, and the plain language summary of the FAP is widely available on the organizations website at https://stlouise.verity.org/patients-and-visitors/financial-assistance/. These documents were not on the website at the start of the June 30, 2017 tax year (the tax year starting in 2016, when the IRC Section 501r regulations came into effect), but has since been corrected at the time of the filing of this return.

Schedule H (Form 990) 2015

Page 8

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?1
Name and address		Type of Facility (describe)
1	De Paul Urgent Care Center 18550 De Paul Drive Suite 109 Morgan Hill,CA95037	Urgent Care Center
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2015

Page 9

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:	N/A
Part I, Line 6a:	Saint Louise Regional Hospital ("SLRH") prepares an annual Community Benefit Report. It is developed in conjunction with SLRHs strategic planning process that is based on the Community Health Needs Assessment, organizational capacity, and resource allocation. Reports on community benefit activities and outcomes are provided by managers and directors responsible for specific community benefit programs. Quarterly reports are presented to the SLRH Board of Directors and Verity Health System of California, Inc. ("VHS") corporate officers. An annual update is prepared and presented to the SLRH Board of Directors for approval. The annual update is made available to medical center leadership, key stakeholders, VHS, and the community. The annual update is presented to the California Office of Statewide Planning and Development, in accordance with SB697. SLRHs Community Benefit Report is developed using results from the Community Health Needs Assessment, data and input provided by the managers and directors responsible for specific community benefit programs, and feedback from the Community Benefits Committee. SLRHs Board of Directors reviews and gives final approval of SLRH's Community Benefit Report. Continual monitoring and evaluation of existing Healthy Community Initiatives provide vital information to the strategic planning process for community benefit programs.
Part I, Line 7, Column (f): Bad Debt Expense	Form 990, Part IX, line 25, Column A for SLRH reflects a bad debt expense of $2,088,267 which is not included in the line 7 calculation.
Part I, Line 7g:	N/A
Part I, Line 7:	SLRH utilizes a cost accounting system that determines costs for providing medical services based on the organizations relationship of costs to charges.
Part II:	Refer to Part VI questions 4 and 5.
Part III, Line 2:	Bad debt expense is estimated by utilizing historical collections data of self-pay patients. Management also considers business and general economic conditions in its service area.
Part III, Line 3:	N/A
Part III, Line 4:	SLRH is included in the VHS Consolidated Audited Financial Statements. The financial statements for the 6/30/2016 fiscal year do not contain a separate footnote on bad debts.
Part III, Line 8:	As a not-for-profit hospital, it is SLRH's mission to improve the health status of all people within its community and provide healthcare to all patients regardless of their ability to pay or their insurance status. SLRH accepts Medicare which results in shortfalls in the costs for caring for patients utilizing this program. SLRH utilizes a cost accounting system that determines costs for providing medical services based on the organizations relationship of costs to charges. The entire shortfall shown on Part III, Line 7 should be reflected as a community benefit.
Part III, Line 9b:	SLRH follows the Collection Practices as outlined in VHS Charity Care and Financial Discount and Financial Assistance operating policies. For patients who qualify for charity care and financial discount, SLRH provides the patient with a written notice prior to commencing collection activities. The notice states that nonprofit counseling services may be available in the area and provides information concerning state and federal law requirements for debt collectors. SLRH does not pursue legal action for non-payment of bills against any household where the primary wage earner(s) is unemployed or there are not significant income sources. SLRH does not assign patients meeting an agreed upon monthly payment plan to a collection agency and does not report the patient to credit bureaus. SLRH does not report adverse information to a consumer credit agency or commence civil action for nonpayment of a patient debt prior to 150 days after the initial billing of the patient. SLRH does not use wage garnishments or liens on real property as a means of collecting unpaid hospital bills for eligible patients. SLRH expects its external collection agencies to not pursue legal action against an eligible patient without prior approval from SLRH. SLRH expects its external collection agencies to follow Fair Debt and Collection Practices, Assembly Bill AB774, and act in a manner that treats individuals with dignity, respect and compassion. In addition, for patients who qualify for financial assistance, SLRH does not pursue legal action for non-payment of bills against any household where the primary wage earner(s) is unemployed, uninsured or there are not significant income sources or assets. SLRH does not assign eligible patients meeting an agreed upon monthly payment plan to a collection agency and does not report the patient to credit bureaus. SLRH does not use liens on real property as a means of collecting unpaid hospital bills for eligible patients.
Part VI, Question 2:	The Santa Clara County Community Benefit Coalition ("the Coalition") began the 2016 CHNA planning process in the fall of 2014. The Coalitions goal for the CHNA was to collectively gather community feedback and existing data about health status to inform the member hospitals respective needs prioritization and selection. The Coalition contracted with Applied Survey Research ("ASR"), which prepared the CHNA on behalf of the Coalition. ASR obtained community input during the winter and spring of 2015 via key informant interviews with local health experts, focus groups with community leaders and representatives, and resident focus groups. This primary qualitative data included input from various populations including: low-income, minority, the medically underserved, linguistically isolated populations, youth, older adults, and undocumented immigrants. ASR conducted three out of five resident focus groups in languages other than English and intentionally recruited people with low incomes for resident focus groups. ASR also solicited input from almost 100 community leaders, invited an additional 65 community leaders with expertise in serving the community to participate in an online survey, conducted primary research via key informant interviews with five Santa Clara County experts from various organizations within the health sector, and conducted community leader focus groups in which 68 professionals participated. ASR recorded and summarized each group and interview as a stand-alone piece of data. When all data had been collected, the team used qualitative research software tools to analyze the information. ASR then tabulated how many times health needs had been prioritized by each of the focus groups or described as a priority in a key informant interview. The Coalition used this tabulation to help assess community health priorities. In addition, ASR collected quantitative and qualitative secondary data from multiple Santa Clara County Public Health Department sources, including: 2014 Santa Clara County Community Health Assessment; Behavioral Risk Factors Survey (BRFS) Quick Facts 2014; Status of Africa/African Ancestry Health: Santa Clara County, 2014; Status of LGBTQ Health: Santa Clara County, 2013; Status of Vietnamese Health: Santa Clara County, 2011; and HIV/AIDS Epidemic in Santa Clara County, 2012. In September 2015, ASR identified health needs by synthesizing primary qualitative research and secondary data, and then filtering those needs against the following criteria: (i) The issue must fit the definition of a "health need (ii) The issue is suggested or confirmed by more than one source of secondary and/or primary data; (iii) The issue meets either qualitative or quantitative data criteria (meaning at least one related indicator performs poorly against the Healthy People 2020 benchmark or state average, and, the community prioritized it in three of eleven focus groups, or it was mentioned by a key informant). Based on community input and secondary data, the Coalition generated list of health needs that reflected the communitys priorities. The Coalition generated a list of 17 health needs, as follows: 1. Obesity and Diabetes 2. Behavioral Health 3. Access to Healthcare and Healthcare Delivery 4. Violence 5. Birth Outcomes 6. Alzheimers Disease and Dementia 7. Cancer 8. Cerebrovascular Diseases 9. Communicable Diseases 10. Economic Security 11. Housing 12. Learning Disabilities 13. Oral and Dental Health 14. Respiratory Conditions 15. Sexual Health 16. Tobacco Use 17. Unintentional Injuries For further details, including statistical data and citations, please consult the full health needs descriptions in Section 6 of the CHNA report found in the full Health Needs Assessment. Please refer to Schedule H, Part V for a description on how SLRH is addressing to the five health needs it has identified as a priority.
Part VI, Question 3:	Patients who present at SLRHs Emergency Department and SLRHs Admitting Department are provided with a financial assistance packet that consists of an informational flyer on various programs for which they may be eligible, along with the contact number for SLRHs Health Benefits Resource Center (HBRC). The flyer is in English and Spanish. The packet includes a Medi-Cal application, as well as a Charity Care application. Should they make an appointment with HBRC, patients can fill out the forms prior to their appointment. HBRC staff visits Cash/Self-Pay patients at bedside, screens patients and identifies the programs for which they are eligible. If they have no linkage, HBRC provides information about other programs for which they may qualify such as Charity Care. In addition, there are signs posted in English and Spanish in the Patient Financial Services department and at every point of registration stating that SLRH has financial assistance and charitable programs available for qualified low income, uninsured patients who may not have the ability to meet the financial obligation of their hospital services and a contact number to call. After discharge, the back of the monthly patient bills includes this same statement.
Part VI, Question 4:	Santa Clara County is located in the San Francisco Bay Area. The 2014 estimated population was 1.89 million people, making it the sixth largest county in California by population. Twelve percent (12%) of the population is linguistically isolated in the county overall, with wide differences seen across cities. Nearly one quarter (23%) of the population in Santa Clara County is under the age of 18, while 11% is 65 years or older, leaving two thirds of adults between 18 65 years of age. Santa Clara is also very diverse. Notably, those of "some other race" are the third largest racial group behind White and Asian, comprising 10% of the population. Nearly 5% of the population is of two or more races. About half of the population is White alone. Over a third (37%) of Santa Clara county residents are foreign-born. Two key social determinants, income and education, have a significant impact on health outcomes. Santa Clara County has one of the highest annual median incomes in the country and one of the highest costs of living. The median household income is $91,201, which is far higher than California ($59,645) and higher than neighboring San Mateo County ($86,245). Despite the fact that half of households in the county earn more than $100,000 per year, one in five (20%) county residents live below 200% of the federal poverty level, with a disproportionate amount found within SLRHs service area. In addition more than 25% of the population aged 25+ do not have a high school diploma in the towns of Morgan Hill and Gilroy, which are within SLRHs service area. SLRH is the largest hospital serving South Santa Clara and San Benito Counties, with only one other hospital in its service area. SLRH also provides the only emergency services within 30 miles. The percentage of uninsured adults in Santa Clara County was 12% in 2014.
Part VI, Question 5:	SLRH, a California nonprofit corporation, is a 93 bed acute-care hospital in Gilroy, CA. SLRH is the largest hospital serving the growing communities of southern Santa Clara County and northern San Benito County, with only one other small hospital in our service area. Currently we also operate an Urgent Care Center on our Morgan Hill campus: De Paul Health Center. We believe our not-for-profit hospital plays a vital role in continuing to emphasize high quality, compassionate service to the underserved in this changing, challenging environment. The majority of the organizations Board of Directors at year-end represent those who currently reside in the SLRHs primary service area; all but 2 of those individuals are not compensated as independent contractors or employees of the organization. In addition, the organization utilizes any surplus funds to assist with Care; in fiscal year 2016, SLRH provided services for 503 cases at a net cost of $622,000. In addition, SLRH provided services to more than 18,000 Medi-Cal cases at a net cost of approximately $13 million. SLRH also provides health screenings to the community at a variety of businesses and health fairs and hosts support groups for individuals suffering with bereavement, tremors, dystonia, and weight loss. Since August of 2015, the hospital has offered prenatal health and education classes to the community, free of charge. This includes childbirth preparation classes and pre- and post-natal yoga classes. SLRH has also partnered with local organizations and agencies to promote the health of the community, as follows: The South County Collaborative is a community partnership sharing strengths and resources. Over 50 agencies are represented including schools, healthcare, businesses, and community members. The Collaborative meets monthly and annually sets goals to improve the quality of life in South County. The Director of Community Health serves as a member of the Board of Directors as well as the co-chair of the Nutrition and Health Sub-Committee. The Nutrition and Health Sub-Committee meets monthly to collaborate on ways to improve health and nutrition in South County. Some of the activities of this committee included: planning and sponsoring of a workshop related to the effects of poverty on health in the Latino community during Binational Health Week annually; advocacy for prevention activities related to obesity and chronic health conditions; increased utilization of the Food Stamp program by providing food assistance training; supported the implementation of a breastfeeding project; and the CUP grant to promote drug/alcohol free communities. Gilroy Community Health Day is a collaborative effort of several local agencies serving the underserved. SLRH was actively involved with the planning and sponsorship of this event. The health screening results assisted us in setting priorities. The Gilroy Unified School District Health Council is a collaborative group that meets regularly to address the implementation of the Wellness Policy in each school. Participation on this council provided input into the many obstacles to healthy eating which are present in the schools and therefore in the community at large. The Council continues to work with parents to provide 100% compliance with this policy. In addition, members of Senior Management and SLRH associates served in a variety of roles on the various Chambers, Rotary and other community organizations.
Part VI, Question 6:	Prior to December 14, 2015, SLRH was a part of Daughters of Charity Health System ("DCHS") a regional health care system of hospitals and medical centers spanning the California coast from the San Francsico Bay Area to Los Angeles, formed and operated as religious corporations. In July 2015, DCHS selected BlueMountain Capital Management LLC, a private investment firm, to recapitalize its operations and transition leadership of the hospital system to the new Verity Health System. The transaction was approved by the California Attorney General on December 14, 2015, whereby DCHS amended its name to Verity Health System of Claifornia, Inc. ("VHS") and VHS and all of its nonprofit corporate affiliates (including SLRH) changed status from religious corporations to public benefit corporations under the California Nonprofit Corporation Law. As a non-profit, non-religious health care system, VHS seeks to build on the rich legacy left by the Daughters of Charity Health System. SLRH is a 93-bed acute care hospital in Gilroy, CA which serves South Santa Clara and San Benito Counties. SLRH provides the only emergency services within 30 miles, is a Certified Stroke Center and has diagnostic services, ICU, and general medical surgical services including obstetrics. A CALSTAR emergency helicopter transport is based on the premises. SLRH also provides minimally invasive surgical procedures, general medicine including specialties that are not often seen in a small community hospital, maternal and child health services, wound care and hyperbaric medicine with two hyberbaric oxygen champers on site, stroke and a telemedicine program, physician referral services, and support groups. The hospitals Breast Care Center provides mammography, other methods of cancer detection, and bone density screening.
Part VI, Question 7:	SLRH annually updates its Community Benefits Report and files a copy of it on an annual basis with the State of California.

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
Saint Louise Regional Hospital

Employer identification number
91-2154437

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) Verity Medical Foundation
400 Race Street
San Jose,CA95126

45-3691852

501(c)(3)

39,749

General Support

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

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

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference

Explanation

Schedule I, Part I, Line 2:

Saint Louise Regional Hospital is a part of a group of related tax-exempt organizations, which includes Verity Medical Foundation. During the June 30, 2016 fiscal year, Saint Louise Regional Hospital made equity transfers to Verity Medical Foundation, whose sole corporate member is also Verity Health System of California, Inc. Proper use of transferred amounts is monitored through common control throughout the health system.

Schedule I (Form 990) 2015

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" on 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

2015

Open to Public Inspection

Name of the organization

Saint Louise Regional Hospital

Employer identification number

91-2154437

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 on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

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

The organization?

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

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

For persons listed on 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 on 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" on 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) 2015

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 on 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 on 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)
1Robert IssaiBoard Member through 12/2015	(i) (ii)	0 ------------- 1,123,278	0 ------------- 0	0 ------------- 2,709,323	0 ------------- 233,622	0 ------------- 48,949	0 ------------- 4,115,172	0 ------------- 0
2George Green MDBoard Member through 12/2015	(i) (ii)	152,720 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	152,720 ------------- 0	0 ------------- 0
3Carol FurgursonCAO through 02/2016	(i) (ii)	273,066 ------------- 0	176,975 ------------- 0	83,732 ------------- 0	40,571 ------------- 0	23,585 ------------- 0	597,929 ------------- 0	0 ------------- 0
4Lori KatterhagenVP Patient Care/Clinical Svcs	(i) (ii)	165,765 ------------- 0	58,150 ------------- 0	24,836 ------------- 0	12,571 ------------- 0	34,815 ------------- 0	296,137 ------------- 0	0 ------------- 0
5Marc QuarlesUltrasound Tech III	(i) (ii)	249,143 ------------- 0	0 ------------- 0	18,867 ------------- 0	15,393 ------------- 0	31,880 ------------- 0	315,283 ------------- 0	0 ------------- 0
6Elizabeth AgooStaff Nurse IV	(i) (ii)	220,495 ------------- 0	0 ------------- 0	34,250 ------------- 0	4,511 ------------- 0	26,268 ------------- 0	285,524 ------------- 0	0 ------------- 0
7Cynthia MurrayStaff Nurse III	(i) (ii)	221,547 ------------- 0	0 ------------- 0	24,748 ------------- 0	4,378 ------------- 0	35,024 ------------- 0	285,697 ------------- 0	0 ------------- 0
8Mary Lou RoachStaff Nurse III	(i) (ii)	202,661 ------------- 0	0 ------------- 0	18,621 ------------- 0	3,706 ------------- 0	23,726 ------------- 0	248,714 ------------- 0	0 ------------- 0
9Paul DicksonStaff Nurse II	(i) (ii)	193,616 ------------- 0	0 ------------- 0	19,024 ------------- 0	3,741 ------------- 0	31,822 ------------- 0	248,203 ------------- 0	0 ------------- 0
10James DoverFormer President & CEO	(i) (ii)	0 ------------- 260,274	0 ------------- 0	0 ------------- 7,151	0 ------------- 9,596	0 ------------- 24,340	0 ------------- 301,361	0 ------------- 0
11Joanne Evelyn AllenFormer President & CEO	(i) (ii)	0 ------------- 435,320	0 ------------- 0	0 ------------- 729,157	0 ------------- 39,515	0 ------------- 27,411	0 ------------- 1,231,403	0 ------------- 0
12David CarrollFormer CFO	(i) (ii)	0 ------------- 132,161	0 ------------- 50,249	0 ------------- 215,337	0 ------------- 9,908	0 ------------- 2,990	0 ------------- 410,645	0 ------------- 0

Schedule J (Form 990) 2015

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
Methods Used to Establish compensation of CEO by a Related Organization:	Schedule J, Part I, Line 3: The President & CEO is an employee of Verity Health System of California, Inc. ("VHS"). VHS uses the following methods to establish top management officials' compensation: independent compensation consultant, compensation survey or study, approval by the Board or Compensation Committee, Form 990 of other organizations, and written employment contracts.
Severance Payments	Schedule J, Part I, Line 4a: The following individuals received a severance payment from related organizations during the 2015 calendar year, which was reported as taxable compensation on Form 990, Part VII, Section A, Column (E) and Schedule J, Part II, Column (b)(iii): Robert Issai $1,893,008 Joanne Evelyn Allen $ 720,387 David Carroll $ 188,431 Additionally, some of the individuals listed on Schedule J, Part II have a severance provision as a part of their employment arrangement. The severance provision ranges from 6 months to 2 years, dependent on the job title, length of service, and reason for termination.
Nonqualified Retirement Plan	Schedule J, Part I, Line 4b: The following individuals participated in a supplemental nonqualified retirement plan provided by the organization or a related organization, which is included in compensation reported on Form 990, Part VII, Section A, Column (F) and Schedule J, Part II, Column (c): Robert Issai $58,059 Carol Furgurson $17,383 Joanne Evelyn Allen $ 6,983
Explanation of Other Reportable Compensation	Schedule J, Part II, Column (b)(iii): Two individuals listed on Schedule J, Part II received a one-time payout of a 401(a)(17) plan; the taxable amount of that payout is reflected as other reportable compensation on Schedule J, Part II, Column (b)(iii).

Schedule J (Form 990) 2015

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

2015

Open to Public
Inspection

Name of the organization

Saint Louise Regional Hospital

Employer identification number

91-2154437

Return Reference	Explanation
Form 990, Part VI, Section A, Line 4:	During the June 30, 2016 fiscal-year, the organization amended its mission and exempt purpose in its Articles of Incorporation to reflect language indicative of the Health Systems change from religious corporations to public benefit corporations under the California Nonprofit Corporation Law. In addition, the organization made similar changes to its bylaws, as well as the following additional changes: (1) changes to the composition of its Board of Directors, including mandating that no more than twenty percent of the members of the Board of Directors should have any financial relationship with BlueMountain Capital Management, LLC (which infused VHS with financing in exchange for an option to acquire the assets VHS), or Integrity Healthcare, LLC (its wholly owned subsidiary); (2) provided that VHS, as the sole corporate member of the organization, has the authority to appoint and remove the chairperson, president, and chief executive officer of the organization and its direct subsidiaries (3) provided that VHS has the authority to dissolve the organizations audit committee and direct its responsibilities to the audit committee of VHS; (4) included restrictions on transactions with interested directors; (5) provided that Directors may receive reasonable compensation fixed by VHS; and (6) provided that members of the audit committee may receive compensation not to exceed the compensation paid to Directors, but may not be employees of the organization or have a material financial interest in entities doing business with the organization.
Form 990, Part VI, Section A, Line 6:	Saint Louise Regional Hospital has one member, Verity Health System of California, Inc. (formerly known as Daughters of Charity Health System through December 14, 2015), a California nonprofit corporation.
Form 990, Part VI, Section A, Line 7a:	The organization's sole member, Verity Health System of California, Inc. ("VHS") has the power to fix the number and appoint and remove the Trustees of Saint Louise Regional Hospital ("SLRH").
Form 990, Part VI, Section A, Line 7b:	As the sole member of SLRH, VHS has the power to take or approve the following actions as it relates to SLRH: (1) approve or change the mission, role, and purpose of this organization; (2) amend the Bylaws and Articles of Incorporation (or authorize the Board of Trustee to do so); (3) approve the formation, merger, dissolution, consolidation, divestiture, closure, change in corporate membership or control and reorganization of each direct Affiliate of this Corporation; (4) fix the number and appoint and remove the Trustees of this Corporation; (5) appoint and remove the Chairperson of the Board and President and Chief Executive Officer of this Corporation and of each direct Affiliate or Subsidiary of this Corporation; (6) approve the merger, consolidation, reorganization, dissolution, or disposition of assets of this Corporation or any direct Affiliate of this Corporation; (7) approve the acquisition, sale, lease, mortgage, transfer or other alienation of real or personal property of this Corporation; (8) approve the capital and operating budgets; (9) approve the incurrence of debt or guaranties; (10) establish policy concerning quality of care and services for the Corporation; (11) establish policy and procedures concerning finance and resources; (12) establish criteria for the long-range financial and strategic plans of the Corporation; (13) establish an internal auditing program and approve any material element of the internal auditing program; (14) approve capital expenditures; (15) approve the transfer of funds, by gift or loan, between this Corporation and one or more other Affiliates of Verity health System; (16) approve any other action by this Corporation or for any Affiliate controlled by this Corporation that has been established by resolution of the Corporate Member as requiring its approval, including, but not limited to, any approvals of authority necessary to ensure compliance with any credit agreement, master indenture or loan agreement to which this Corporation is a party.
Form 990, Part VI, Section B, Line 11b:	The organizations independent tax preparers and finance staff work together to gather the required information necessary to complete the Form 990. The initial draft Form 990 is reviewed by the organizations finance and legal department. After the Form 990 is reviewed, recommended changes are discussed and a final Form 990 is prepared. Prior to filing with the Internal Revenue Service, the final version Form 990 is distributed to the organizations Board of Directors for review.
Form 990, Part VI, Section B, Line 12c:	VHS has a Conflict of Interest Policy that covers VHS and all of its affiliates. The policy provides for a systematic and ongoing method of requiring individuals who have decision making responsibilities to disclose and address potential and actual conflicts of interest. Covered individuals are required to complete an annual statement disclosing any conflicts of interest and have a duty to update the disclosure for any potential conflicts of interest that arise during the year. The President & CEOs of the individual hospitals within the health system report the conflict of interest findings and resolutions to their respective Board of Directors. This policy is reviewed annually for compliance by VHSs Corporate Responsibility Officer.
Form 990, Part VI, Section B, Lines 15a and 15b:	The VHS compensation programs cover VHS and all of its affiliated hospitals. The President & CEO of each hospital is employed by VHS; as such, Form 990, Part VI, Section B, Line 15a has been answered "no" as mandated by the Form 990 instructions. The VHS compensation programs are designed to recruit, retain, and motivate qualified executives. The programs are designed for positions that have a significant impact on the high-level strategic and policy direction of VHS and its affiliated hospitals. All of the hospital President & CEOs are paid directly by VHS and covered by the VHS compensation programs. Market data analyses are made of comparable organizations within the industry and within the region. Total compensation is established for all executive positiions to target similar total compensation of comparable organization's market compensation. Base pay is established for all executive positions to target the median range of comparable organization market compensation. VHS utilized a Benefits committee to review compensation and benefits. The VHS Board of Directors reviews and approves compensation recommended by the Benefits Committee, and documents its conclusion that the proposed compensation is reasonable. In evaluating and finalizing its determination of base pay and total compensation for comparable positions at comparable organizations in comparable markets, VHS utilizes available market data analyses which includes independent compensation consultants, Form 990s of other organizations, written employment contracts, compensation surveys or studies, and recommendations from the Benefits Committee and approval by the VHS Board of Directors.
Form 990, Part VI, Section C, Line 19:	The audited financial statements are made available to the public upon request. The Articles of Incorporation, Bylaws, and Conflict of Interest Policy are not made available to the public.
Form 990, Part XI, Line 9:	The other changes in net assets or fund balances consist of a change in the funded status of pension plans of ($1,817,000) and a net transfer of medical office buildings to Verity Health System of California, Inc., a related organization, of ($5,232,571).
FORM 990 PART IX LINE 11G	DESCRIPTION:REGISTRY NURSING TOTAL FEES:1653608
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER CONTRACT LABOR TOTAL FEES:1576323
FORM 990 PART IX LINE 11G	DESCRIPTION:MEDICAL FEES TOTAL FEES:4383075
FORM 990 PART IX LINE 11G	DESCRIPTION:PURHASED SRVCS: OUTSIDE ORGS TOTAL FEES:3831814
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTANTS TOTAL FEES:285678

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

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

2015

Open to Public Inspection

Name of the organization

Saint Louise Regional Hospital

Employer identification number

91-2154437

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Daughters of Charity Ministry Svcs Corp 26000 Altamont Rd Los Altos Hills,CA94022 77-0482943	Outreach	CA	501(c)(3)	1	DOC SVDP		No
(2)Verity Health System of California Inc 203 Redwood Shores Pkwy 800 Redwood City,CA94065 91-2145484	Hosp Ldrship	CA	501(c)(3)	11-III FI	NA		No
(3)O'Connor Hospital 2105 Forest Avenue San Jose,CA95128 91-2154436	Healthcare	CA	501(c)(3)	3	VHS		No
(4)O'Connor Hospital Foundation 2105 Forest Avenue San Jose,CA95128 77-0006295	Fundraising	CA	501(c)(3)	11-I	OCH		No
(5)Robert F Kennedy Medical Center Found 203 Redwood Shores Pkwy 800 Redwood City,CA94065 95-3745227	Fundraising	CA	501(c)(3)	11-I	RFKMC		No
(6)St Francis Medical Center 3630 East Imperial Highway Lynwood,CA90262 91-2154439	Healthcare	CA	501(c)(3)	3	VHS		No
(7)St Francis Med Center of Lynwood Found 3630 East Imperial Highway Lynwood,CA90262 95-3190773	Fundraising	CA	501(c)(3)	11-I	SFMC		No
(8)Saint Louise Regional Hospital Found 9400 No Name Uno Gilroy,CA95020 56-2384735	Fundraising	CA	501(c)(3)	11-I	SLRH	Yes
(9)St Vincent Medical Center 2131 West Third Street Los Angeles,CA90057 91-2154438	Healthcare	CA	501(c)(3)	3	VHS		No
(10)St Vincent Dialysis Center 2131 West Third Street Los Angeles,CA90057 95-3749293	Healthcare	CA	501(c)(3)	3	SVMC		No
(11)St Vincent Foundation 2131 West Third Street Los Angeles,CA90057 95-3922511	Fundraising	CA	501(c)(3)	11-I	SVMC		No
(12)Seton Medical Center 1900 Sullivan Avenue Daly City,CA94015 91-2154441	Healthcare	CA	501(c)(3)	3	VHS		No
(13)Seton Medical Center Foundation 1900 Sullivan Avenue Daly City,CA94015 94-2824033	Fundraising	CA	501(c)(3)	11-I	SMC		No
(14)Verity Business Services 203 Redwood Shores Pkwy 800 Redwood City,CA94065 51-0659139	Hosp Support	CA	501(c)(3)	11-II	VHS		No
(15)Verity Medical Foundation 400 Race Street San Jose,CA95126 45-3691852	Healthcare	CA	501(c)(3)	9	VHS		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) O'Connor Health Center 1 1960 The Alameda Suite 20 San Jose,CA95126 77-0419045	Rental	CA	VHS							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) Marillac Insurance Company LTD PO Box 69 Grand Cayman KY1-1102 CJ 98-0417930	Captive Insurance	CJ	VHS					No
(2) Robert F Kennedy Medical Center 203 Redwood Shores Pkwy 800 Redwood City,CA94065 91-2154440	Inactive	CA	VHS					No

Schedule R (Form 990) 2015

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

Yes

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

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

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
(1) Saint Louise Regional Hospital Foundation	c	57,065	Cost
(2) Saint Louise Regional Hospital Foundation	o	89,528	Cost

Schedule R (Form 990) 2015

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) 2015

Page 5

Part VII

Supplemental Information

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

Return Reference

Explanation

Schedule R, Part II:

Daughters of Charity Ministry Services Corporation was a related organization of Verity Health System of California, Inc., formerly known as Daughters of Charity Health System ("Parent"), until December 14, 2015 by reason of Daughters of Charity Ministry Services Corporation being the sole member of the Parent with the power to appoint the majority of the Board of Directors. On December 14, 2015, the California Attorney General approved a System Restructuring and Support Agreement to change the governance of and recapitalize the Parent and its subsidiaries. Under the Restructuring Agreement, the Parent and other members were converted from religious corporations to public benefit corporations. Effective December 14, 2015, the Board of Directors of the Parent resigned and Daughters of Charity Ministry Services Corporation, acting as sole corporate member of the Parent, appointed an independent board of the Parent and amended the bylaws of the Parent to eliminate the corporate membership rights of Daughters of Charity Ministry Services Corporation, effectively converting the Parent into a nonprofit corporation without members.

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Saint Louise Regional Hospital is a 93 bed acute care hospital offering a wide range of services to residents in both Santa Clara and San Benito counties.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	5
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 2015 (Part V, line 2a) ......	5	594
6	Total number of volunteers (estimate if necessary) .............	6	150
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	625,973	60,110
9	Program service revenue (Part VIII, line 2g) .........	88,658,281	82,898,283
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-10,318	0
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,404,819	152,674
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	90,678,755	83,111,067
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	360,600	39,749
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	54,760,488	51,497,200
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	45,264,338	44,726,320
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	100,385,426	96,263,269
19	Revenue less expenses. Subtract line 18 from line 12.......	-9,706,671	-13,152,202
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	66,642,041	37,629,622
21	Total liabilities (Part X, line 26).............	110,098,462	101,287,816
22	Net assets or fund balances. Subtract line 21 from line 20.....	-43,456,421	-63,658,194

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 73,068,533 including grants of $ 39,749 ) (Revenue $ 82,898,283 )
	Saint Louise Regional Hospital ("SLRH"), a California nonprofit corporation, is a 93-bed acute care hospital in Gilroy, CA which serves South Santa Clara and San Benito Counties. SLRH also operates an urgent care center on its Morgan Hill campus--De Paul Health Center. The organization plays a vital role in continuing to emphasize high-quality, compassionate service to the underserved. SLRH provides the only emergency services within 30 miles, is a Certified Stroke Center and has diagnostic services, ICU, and general medical surgical services, including obstetric services. SLRH also provides minimally invasive surgical procedures, general medicine (including specialties that are not often seen in a community hospital), maternal and child health services, wound care, hyperbaric medicine with two hyperbaric oxygen chambers on site, stroke and a telemedicine program, physician referral services, and support groups. The hospital's Breast Care Center also provides mammography, other methods of cancer detection, and bone density screening. During the June 30, 2016 fiscal year, SLRH provided over $14 million in community benefit programs to the community in addition to the more than $12 million in care for the elderly. Annually, SLRH oversees approximately 3,000 inpatient discharges, 47,000 outpatient visits, 2,000 surgical cases, 500 births, 29,000 emergency visits, and 7,500 urgent care center visits.

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 expenses73,068,533

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)				(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Lori Katterhagen........................................................................ VP Patient Care/Clinical Svcs	40.0 .......................0.0	X			248,751	0	47,386
(19) Marc Quarles........................................................................ Ultrasound Tech III	40.0 .......................0.0		X		268,010	0	47,273
(20) Elizabeth Agoo........................................................................ Staff Nurse IV	40.0 .......................0.0		X		254,745	0	30,779
(21) Cynthia Murray........................................................................ Staff Nurse III	40.0 .......................0.0		X		246,295	0	39,402
(22) Mary Lou Roach........................................................................ Staff Nurse III	40.0 .......................0.0		X		221,282	0	27,432
(23) Paul Dickson........................................................................ Staff Nurse II	40.0 .......................0.0		X		212,640	0	35,563
(24) James Dover........................................................................ Former President & CEO	0.0 .......................0.0			X	0	267,425	33,936
(25) Joanne Evelyn Allen........................................................................ Former President & CEO	0.0 .......................42.0			X	0	1,164,477	66,926
(26) David Carroll........................................................................ Former CFO	0.0 .......................0.0			X	0	397,747	12,898

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,155,516	5,856,593	694,884

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	60,110
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		60,110

			Business Code
2a	NET PATIENT REVENUE	621110	82,898,283	82,898,283
b
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			82,898,283

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			0
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....			0
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA		722514	110,232		110,232
b	GIFT SHOP		453220	34,983		34,983
c	MISCELLANEOUS REVENUE		900099	7,459		7,459
d	All other revenue ....
e	Total. Add lines 11a–11d ......			152,674
12	Total revenue. See Instructions......			83,111,067	82,898,283	152,674

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	39,749	39,749
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	864,750	466,157	398,593
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	37,083,426	28,017,248	9,066,178
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,719,611	2,806,851	912,760
9	Other employee benefits .......	7,165,246	5,377,023	1,788,223
10	Payroll taxes ...........	2,664,167	1,998,125	666,042
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	667,202		667,202
c	Accounting ...........	0
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	11,730,498	10,534,797	1,195,701	0
12	Advertising and promotion ....	43,144		43,144
13	Office expenses .......	444,474	311,132	133,342
14	Information technology ......	3,410,678	3,069,610	341,068
15	Royalties ..	0
16	Occupancy ...........	1,118,066	782,646	335,420
17	Travel ............	17,469		17,469
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	53,759	37,631	16,128
20	Interest ...........	2,178,231	2,178,231
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	2,659,260	2,659,260
23	Insurance ...	1,191,543	338,146	853,397
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	7,186,232	7,186,232
b	ALLOCATED HEALTH SYSTEM EXP.	6,231,233		6,231,233
c	PROVIDER FEES	3,943,476	3,943,476
d	BAD DEBT EXPENSE	2,088,267	2,088,267
e	All other expenses	1,762,788	1,233,952	528,836
25	Total functional expenses. Add lines 1 through 24e	96,263,269	73,068,533	23,194,736	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).

1	Cash–non-interest-bearing ........			0	1	0
2	Savings and temporary cash investments .........			11,485,527	2	3,934,486
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			10,300,471	4	10,631,033
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net ....			66,877	7	24,017
8	Inventories for sale or use ........			1,283,035	8	1,254,409
9	Prepaid expenses and deferred charges ......			200,932	9	1,224,067
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	51,003,590
b	Less: accumulated depreciation	10b	38,904,786	19,149,890	10c	12,098,804
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			143,818	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			24,011,491	15	8,462,806
16	Total assets. Add lines 1 through 15 (must equal line 34)...			66,642,041	16	37,629,622

17	Accounts payable and accrued expenses .....	10,265,017	17	11,256,593
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	23,012,259	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	76,821,186	25	90,031,223
26	Total liabilities. Add lines 17 through 25..	110,098,462	26	101,287,816

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	-43,456,421	27	-63,658,194
28	Temporarily restricted net assets ...........	0	28	0
29	Permanently restricted net assets	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	-43,456,421	33	-63,658,194
34	Total liabilities and net assets/fund balances ........	66,642,041	34	37,629,622