TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) JUDITH ANDRUCKI...................................................................... DIRECTOR	0.10 ................. 0.30	X		0	0	0
(2) JOHN CHAPMAN...................................................................... DIRECTOR	0.10 ................. 0.30	X		0	0	0
(3) DONALD FOURNIER...................................................................... DIRECTOR	0.10 ................. 0.30	X		0	0	0
(4) RALPH HARDER...................................................................... DIRECTOR	0.10 ................. 0.30	X		0	0	0
(5) LENA HARTLEY...................................................................... DIRECTOR	0.10 ................. 0.20	X		0	0	0
(6) JOHN ISAACSON...................................................................... DIRECTOR	0.10 ................. 0.20	X		0	0	0
(7) JACK KEITH...................................................................... DIRECTOR	0.10 ................. 0.20	X		0	0	0
(8) MICHAEL KELLEY MD...................................................................... DIRECTOR	40.00 ................. 0.20	X		502,955	0	25,324
(9) CAROLYN LEPAGE...................................................................... DIRECTOR	0.10 ................. 0.20	X		0	0	0
(10) KATHY MCMANUS...................................................................... DIRECTOR	0.10 ................. 0.20	X		0	0	0
(11) CATHERINE RYDER END 31718...................................................................... DIRECTOR	0.10 ................. 0.20	X		0	0	0
(12) ANNE SCHUETTINGER...................................................................... DIRECTOR	0.10 ................. 0.20	X		0	0	0
(13) MARK ANTHOINE...................................................................... CHAIR	0.10 ................. 0.20	X	X	0	0	0
(14) JAMES PLACE MD...................................................................... VICE CHAIR	0.10 ................. 0.20	X	X	0	0	0
(15) STEVE JORGENSEN BEG 72418...................................................................... PRESIDENT (EX-OFFICIO)	0.10 ................. 40.00	X	X	0	205,229	8,901
(16) PETER HOLDEN END 72018...................................................................... INTERIM PRESIDENT (EX-OFFI	0.10 ................. 40.00	X	X	0	0	0
(17) MICHAEL HENDRIX...................................................................... TREASURER & CFO	0.10 ................. 40.00	X	X	0	265,755	33,859

(A) Name and business address	(B) Description of services	(C) Compensation
COVENANT HEALTH INC 100 AMES POND ROAD TEWKSBURY,MA01876	MANAGEMENT SERVICES	20,320,260
MEDEFIS INC PO BOX 5068 NEW YORK,NY100875068	LOCUM NURSING SERVICES	6,065,308
METZ CULINARY MANAGEMENT TWO WOODLAND DRIVE DALLAS,PA18612	MEAL SERVICES	5,274,361
UNITED AMBULANCE SERVICE 192 RUSSELL STREET LEWISTON,ME04240	AMBULANCE SERVICES	2,001,514
REHABCARE GROUP EAST INC PO BOX 503534 ST LOUIS,MO631503534	THERAPY SERVICES	1,768,245
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 34

- 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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number

01-0211551

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 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. 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—2017. 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—2018. 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—2017. 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) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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—2017. 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) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2018

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) 2018

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 (explain in Part VI). 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) 2018

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

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) 2018

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.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number

01-0211551

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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization ST MARY'S REGIONAL MEDICAL CENTER

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization ST MARY'S REGIONAL MEDICAL CENTER		Employer identification number 01-0211551

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization ST MARY'S REGIONAL MEDICAL CENTER			Employer identification number 01-0211551
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) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number

01-0211551

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................
d	Other exempt purpose expenditures ........................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

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

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

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

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

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

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

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

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

Yes

17,620

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

17,620

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	ST. MARY'S REGIONAL MEDICAL CENTER IS A MEMBER OF THE MAINE HOSPITAL ASSOCIATION AND A PORTION OF THE DUES PAID IN THE AMOUNT OF $17,620 WAS USED FOR LOBBYING.

Schedule C (Form 990 or 990EZ) 2018

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number

01-0211551

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 7/25/06, 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) 2018

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 ....	29,998,051	5,847,103	2,035,795	2,006,226	1,689,157
b	Contributions ...	1,608,019	26,243,632	4,917,990	1,100,997	1,130,245
c	Net investment earnings, gains, and losses			389	345	192
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	23,800,402	2,092,684	1,107,071	1,071,773	813,368
f	Administrative expenses ....
g	End of year balance ......	7,805,668	29,998,051	5,847,103	2,035,795	2,006,226

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

9.000 %

Temporarily restricted endowment SchDMd Bullet

91.000 %

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 .....	950,446		950,446
b	Buildings ....	89,436,932	45,511,605	43,925,327
c	Leasehold improvements	1,045,631	519,779	525,852
d	Equipment ....	55,507,138	45,391,796	10,115,342
e	Other .....	5,662,428	2,358,540	3,303,888
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				58,820,855

Schedule D (Form 990) 2018

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 AFFILIATES				21,370,158
(2) DONOR RESTRICTED FUNDS				7,303,772
(3) LONG TERM INVESTMENTS				5,493,947
(4) INVESTMENT IN JOINT VENTURES				2,679,762
(5) FUNDS HELD BY TRUSTEE - DEBT SERVICE RESERVE				5,399,701
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				42,247,340

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
DUE TO AFFILIATES	8,000,000
DUE TO THIRD PARTIES	5,270,441
DEFERRED FIXED ASSET EXP (FIN47)	25,123
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	13,295,564
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) 2018

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

PART V, LINE 4:

CAPITAL IMPROVEMENTS,PATIENT CARE EQUIPMENT, EDUCATION, AND TO ASSIST PATIENTS AND COMMUNITY MEMBERS EXPERIENCING FINANCIAL HARDSHIPS

PART X, LINE 2:

COVENANT AND ITS MEMBER ORGANIZATIONS ARE CONSIDERED NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE, EXCEPT AS NOTED BELOW. TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION FOR INCOME TAXES AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS INCLUDING UNRELATED BUSINESS INCOME OR TAX STATUS. UNDER GUIDANCE ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD, ASSETS AND LIABILITIES ARE ESTABLISHED FOR UNCERTAIN TAX POSITIONS TAKEN OR POSITIONS EXPECTED TO BE TAKEN IN INCOME TAX RETURNS WHEN SUCH POSITIONS ARE JUDGED TO NOT MEET THE "MORE-LIKELY-THAN-NOT" THRESHOLD, BASED UPON THE TECHNICAL MERITS OF THE POSITION. ESTIMATED INTEREST AND PENALTIES, IF APPLICABLE, RELATED TO UNCERTAIN TAX POSITIONS ARE INCLUDED AS A COMPONENT OF INCOME TAX EXPENSE. THE SYSTEM HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE SYSTEM HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT DECEMBER 31, 2018.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

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

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number

01-0211551

Part I

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

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

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

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

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

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

YesNo

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

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










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

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

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2018

Page 2

Part II

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

		(a) Event #1 COMMIT TO GET FIT MAY 2018 (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	69,907	69,907
2	Less: Contributions . . . .	60,900	60,900
3	Gross income (line 1 minus line 2) . . . . . .	9,007	9,007

4	Cash prizes . . . . .	0
5	Noncash prizes . . . .	600	600
6	Rent/facility costs . . . .	450	450
7	Food and beverages . . .	0
8	Entertainment . . . .	0
9	Other direct expenses . . .	9,033	9,033
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		10,083
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		-1,076

Part III

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

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

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

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

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

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

YesNo

If "No," explain:

10a

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

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2018

Page 3

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

YesNo

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

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

YesNo

Indicate the percentage of gaming activity conducted in:

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

13a

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

13b

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

Name

Address

15a

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

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

YesNo

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

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

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

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

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

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

YesNo

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

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

Part IV

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

Return Reference

Explanation

SCHEDULE G, PART II, FUNDRAISING EVENTS

IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR THE REPORTING OF INCOME ON SCHEDULE G, EVENT REVENUE DEEMED TO BE CHARITABLE CONTRIBUTIONS HAS BEEN REPORTED ON LINE 2, THUS REDUCING THE TOTAL GROSS EVENT INCOME ON LINE 3. THIS PRESENTATION GIVES THE APPEARANCE ON SCHEDULE G OF A LOSS FROM THE RESPECTIVE EVENT. HOWEVER, WHEN THE CHARITABLE CONTRIBUTIONS ARE CONSIDERED AND ADDED BACK, THE EVENT HAD A PROFIT OF $59,824.

Schedule G (Form 990 or 990-EZ) 2018

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

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number

01-0211551

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: . . . . . . . .

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"? . . . . . . . . . . . . .

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		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			5,779,566		5,779,566	2.480 %
b	Medicaid (from Worksheet 3, column a) . . . . .			34,833,669	26,773,835	8,059,834	3.460 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			40,613,235	26,773,835	13,839,400	5.940 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	11	10,546	942,460	5,000	937,460	0.400 %
f	Health professions education (from Worksheet 5) . . .	6	716	874,614	1,800	872,814	0.370 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .			7,579	0	7,579	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	12	61,547	400,123	8,509	391,614	0.170 %
j	Total. Other Benefits . .	29	72,809	2,224,776	15,309	2,209,467	0.940 %
k	Total. Add lines 7d and 7j .	29	72,809	42,838,011	26,789,144	16,048,867	6.880 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	1	10,463	154,556	76,850	77,706	0.030 %
2	Economic development
3	Community support	3	3,690	119,373	37,250	82,123	0.040 %
4	Environmental improvements
5	Leadership development and training for community members	1	84	78,932	15,000	63,932	0.030 %
6	Coalition building	2	685	25,973	23,200	2,773	0 %
7	Community health improvement advocacy	2	79	19,129	0	19,129	0.010 %
8	Workforce development
9	Other
10	Total	9	15,001	397,963	152,300	245,663	0.110 %

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. ......

12,547,179

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).....

31,546,181

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

48,838,843

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

-17,292,662

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 %
11 UNITED AMBULANCE	AMBULANCE SERVICE	50.000 %	0 %	0 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

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?1Name, 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	ST MARY'S REGIONAL MEDICAL CENTER 93 CAMPUS AVE LEWISTON,ME042430291 38244	X

Schedule H (Form 990) 2018

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)

	ST MARY'S REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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): WWW.STMARYSMAINE.COM

Other website (list url): WWW.COVENANTHEALTH.NET

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 SCHEDULE H, 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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ST MARY'S REGIONAL MEDICAL CENTER
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 200.000000000000% and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

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)

Was widely publicized 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):

WWW.STMARYSMAINE.COM

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

WWW.STMARYSMAINE.COM

A plain language summary of the FAP was widely available on a website (list url):
WWW.STMARYSMAINE.COM

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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	ST MARY'S REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

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)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	ST MARY'S REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2018

Page 8

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, 16j, 18e, 19e, 20e, 21c, 21d, 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
ST. MARY'S REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 5: UNDERSTANDING THE HEALTH NEEDS OF A COMMUNITY ALLOWS PUBLIC HEALTH AND HEALTH CARE ORGANIZATIONS TO DESIGN AND IMPLEMENT COST-EFFECTIVE STRATEGIES THAT IMPROVE THE HEALTH STATUS OF THE POPULATIONS THEY SERVE. A COMPREHENSIVE DATA DRIVEN ASSESSMENT PROCESS CAN IDENTIFY, WITH A HIGH DEGREE OF ACCURACY, PRIORITY HEALTH NEEDS AND ISSUES RELATED TO PREVENTION, DIAGNOSIS AND TREATMENT. ASSESSMENT TOOLS ALSO MAY ASSIST IN PINPOINTING ACCESS TO CARE BARRIERS, UTILIZATION OF EVIDENCE BASED GUIDELINES, AND UTILIZATION OF HEALTH SERVICES. IN MAINE, HEALTHCARE LEADERS AND PUBLIC HEALTH LEADERS COLLABORATED TO CONDUCT THE ASSESSMENT AND ANALYZE THE DATA FOR THIS LATEST CHNA IN A COLLABORATION DESIGNATED AS THE MAINE SHARED HEALTH NEEDS ASSESSMENT & PLANNING PROCESS.ABOUT THE COLLABORATIVETHE MAINE SHARED HEALTH NEEDS ASSESSMENT & PLANNING PROCESS (SHNAPP) WAS ESTABLISHED FROM A SERIES OF PLANNING EVENTS AND CONVERSATIONS AMONG HEALTHCARE AND PUBLIC HEALTH LEADERS IN RESPONSE TO EMERGING STATE AND FEDERAL MANDATES TO IMPROVE THE HEALTH OF MAINE COMMUNITIES. A MEMORANDUM OF UNDERSTANDING (MOU) WAS DEVELOPED AND SIGNED IN JUNE 2014 BY CEOS FROM CENTRAL MAINE HEALTHCARE, EASTERN MAINE HEALTHCARE SYSTEMS, MAINEGENERAL HEALTH, AND MAINEHEALTH IN ADDITION TO THE COMMISSIONER OF MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES. TANGIBLE PRODUCTS INCLUDE SHARED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORTS CREATED FROM SECONDARY QUANTITATIVE DATA AND PRIMARY QUALITATIVE DATA ANALYSES, COMMUNITY ENGAGEMENT ACTIVITIES, AND HEALTH IMPROVEMENT PLANS.ABOUT THE SHARED COMMUNITY HEALTH NEEDS ASSESSMENTTHE SHARED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY MAINE SHNAPP MEMBERS. THE SERIES OF REPORTS PRODUCED AS A RESULT SUPPORT EFFORTS TO MAKE MAINE'S COMMUNITIES THE HEALTHIEST IN AMERICA. THE CHNA REPORT (SEE APPENDIX 1 FOR THE COMPLETE ANDROSCOGGIN COUNTY REPORT) PRESENTS BOTH QUANTITATIVE AND QUALITATIVE FINDINGS. THE QUANTITATIVE DATA CAME FROM 25 SOURCES (SURVEYS SUCH AS THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, THE MAINE INTEGRATED YOUTH HEALTH SURVEY; PATIENT CLAIMS DATA FROM THE MAINE HEALTH DATA ORGANIZATION; AND DISEASE REGISTRIES SUCH AS THE CANCER REGISTRY) FOR OVER 160 INDICATORS WITHIN 18 DOMAINS OR HEALTH CATEGORIES. THE QUALITATIVE DATA WAS GLEANED FROM AN ONLINE STAKEHOLDER SURVEY MEANT TO CAPTURE OPINIONS OF HEALTH PROFESSIONALS AND COMMUNITY STAKEHOLDERS ON THE HEALTH ISSUES AND NEEDS OF COMMUNITIES ACROSS THE STATE. THE DATA GATHERED FROM THESE SOURCES ALLOWED LOCAL HOSPITALS TO IDENTIFY THE TOP HEALTH ISSUES OR PRIORITIES FOR THEIR COUNTY AND LOCAL COMMUNITIES.COMMUNITY INPUTCOMMUNITY ENGAGEMENT USING SHARED CHNA REPORTS FOR LOCAL AND REGIONAL PLANNING IS A CRITICAL PART OF THE NEEDS ASSESSMENT AND HEALTH IMPROVEMENT PLANNING PROCESS. THE PROCESS, CO-LED BY MAINE CDC DISTRICT LIAISONS AND REPRESENTATIVES FROM MAINE SHNAPP NOT-FOR-PROFIT HOSPITALS, ACHIEVED THE FOLLOWING:- ENSURED BROAD INTERESTS OF THE LOCAL COMMUNITY WERE REPRESENTED;- OBTAINED STAKEHOLDER INPUT ON IDENTIFYING SIGNIFICANT HEALTH NEEDS BASED ON REVIEW OF DATA;- SOLICITED STAKEHOLDER FEEDBACK ON PRIORITIZING SIGNIFICANT HEALTH NEEDS; AND- IDENTIFIED LOCAL ASSETS AND RESOURCES THAT COULD ADDRESS LOCAL HEALTH PRIORITIES.PREPARING FOR COMMUNITY ENGAGEMENTSEPTEMBER 2014-SEPTEMBER 2015THE SHNAPP COMMUNITY ENGAGEMENT PLANNING PROCESS INCLUDED THE DISTRICT LIAISON FROM THE MAINE CDC AND REPRESENTATIVES FROM PARTICIPATING MAINE SHNAPP HOSPITALS IN THE REGION (ST. MARY'S REGIONAL MEDICAL CENTER AND CENTRAL MAINE MEDICAL CENTER IN LEWISTON.) IT WAS DECIDED THAT THE EXISTING COMMUNITY HEALTH STAKEHOLDER COALITION WOULD BE THE LOCAL GROUP TO COORDINATE COMMUNITY ENGAGEMENT SESSIONS IN ANDROSCOGGIN COUNTY.IN 2012, REPRESENTATIVES FROM THE TWO LOCAL HOSPITAL SYSTEMS CAME TOGETHER TO ESTABLISH THE COMMUNITY HEALTH STAKEHOLDER COALITION, A GROUP OF COMMUNITY HEALTH AGENCIES, THE PUBLIC HEALTH SECTOR AND HOSPITALS. THEY DEVELOPED THIS PURPOSE STATEMENT:IMPROVE THE HEALTH OF ANDROSCOGGIN COUNTY BY CONVENING COMMUNITY HEALTH STAKEHOLDERS TO COLLABORATE ON:-CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS-EDUCATING MEMBERS AND CONSTITUENTS ON FINDINGS OF COMMUNITY HEALTH NEEDS ASSESSMENTS-DEVELOPING STRATEGIES TO ADDRESS PRIORITIZED NEEDS-SHARING RELEVANT RESOURCES THROUGH NETWORKINGADDITIONALLY THE STAKEHOLDER GROUP CONTINUES TO ASSESS METHODS TO INCREASE THE COMMUNITIES' KNOWLEDGE OF, AND ACCESS TO, RESOURCES IN OUR AREA SUCH AS 2-1-1 MAINE AND TO EXPLORE OPTIONS FOR DIRECT REFERRAL TO RESOURCES FROM WITHIN THE HEALTHCARE SYSTEMS. OBTAINING LOCAL COMMUNITY ENGAGEMENT INPUTOCTOBER 2015-MARCH 2016IN ORDER TO OBTAIN LOCAL COMMUNITY INPUT, THE COMMUNITY HEALTH STAKEHOLDER COALITION REVIEWED THE DATA IN THE ANDROSCOGGIN COUNTY SHNAPP CHNA REPORT AND THEN DEVELOPED AN APPROACH TO COMMUNITY ENGAGEMENT TO MAXIMIZE PARTICIPATION OF A CROSS SECTION OF THE COMMUNITYTHE COMMUNITY HEALTH STAKEHOLDER COALITION COORDINATED TWO COMMUNITY FORUMS HELD IN MARCH 2016 AND 13 OTHER GROUP PRESENTATION/KEY INFORMANT INTERVIEWS WITH EXISTING COMMUNITY GROUPS (SEE APPENDIX 2-COMMUNITY ENGAGEMENT)THE OBJECTIVES OF THE FORUM INCLUDED:- PROVIDE AWARENESS AMONG COMMUNITY STAKEHOLDERS OF THE DATA/RESULTS FROM THE MAINE SHNAPP OR SUBSEQUENT RESEARCH BUILT ON THAT RESOURCE;- INVITE LOCAL INPUT ON WHAT THE DATA MEANS TO EACH LOCAL COMMUNITY/REGION; - SOLICIT LOCAL INPUT ON WHAT ISSUES SHOULD BE PRIORITIZED LOCALLY; - SOLICIT LOCAL IDEAS ON EXISTING RESOURCES, ASSETS, OR NEW INITIATIVES THAT SHOULD BE ALIGNED/DEVELOPED TO ADDRESS THE PRIORITIZED ISSUES; AND- CAPTURE AND SHARE INPUT FROM THE FORUM USING THE MODEL LOCAL SHNAPP COMMITTEE REPORTING FORM.THE COALITION ALSO DECIDED TO APPROACH EXISTING COMMUNITY GROUPS SUCH AS THE CHAMBER OF COMMERCE AND SENIORS PLUS AND INDIVIDUAL COMMUNITY MEMBERS TO OFFER GROUP PRESENTATIONS, KEY INFORMANT INTERVIEWS AND EVEN WRITTEN SURVEYS OFFERING THE ABOVE ELEMENTS. IN ALL, 520 PEOPLE PARTICIPATED IN EITHER THE COMMUNITY FORUMS, GROUP PRESENTATIONS, INTERVIEWS AND WRITTEN SURVEYS IN ANDROSCOGGIN COUNTY. THE SECTORS REPRESENTED INCLUDED: PUBLIC HEALTH, MEDICALLY UNDERSERVED, COMMUNITY HEALTH COALITION, NON-PROFIT AGENCIES, LOW INCOME, RACIAL/ETHNIC MINORITIES, BUSINESS AND EDUCATION. THE CONVERSATIONS LARGELY INFORMED BOTH THE IMPLEMENTATION STRATEGIES AND STRATEGIC PLANS FOR THE HOSPITALS. SUMMARIES AND/OR NOTES FROM ALL OF THE FORUMS ARE AVAILABLE AT: HTTPS://WWW.MAINEGENERAL.ORG/PAGES/MAINE-PUBLIC-HEALTH-DISTRICTS.ASPZ
ST. MARY'S REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 6A: CENTRAL MAINE MEDICAL CENTER IN LEWISTON, MAINE
ST. MARY'S REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 6B: THE SHARED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY MAINE SHNAPP MEMBERS. THE MAINE SHARED HEALTH NEEDS ASSESSMENT & PLANNING PROCESS (SHNAPP) WAS ESTABLISHED FROM A SERIES OF PLANNING EVENTS AND CONVERSATIONS AMONG HEALTHCARE AND PUBLIC HEALTH LEADERS IN RESPONSE TO EMERGING STATE AND FEDERAL MANDATES TO IMPROVE THE HEALTH OF MAINE COMMUNITIES. A MEMORANDUM OF UNDERSTANDING (MOU) WAS DEVELOPED AND SIGNED IN JUNE 2014 BY CEOS FROM CENTRAL MAINE HEALTHCARE, EASTERN MAINE HEALTHCARE SYSTEMS, MAINEGENERAL HEALTH, AND MAINEHEALTH IN ADDITION TO THE COMMISSIONER OF MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES. FOR THE MOST RECENT CHNA, COALITION MEMBERS INCLUDED: JAMIE PAUL, WESTERN MAINE DISTRICT COORDINATING COUNCIL OF THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION, CYNTHIA RICE, DIRECTOR OF COMMUNITY HEALTH, WELLNESS AND CARDIOPULMONARY REHAB, CENTRAL MAINE MEDICAL CENTER, ELIZABETH KEENE, VP OF MISSION INTEGRATION, ST. MARY'S HEALTH SYSTEM, ERIN GUAY, EXECUTIVE DIRECTOR, HEALTHY ANDROSCOGGIN, CATHERINE RYDER, EXECUTIVE DIRECTOR, TRI-COUNTY MENTAL HEALTH SERVICES, GINNY ANDREWS, NUTRITION SERVICES PROGRAM MANAGER, WESTERN MAINE COMMUNITY ACTION, STEVE JOHNDRO, EXECUTIVE DIRECTOR, WESTERN MAINE COMMUNITY ACTION, BRENDA CZADO, DIRECTOR HOME CARE, ANDROSCOGGIN HOME CARE AND HOSPICE, REBECCA AUSTIN, DIRECTOR OF OUTREACH SERVICES, SAFE VOICES, SAM BOSS, HARWOOD CENTER AT BATES COLLEGE, JOAN CHURCHILL, EXECUTIVE DIRECTOR, COMMUNITY CLINICAL SERVICES, SHAWN YARDLEY, EXECUTIVE DIRECTOR, COMMUNITY CONCEPTS, LARRY MARCOUX, UNITED WAY AND QUINN GORMLEY, HEALTH EQUITY ALLIANCE. THESE MEMBERS REPRESENTED COMMUNITY HEALTH, PUBLIC HEALTH, HOSPITALS, MINORITY POPULATIONS, LOCAL COLLEGES, COMMUNITY ACTION AGENCIES AND THE LOCAL FEDERALLY QUALIFIED HEALTH CENTER (FQHC.)
ST. MARY'S REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 11: ST. MARY'S WAS ESTABLISHED IN 1888 BY THE SISTERS OF CHARITY OF SAINT-HYACINTHE, CANADA. THEIR LEGACY, IN THE SPIRIT OF FOUNDRESS ST. MARGUERITE D'YOUVILLE, COMPELS US TO CONTINUE THEIR VISION OF SERVING THE MOST VULNERABLE OF OUR COMMUNITY. OUR GOALS FOR 2018 WERE TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS BY PROVIDING PROGRAMS AND SERVICES RELATED TO THESE NEEDS, CARING FOR THE POOR AND VULNERABLE IN ANDROSCOGGIN COUNTY, PROVIDING EDUCATION TO COMMUNITY GROUPS AND HEALTH CARE PROFESSIONALS, AND FACILITATING COMMUNITY PARTNERSHIPS TO DEEPEN THE IMPACT OF OUR EFFORTS.COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY ENGAGEMENTTHE MAINE SHARED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS INTENDED TO COORDINATE STATE AND COUNTY NEEDS ASSESSMENTS. THIS EFFORT IS A UNIQUE PUBLIC-PRIVATE STATEWIDE COLLABORATIVE EFFORT AMONG THE MAJOR HEALTH SYSTEMS IN MAINE AND THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION OF THE MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES (MAINE CDC).THE MAINE SHARED CHNA COLLABORATIVE CONTRACTED WITH JOHN SNOW, INC. (JSI) TO CONDUCT DATA ANALYSIS AND SUPPORT THE COMMUNITY ENGAGEMENT PROCESS.THE MAINE SHARED CHNA PROCESS WILL ROLL OUT IN THREE STAGES:- HEALTH DATA PROFILES WERE RELEASED IN AUGUST 2018. ALMOST 200 INDICATORS HAVE BEEN SELECTED TO DESCRIBE THE HEALTH OUTCOMES, HEALTH BEHAVIORS, HEALTHCARE ACCESS AND QUALITY, AND THE SOCIAL, COMMUNITY, AND PHYSICAL ENVIRONMENT THAT AFFECT OUR HEALTH.- FORUMS AND OTHER OUTREACH WERE CONDUCTED IN THE FALL OF 2018. FORUMS WERE FOLLOWED BY KEY INFORMANT INTERVIEWS AND A COMMUNITY HEALTH SURVEY. THE PURPOSE OF THIS OUTREACH WAS TO GATHER FEEDBACK ON THE DATA, IDENTIFY HEALTH PRIORITIES AND COMMUNITY ASSETS THAT CAN BE USED IN HEALTH IMPROVEMENT PLANNING.- FINAL CHNA REPORTS ARE SCHEDULED TO BE RELEASED IN MARCH OF 2019. THESE REPORTS WILL INCLUDE THE INFORMATION FROM THE HEALTH PROFILES ALONG WITH SUMMARIES FROM FORUMS, KEY INFORMANT INTERVIEWS, AND THE SURVEY TO CREATE 1 STATE, 16 COUNTY, AND PUBLIC HEALTH DISTRICT LEVEL REPORTS. IN 2012, ST. MARY'S AND THE OTHER LOCAL HOSPITAL ESTABLISHED A GROUP OF COMMUNITY HEALTH-CARE RELATED AGENCIES TO REVIEW THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE GROUP HAS CONTINUED MONTHLY MEETINGS TO ANALYZE COMMUNITY HEALTH NEEDS ASSESSMENT DATA, COLLABORATE ON APPROPRIATE INITIATIVES AND NETWORK ABOUT EXISTING COMMUNITY RESOURCES. IN 2018 THE COALITION FOCUSED ON THE THREE PRIORITY AREAS IDENTIFIED IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT: SUBSTANCE USE, MENTAL HEALTH AND PHYSICAL ACTIVITY/OBESITY/NUTRITION AND THEN BEGAN WORKING ON THE NEXT CHNA BY PLANNING AND HOSTING COMMUNITY ENGAGEMENT FORUMS TO OBTAIN FEEDBACK ON THE HEALTH INDICATOR DATA FOR ANDROSCOGGIN COUNTY AND THEN ASK FOR THE COMMUNITY'S PERSPECTIVE IN PRIORITIZING THE HEALTH ISSUES. TWO SESSIONS WERE HELD IN ANDROSCOGGIN COUNTY IN THE FALL OF 2018. ATTENDANCE INCLUDED REPRESENTATIVES OF THE COMMUNITY, LEADERS OF COMMUNITY HEALTH AND SOCIAL SERVICE AGENCIES AND THE PRESIDENTS OF BOTH LOCAL HOSPITALS. PARTICIPANTS REVIEWED THE DATA ELEMENTS FOR ANDROSCOGGIN COUNTY, FOCUSING PRIMARILY ON AREAS WHERE THE HEALTH OF THIS COMMUNITY WAS SIGNIFICANTLY WORSE THAN THE STATE OR THE COUNTRY. PARTICIPANTS THEN REVIEWED THE NEEDS AND PRIORITIZED THEM (WITH AN OPPORTUNITY TO ADD THEIR OWN CONCERNS.) IN ADDITION, KEY INFORMANT INTERVIEWS FROM VULNERABLE POPULATIONS (SUCH AS VETERANS, MINORITY COMMUNITIES AND THE ELDERLY) PROVIDED ADDITIONAL FEEDBACK, PERSPECTIVE AND PRIORITIZED NEEDS. THE PRIORITIZED NEEDS WILL THEN INFORM ST. MARY'S IMPLEMENTATION STRATEGY AND STRATEGIC PLANNING IN 2019.ST. MARY'S IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY THROUGH STAFF LEADERSHIP, STRATEGIC PARTNERSHIPS, COMMUNITY AND HEALTH CARE PROFESSIONAL'S EDUCATION AND COMMUNITY BUILDING. THESE EFFORTS ARE EXAMPLES OF HOW WE LIVE AND FULFILL OUR MISSION OF HEALING AND CARE SO THAT THOSE IN OUR COMMUNITY CAN FLOURISH.
ST. MARY'S REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 13H: HOUSEHOLD SIZE
ST. MARY'S REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 15E: ST. MARY'S WEBSITE PROVIDES ACCESS TO THE FREE CARE APPLICATION AS WELL AS CONTACT INFORMATION FOR ASSISTANCE IN ANSWERING ANY QUESTIONS OR IN COMPLETING THE APPLICATION.
SCHEDULE H, PART V, SECTION B, LINE 10A:	WWW.STMARYSMAINE.COM/COMMUNITY-HEALTH/IMPLEMENTATION-STRATEGY-2016-2018

Schedule H (Form 990) 2018

Page 9

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	1 - ST MARY'S D'YOUVILLE PAVILION 102 CAMPUS AVE LEWISTON,ME04240	NURSING HOME
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2018

Page 10

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, LN 7 COL(F):	WE HAVE ESTIMATED THAT 2% OF OUR BAD DEBT MAY POTENTIALLY BE FREE CARE ACCOUNTS HOWEVER THIS HAS NOT BEEN INCLUDED IN PART I OR PART II.
PART II, COMMUNITY BUILDING ACTIVITIES:	ST. MARY'S IS VERY ACTIVE IN PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL CONCERNS. LEADERSHIP IS INVOLVED IN LOCAL ECONOMIC DEVELOPMENT AND COALITION BUILDING TO ADDRESS THESE ISSUES. ST. MARY'S NUTRITION CENTER HAS MANY PROGRAMS FOCUSED ON COMMUNITY BUILDING, INCLUDING OUR FARMERS' MARKETS, COMMUNITY GARDENS, AND PARTICIPATION ON COUNCILS RELATED TO IMPROVING FOOD ACCESS. THE NUTRITION CENTER HAS IDENTIFIED KEY STRATEGIC PRIORITIES FRAMED UNDER THE UMBRELLA OF GROWING FOOD TOGETHER, WITH A BROAD GOAL TO BRING OUR COMMUNITY TOGETHER AND STRENGTHEN COLLECTIVE ASSETS TOWARDS CULTIVATING MORE EQUITABLE AND RESILIENT ACCESS TO FOOD AND LAND IN LEWISTON-AUBURN. THIS WORK AIMS TO ADDRESS SEVERAL INTERRELATED ISSUES IN THE GREATER LEWISTON-AUBURN MAINE REGIONS: - THE NEED FOR EXPANDED AND EQUITABLE ACCESS TO LAND TO GROW FOOD - BOTH IN URBAN COMMUNITY GARDENS AND NEARBY FARMLAND ACCESS. THIS IS OF PARTICULAR NEED FOR DISADVANTAGED AFRICAN IMMIGRANTS, REFUGEES, AND ASYLEES.- THE NEED OF LOW-INCOME HOUSEHOLDS FOR ACCESS TO HEALTHY FOOD IN A COMMUNITY WITH HIGH LEVELS OF POVERTY AND FOOD INSECURITY.- THE NEED FOR MORE COORDINATED, IMPROVED LOCAL FOOD ACCESS STRATEGIES THAT ARE CONVENIENT, AFFORDABLE, EASY TO NAVIGATE, AND RESPOND TO COMMUNITY INPUT.- THE NEED TO CULTIVATE LOCAL LEADERSHIP, VISION, AND POLITICAL WILL TO PROTECT FARMLAND AND TO INCLUDE AGRICULTURE AND FARM/FOOD ENTERPRISE AS AN INTEGRATED PART OF COMMUNITY AND ECONOMIC DEVELOPMENT PLANNING.- THE NEED FOR TRAINING AND LEADERSHIP OPPORTUNITIES FOR UNDERSERVED YOUTH THAT CREATE PATHWAYS FOR MEANINGFUL COMMUNITY ENGAGEMENT. THE GOOD FOOD BUS IS A MOBILE FOOD MARKET WHICH CREATES EASIER ACCESS TO GOOD FOOD. IT PROVIDES DIRECT AND CONVENIENT ACCESS TO FRESH VEGETABLES, FRUIT, EGGS, BREAD, HONEY, PICKLES, NUTS, FROZEN PREPARED ITEMS AND ANCHOR MEALS (READY-TO-MAKE MEALS.). IN 2018 SNAP/EBT SALES REACHED $2500 WITH TOTAL SALES OF $35,177 FOR THE MOBILE MARKET. OUR "MAINE HARVEST BUCKS" PROGRAM ALLOWS PEOPLE TO INCREASE THEIR PURCHASE POWER OF SNAP BENEFITS AND BRING HOME MORE FRESH FRUITS AND VEGETABLES THROUGH A MATCHING PROGRAM. ANOTHER NEW INITIATIVE IN 2018 WAS A MEMBERSHIP PROGRAM BASED ON FEEDBACK FROM COMMUNITY LISTENING SESSIONS. IT WAS LAUNCHED IN RECOGNITION OF THE DECLINE OF FEDERAL FOOD ASSISTANCE ELIGIBILITY TO MANY IN OUR COMMUNITY. THE MEMBERSHIP PROGRAM AUTOMATICALLY DISCOUNTED PRODUCE COSTS AT LOW-INCOME STOPS AND REWARDED RETURN VISITS. THERE WERE 700 PEOPLE WHO SIGNED UP FOR THE MEMBERSHIP PROGRAM. COMMUNITY GARDENS THREE NEW URBAN GARDENS WERE CONSTRUCTED, PROVIDING GROWING SPACES FOR AN ADDITIONAL 54 HOUSEHOLDS, BRINGING THE TOTAL HOUSEHOLDS TO 176. THE GARDENS ARE INTENTIONALLY LOCATED IN NEIGHBORHOODS OF LOW-INCOME THAT FACE BARRIERS TO ACCESSING FRESH FOODS.WE PUBLISHED A CASE STUDY ABOUT THE HISTORY OF COMMUNITY GARDENS AND THE ROLE THEY PLAY IN POPULATION HEALTH IN LEWISTON-AUBURN:- FROM THE GROUND UP: IMPROVING COMMUNITY HEALTH THROUGH COLLABORATION." IN PARTNERSHIP WITH THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT, AN AFFILIATE OF THE AMERICAN HOSPITAL ASSOCIATION AND THE HEALTH RESEARCH & EDUCATIONAL TRUST, PUBLISHED AN ONLINE CASE STUDY, OR "BRIGHT SPOT." THIS USES A WEB PLATFORM TO SHARE STORIES, MODELS, AND LESSONS - OUR CASE STUDY EXAMINED THE VALUABLE ROLE COMMUNITY GARDENING CAN PLAY IN COMMUNITY DEVELOPMENT AND COMMUNITY ENGAGEMENT, WHILE STRENGTHENING FOOD ACCESS AND LOCAL FOOD SYSTEMS. THIS WAS THE FEATURED STORY FOR ONE DAY OF THE NATIONAL COMMUNITY HEALTH IMPROVEMENT WEEK:HTTPS://INSIGHT.LIVESTORIES.COM/S/V2/NEW-STORY/CECAC080-44D4-4CD7-A3D9-20552B15AD49/YOUTH PROGRAMSTHE GOAL OF ST. MARY'S NUTRITION CENTER YOUTH PROGRAMS IS TO PROVIDE FOOD, GARDEN-BASED LEADERSHIP AND JOB TRAINING OPPORTUNITIES FOR YOUTH. THE FOCUS FOR YOUTH PROGRAMMING IN 2018 WAS TO EXPAND THE OPPORTUNITIES OFFERED FOR THE 59 UNDERSERVED TEENS IN THE PROGRAM:- EXPANDED TRAINING OPPORTUNITIES FOR YOUTH AND STAFF: SEVEN CONFERENCE AND TRAININGS WERE ATTENDED INCLUDING THE NATIONAL ROOTED IN COMMUNITY CONFERENCE, MAINE YOUTH ACTION NETWORK YOUTH LEADERSHIP SUMMIT, EMERGING ENVIRONMENTAL CHANGEMAKERS GATHERING RUN BY THE NEW ENGLAND ENVIRONMENTAL EDUCATION ASSOCIATION, THE AND MAINE YOUTH AGRICULTURE SUMMIT. - EXPANDED COMMUNITY ENGAGEMENT OPPORTUNITIES FOR YOUTH PARTICIPANTS INCLUDING COMMUNITY EVENTS, SITE VISITS, AND COMMUNITY PLANNING EFFORTS. GOOD FOOD IN THE SCHOOLSANOTHER FOCUS FOR 2018 WAS TO EXPAND FARM TO SCHOOL OPPORTUNITIES IN LEWISTON AND AUBURN SCHOOL DISTRICTS. THE NUTRITION CENTER BROUGHT TOGETHER BOTH SCHOOL DISTRICTS AND PARTNERS AND SUBMITTED A SUCCESSFUL FARM TO SCHOOL IMPLEMENTATION PROPOSAL THAT WAS AWARDED IN JUNE 2018. THE NUTRITION CENTER ALSO HOSTED TWO FULL-TIME FOOD CORPS MEMBERS TO SUPPORT ONGOING SCHOOL GARDEN EDUCATION PROGRAMMING. WE WERE ABLE TO PROVIDE REGULAR PROGRAMMING IN OVER 60 DISTINCT CLASSROOMS AND AFTERSCHOOL/SUMMER SCHOOL PROGRAMS, IN 7 LOCATIONS. 2415 YOUTH AND CHILDREN PARTICIPATED IN GARDEN-BASED EDUCATIONAL PROGRAMMING. COMMUNITY FOOD CHAMPIONS FROM JULY -OCTOBER 2018 THE ST. MARY'S NUTRITION CENTER PILOTED A PEER-TO-PEER OUTREACH PROGRAM, COMMUNITY FOOD CHAMPIONS, TO HELP INCREASE AWARENESS OF FRESH FOOD OPPORTUNITIES ACROSS LEWISTON-AUBURN INCLUDING FARMERS' MARKETS, FARM STANDS, STORES, AND MOBILE MARKETS. THE PROGRAM ALSO SOUGHT TO GATHER QUALITATIVE INFORMATION FROM COMMUNITY MEMBERS ABOUT HOW THEY PURCHASE FRESH FOOD AND WHAT BARRIERS PREVENTED THEM FROM DOING SO EASILY. ST. MARY'S NUTRITION CENTER PARTNERED TO FORM THE ANDROSCOGGIN GLEANERS. THIS EFFORT IS BASED ON THE ANCIENT TRADITION OF GLEANING WHEN FARMERS AND FRUIT GROWERS ALLOW PEOPLE INTO THEIR FIELDS OR ORCHARDS TO GATHER THE FOOD THAT WAS NOT HARVESTED. IT IS DEDICATED TO CONNECTING PEOPLE THROUGH VOLUNTEERISM TO ALLEVIATE FOOD INSECURITY AND LOCAL FOOD WASTE IN OUR COUNTY. THE ANDROSCOGGIN GLEANERS WORK WITH FARMS, VOLUNTEERS AND FOOD ACCESS SITES TO HARVEST SURPLUS PRODUCE AND DELIVER TO PEOPLE WHO CAN USE IT. TOGETHER IN 2018, THE ANDROSCOGGIN GLEANERS - FARMERS, FOOD PANTRIES, SOUP KITCHENS, HOUSING SITES, VOLUNTEERS - COLLABORATIVELY HARVESTED, COLLECTED, DELIVERED AND DISTRIBUTED OVER 14,000 POUNDS OF FRESH, NUTRITIOUS AND DELICIOUS FOOD TO OUR NEIGHBORS AND COMMUNITY MEMBERS. PARTNERS IN THIS INITIATIVE INCLUDED THE COOPERATIVE EXTENSION, HEALTHY ANDROSCOGGIN, ANDROSCOGGIN LAND TRUST, WHITING FARM, SCATTERGOOD FARM, AND BATES COLLEGE (FACULTY AND STUDENTS CONDUCTED A SEMESTER-LONG RESEARCH PROJECT TO SUPPORT THE EFFORT).AS ONE OF THE LARGEST EMERGENCY FOOD PANTRIES IN MAINE, ST. MARY'S FOOD PANTRY PROVIDES NUTRITIOUS FOOD TO THOSE IN OUR COMMUNITY WHO ARE FOOD INSECURE. THE FOOD PANTRY DISTRIBUTED OVER 800,000 POUNDS OF FOOD IN 2018, INCLUDING MANY THOUSANDS OF POUNDS OF FRESH PRODUCE.
PART III, LINE 2:	THIS AMOUNT REPRESENTS ACCOUNTS SENT TO THE COLLECTION AGENCY MINUS PAYMENTS THAT HAVE BEEN COLLECTED PLUS A FACTOR ESTIMATING THE SELF-PAY AMOUNTS IN ACCOUNTS RECEIVABLE THAT WILL BE UNCOLLECTIBLE.
PART III, LINE 3:	FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
PART III, LINE 4:	FOOTNOTE 3, PAGE 20 : ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN PERFORMED. THE ESTIMATES FOR IMPLICIT PRICE CONCESSIONS ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL WRITEOFFS AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL, STATE AND PRIVATE EMPLOYER HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITEOFFS AND COLLECTIONS AT FACILITIES THAT REPRESENT A MAJORITY OF THE SYSTEMS REVENUES AND ACCOUNTS RECEIVABLE AS A PRIMARY SOURCE OF INFORMATION IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE.
PART III, LINE 8:	NONE WERE REPORTED BUT IT IS IMPORTANT TO NOTE THAT APPROXIMATELY 30% OF MEDICARE PATIENTS ALSO QUALIFY FOR MEDICAID. COSTING ON LINE 6 IS BASED ON RATIO OF COST TO CHARGE FROM WORKSHEET 2.
PART III, LINE 9B:	ST. MARY'S REGIONAL MEDICAL CENTER WILL MAKE A REASONABLE EFFORT TO DETERMINE WHETHER AN INDIVIDUAL QUALIFIES FOR FINANCIAL ASSISTANCE PRIOR TO INITIATING ANY COLLECTION ACTIVITY.
PART VI, LINE 2:	IN ADDITION TO THE OFFICIAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORTED IN PART V, SECTION B, ST. MARY'S ASSESSES THE NEEDS OF OUR COMMUNITY IN AN ON-GOING BASIS THROUGH SEVERAL KEY METHODS. LEADERS ARE ACTIVE ON COMMUNITY HEALTH BOARDS; THESE MONTHLY MEETINGS ALLOW FOR CONTINUED ASSESSMENT AND SHARING OF INFORMATION. PATIENT OR RESIDENT ADVISORY PANELS ALSO HELP US ASSESS NEEDS OF PATIENTS AND THE COMMUNITY. WE ALSO WORK CLOSELY WITH COMMUNITY CLINICAL SERVICES (AN FQHC LOOK-ALIKE) TO SHARE INFORMATION ABOUT SOME OF THE HEALTH DISPARITIES EXPERIENCED BY COMMUNITY MEMBERS. ST. MARY'S WORKS WITH THE LOCAL ETHNIC COMMUNITY BASED ORGANIZATIONS FOR INFORMATION AS WELL. ST. MARY'S WORKS WITH THE LOCAL ETHNIC COMMUNITY BASED ORGANIZATIONS FOR INFORMATION AS WELL.
PART VI, LINE 3:	ST. MARY'S REGIONAL MEDICAL CENTER PROVIDES FINANCIAL EDUCATION AT THE POINT OF REGISTRATION BY HAVING BROCHURES AVAILABLE. THESE BROCHURES PROVIDE INFORMATION ABOUT THE HOSPITAL BILL AND VARIOUS OPTIONS ON FINANCIAL ASSISTANCE. ON THE BACKSIDE OF THE MONTHLY PATIENT STATEMENTS ALSO PROVIDES EDUCATION OF THE FINANCIAL ASSISTANCE AVAILABILITY AND OPTIONS TO THOSE WHO NEED IT.
PART VI, LINE 4:	ST. MARY'S REGIONAL MEDICAL CENTER (SMRMC) DRAWS MOST OF ITS INPATIENT AND OUTPATIENT POPULATION FROM ANDROSCOGGIN COUNTY, THEREFORE THE NEEDS OF THIS GEOGRAPHIC AREA ARE THE FOCUS OF THE DESCRIPTION. ANDROSCOGGIN COUNTY IS A COUNTY LOCATED IN SOUTH CENTRAL MAINE. IT CONTAINS ROUGHLY 8% OF MAINE'S 1.27 MILLION RESIDENTS. ANDROSCOGGIN COUNTY CONTAINS MAINE'S SECOND AND FIFTH LARGEST CITIES: LEWISTON (POPULATION 36,136 IN THE 2016 CENSUS ESTIMATE) AND AUBURN (POPULATION 22,969 IN THE 2016 CENSUS ESTIMATE) RESPECTIVELY. LOCATED ACROSS FROM EACH OTHER ON THE ANDROSCOGGIN RIVER, THE TWIN CITIES OF LEWISTON AND AUBURN ARE THE CENTRAL HUB OF THE REGION. THE COUNTY IS WORKING TO TRANSFORM THE DOWNTOWN AREA FROM VACANT TEXTILE MILLS AND ABANDONED SHOE FACTORIES TO A REGION KNOWN FOR PROGRESSIVE HEALTH CARE, TOURISM, HIGH-PRECISION MANUFACTURING, TELEMARKETING AND FINANCIAL SERVICES. LEWISTON AND AUBURN ARE ALSO HOME TO A LARGE FRANCO-AMERICAN POPULATION AS WELL AS AN INCREASING NUMBER OF CENTRAL AND EAST AFRICAN IMMIGRANTS. THE REST OF THE COUNTY IS COMPRISED OF SMALL RURAL TOWNS WITH AN AVERAGE POPULATION OF 222 PERSONS PER SQUARE MILE.FROM THE JULY 1, 2018 CENSUS ESTIMATE DATA, THE POPULATION OF ANDROSCOGGIN COUNTY IS 107,679, WITH AN ESTIMATED POVERTY RATE OF 12.4% AND MEDIAN INCOME OF $49,538 ANNUALLY. LEWISTON'S 2016 ESTIMATED POVERTY RATE IS EVEN HIGHER-22% AND THE RATE OF CHILDHOOD POVERTY IN LEWISTON IS 43% (ACCORDING TO THE 2013 MAINE KIDS COUNT SURVEY). THE COUNTY IS PRIMARILY WHITE (91.9%) WITH BLACK/AFRICAN AMERICAN AT 4.4%. WITH THE CONCENTRATION OF CENTRAL AND EASTERN AFRICAN IMMIGRANTS IN LEWISTON, THE CITY HAS A MORE SIGNIFICANT BLACK POPULATION (4.3%) AND TWO OR MORE RACES AT 6.1%. ANDROSCOGGIN COUNTY'S POPULATION REFLECTS TWO INTERESTING TRENDS: THE GREATEST NUMBER OF PEOPLE IS IN THE "UNDER 18 YEARS" CATEGORY (21.7%) AND THE SECOND HIGHEST CONCENTRATION OF THE POPULATION IS OVER AGE 65 (17.7%.) THE DEC 2018 UNEMPLOYMENT RATE WAS 3.1%. SLIGHTLY OVER 10% OF THE PRIMARY LANGUAGES SPOKEN IN THE HOME IS CATEGORIZED "OTHER THAN ENGLISH" SO THERE ARE A MULTITUDE OF INTERPRETATION SERVICES AVAILABLE, AS WELL AS CULTURAL BROKERS HIRED BY THE LOCAL HOSPITALS TO ASSIST NEW MAINERS IN NAVIGATING THE HEALTH SYSTEMS. LEWISTON/AUBURN QUALIFIES AS A MEDICALLY UNDERSERVED AREA DEFINED AS HAVING TOO FEW PRIMARY CARE PROVIDERS, WITH HIGH INFANT MORTALITY, HIGH POVERTY RATES AND/OR HIGH ELDERLY POPULATIONS. ADDITIONALLY THE COMMUNITY NEEDS INDEX (CNI) IDENTIFIES THE SEVERITY OF COMMUNITY HEALTH NEEDS FOR A SPECIFIC GEOGRAPHY BY ANALYZING THE DEGREE TO WHICH THE FOLLOWING HEALTH CARE ACCESS BARRIERS EXIST IN THE COMMUNITY: A. INCOME BARRIERS; B. EDUCATION/LITERACY BARRIERS, C. CULTURE/LANGUAGE BARRIERS, D. INSURANCE BARRIERS, AND E. HOUSING BARRIERS. AS STATED IN "HOSPITAL-BASED STRATEGIES FOR CREATING A CULTURE OF HEALTH" PUBLISHED IN 2014 BY THE ROBERT WOOD JOHNSON FOUNDATION AND THE HEALTH RESEARCH AND EDUCATION TRUST (HRET), "THE PROCESS OF ASSESSING COMMUNITY HEALTH NEEDS PROVIDES A PLATFORM FOR HOSPITALS TO CLEARLY DEFINE AND PRIORITIZE COMMUNITY HEALTH CONCERNS, DEVELOP STRATEGIES TO ADDRESS THEM AND FOSTER SUSTAINABLE COLLABORATIONS WITH KEY PARTNERS. AS THE POPULATION HEALTH PARADIGM GAINS TRACTION, HOSPITALS INCREASINGLY ARE FOSTERING LEADERSHIP COMMITMENT AND ALIGNING THEIR MISSIONS TO ADVANCE THE ULTIMATE GOAL OF A HOSPITAL OR HEALTH CARE SYSTEM: A CULTURE OF HEALTH IN THEIR COMMUNITY." (P. 5) THE PROCESS USED IN THE STATE OF MAINE AND ANDROSCOGGIN COUNTY IS REFLECTIVE OF THIS TYPE OF COLLABORATION.
PART VI, LINE 5:	ST. MARY'S PROVIDED MANY COMMUNITY HEALTH IMPROVEMENT SERVICES TO ADDRESS THE PUBLIC HEALTH NEEDS IDENTIFIED IN ANDROSCOGGIN COUNTY IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. THE MOST SIGNIFICANT PUBLIC HEALTH ISSUES CONTINUE TO BE CHRONIC DISEASES, MENTAL HEALTH, SUBSTANCE USE, OBESITY AND TOBACCO USE. COMMUNITY HEALTH EDUCATION AND IMPROVEMENT SERVICES FOCUSED ON CHRONIC DISEASES AND SUBSTANCE USE. INITIATIVES INCLUDED HEALTH SCREENINGS FOR CANCER, COOKING CLASSES (EMBEDDED WITHIN FOOD ACCESS STRATEGIES) AND SELF-HELP PROGRAMS FOR SMOKING CESSATION AND WEIGHT LOSS. ST. MARY'S ALSO FOCUSED ON ACCESS TO CARE FOR UNDERSERVED POPULATIONS. COMMUNITY EDUCATION AND HEALTH IMPROVEMENT EFFORTSST. MARY'S OFFERED COMMUNITY EDUCATION AND HEALTH SCREENINGS TO ADDRESS THE PRIORITIZED HEALTH NEEDS IN ANDROSCOGGIN COUNTY. ST. MARY'S ALSO HOSTED AND/OR FACILITATED COMMUNITY SUPPORT GROUPS FOR HEALTH SERVICES AS WELL AS EXERCISE PROGRAMS TARGETED FOR WELLNESS AND PREVENTION. - SINCE MAINE HAS AN EXCESSIVELY HIGH RATE OF CANCER INCIDENCE, SEVERAL INITIATIVES WERE RELATED TO CANCER PREVENTION AND SCREENING. STAFF OFFERED SPECIAL MAMMOGRAPHY SCREENINGS ON A SATURDAY FOR THOSE WHO WORK ON WEEKDAYS. TWO EDUCATIONAL SESSIONS WERE HELD AT THE LOCAL AREA ON AGING THAT FOCUSED ON RISK AND PREVENTION OF BREAST CANCER. SIX EMPLOYEES ALSO PARTICIPATED IN THE ANNUAL SURVIVORSHIP DAY AT THE LOCAL CANCER SUPPORT CENTER AND OFFERED A COOKING CLASS THAT FOCUSED ON THE IMPORTANCE OF NUTRITION. ABOUT 100 PEOPLE ATTENDED THE PROGRAM. THE MEDICAL DIRECTOR OF OUR OCCUPATIONAL MEDICINE PROGRAM (WORKMED) ATTENDED A CONFERENCE THAT REPORTED ON THE INCREASED RISK OF CANCER FOR FIREFIGHTERS AND THEN DEVELOPED AND OFFERED A SPECIAL WORKSHOP FOR FIRE CHIEFS IN THE STATE OF MAINE ABOUT CANCER SCREENING AND PREVENTION FOR FIREFIGHTERS. OVER 50 FIRE CHIEFS FROM AROUND THE STATE (AS WELL AS OTHER TOWN/CITY OFFICIALS) ATTENDED THE FALL 2018 PROGRAM WHERE THEY RECEIVED EDUCATION ON THE TYPES OF CANCER FOR WHICH THEIR FIREFIGHTERS ARE AT GREATEST RISK.- MAINE IS FACING AN OPIATE CRISIS. IN 2017, MAINE'S FATAL OPIOID OVERDOSE RATE WAS 29.9 PER 100,000 PEOPLE (THE SIXTH HIGHEST IN THE COUNTRY.) ST. MARY'S IS A PARTNER IN A MAJOR COMMUNITY GRANT FOR THE COMMUNITY IN RECOVERY PROGRAM. ITS GOAL IS TO CREATE A COMMUNITY RESPONSE AND SAFE PATHWAY TO RECOVERY THAT PROVIDES FULL ACCESS, REDUCES STIGMA AND ENCOURAGES THE POSSIBILITY OF SUCCESSFUL OVERALL WELL-BEING AND PARTICIPATION. IN 2018 ST. MARY'S LEADERSHIP CONTINUED TO SERVE ON THE STEERING COMMITTEE AND ALSO OFFERED MEDICATION ASSISTED THERAPY (MAT) TRAINING FOR PROVIDERS IN ORDER TO INCREASE ACCESS TO MAT IN OUR COMMUNITY. PROVIDERS FROM BOTH LOCAL HOSPITALS AND THE LOCAL MENTAL HEALTH SOCIAL SERVICE AGENCY PARTICIPATED IN THE TRAINING.ST. MARY'S ALSO HOSTED A SESSION TO EDUCATE COMMUNITY HEALTH AGENCIES ABOUT STATISTICS RELATED TO SUBSTANCE USE IN ANDROSCOGGIN COUNTY IN THE SUMMER OF 2018 FOLLOWING THE RELEASE OF THE COUNTY LEVEL DATA FOR THE MAINE SHARED COMMUNITY HEALTH NEEDS ASSESSMENT.- ST. MARY'S HOSTED A FOUR-PART FILM CONVERSATION SERIES IN NOVEMBER 2018 ENTITLED "IT'S ABOUT HOW YOU LIVE" IN ORDER TO EDUCATE THE COMMUNITY ABOUT THE IMPORTANCE OF ADVANCE CARE PLANNING AND THE RESOURCES AND SUPPORT AVAILABLE THROUGH PALLIATIVE CARE. THE SERIES WAS WELL-RECEIVED BY THE COMMUNITY MEMBERS WHO ATTENDED.HIV CASE MANAGEMENT PROGRAMTHE HIV/AIDS CASE MANAGEMENT PROGRAM STARTED IN 1998 WHEN ST. MARY'S WAS AWARDED THE RYAN WHITE GRANT/CONTRACT UNDER THE MAINE CDC AND IS NOW THE SECOND LARGEST AIDS SERVICE ORGANIZATION IN THE STATE OF MAINE. THE PROGRAM SERVES 95 CLIENTS BETWEEN PORTLAND AND ELLSWORTH, MAINE. SERVICES PROVIDED INCLUDE: MEDICAL, DENTAL AND EYE CARE LINKAGES; ONGOING MONITORING OF CLIENT HEALTH STATUS INCLUDING TREATMENT AND CARE, LAB RESULTS AND HELPING TO ENSURE ONGOING TREATMENT ADHERENCE ON ALL LEVELS; ACCESS TO VITAL MEDICATIONS, LINKAGES TO HEALTH CARE, SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES; AND ACCESS TO FOOD AND FINANCIAL ASSISTANCE AS WELL AS HOUSING AND TRANSPORTATION ASSISTANCE. THE PROGRAM ALSO OFFERS CLIENT SUPPORT GROUPS, HOLIDAY LUNCHEONS AND MUCH NEEDED PERSONAL CARE SUPPLIES. IN 2018 THE NUMBER OF CLIENTS WHO ARE ASYLUM SEEKERS DOUBLED (FROM 5 TO 10 CLIENTS). SINCE MOST ASYLUM SEEKERS ARE NOT ELIGIBLE FOR ANY ASSISTANCE, THEY ARE VERY GRATEFUL FOR THE SUPPORT PROVIDED THROUGH THE HIV CASE MANAGEMENT PROGRAM, IN TERMS OF BOTH TANGIBLE SUPPORT AND BEING TREATED RESPECTFULLY. ONE CLIENT REMARKED, "WHEREVER I GO HERE AT ST. MARY'S, PEOPLE ATTEND TO ME, RATHER THAN IGNORING ME." HEALTH INITIATIVES/COLLABORATION WITH OTHER HEALTH ENTITIESST. MARY'S IS AN AFFILIATE MEMBER OF MAINEHEALTH, ONE OF THE MAJOR HEALTH SYSTEMS IN MAINE. MAINEHEALTH HAS CREATED THE CENTER FOR HEALTH IMPROVEMENT WHICH SUPPORTS AND SERVES MAINEHEALTH ORGANIZATIONS AND OTHERS WITH INTEGRATED CLINICAL, COMMUNITY AND POLICY APPROACHES. ONE OF ST. MARY'S SENIOR LEADERS HAS BEEN APPOINTED TO SERVE ON THIS COUNCIL. IN 2018, THE COUNCIL DEVELOPED A CHARTER WHICH OUTLINES AREAS FOR WHICH INPUT AND RECOMMENDATIONS WILL BE PROVIDED: - DEVELOPMENT OF POPULATION HEALTH PRIORITIES WITHIN MAINEHEALTH STRATEGIC PLANS (SYSTEM, SERVICE LINES, MEMBER ORGANIZATIONS, ETC.)- DEVELOPMENT AND DISSEMINATION OF ALIGNED STRATEGIES IN CLINICAL, COMMUNITY AND POLICY DOMAINS- IMPLEMENTATION OF APPROPRIATE MEASUREMENT, EVALUATION, AND ACHIEVEMENT OF OUTCOMES- COORDINATION OF POPULATION HEALTH-RELATED INITIATIVES AMONG SYSTEM MEMBERS AND AFFILIATES- CREATION AND MAINTENANCE OF PARTNERSHIPS WITH PUBLIC AND PRIVATE SECTORS- ADVOCACY REGARDING FUNDING AND RESOURCE ALLOCATIONS- EFFECTIVE IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS- EFFECTIVE IMPLEMENTATION OF THE HEALTH INDEX COMMIT TO GET FIT CHALLENGESINCE LACK OF PHYSICAL ACTIVITY AND OBESITY ARE SIGNIFICANT HEALTH CHALLENGES IN OUR COUNTRY, ST. MARY'S DECIDED TO CREATE A COMMUNITY EVENT TO ENCOURAGE PHYSICAL ACTIVITY. THE HEALTH AND WELLBEING OF OUR EMPLOYEES AND COMMUNITY MEMBERS ARE OF THE UTMOST IMPORTANCE TO ST. MARY'S. THE COMMIT TO GET FIT CHALLENGE IS FOCUSED ON ENCOURAGING INDIVIDUALS OF ALL LEVELS OF PHYSICAL ACTIVITY TO ENGAGE IN OUR EVENT. WE WELCOME AND SUPPORT THE PERSON WHO IS COMMITTED TO RUNNING THEIR FIRST 5K WITH AS MUCH ENTHUSIASM AS THE PERSON WHO IS PUTTING ALL THEIR EFFORT INTO WALKING OUR 3K. OUR SUCCESS CAN BE SEEN ON THE FACES OF THE WALKERS AND RUNNERS AS THEY CROSS THE FINISH LINE. ON MAY 5TH, 2018, ST. MARY'S HEALTH SYSTEM HELD OUR 5TH ANNUAL COMMIT TO GET FIT CHALLENGE. CLOSE TO 400 HUNDRED INDIVIDUALS PARTICIPATED IN OUR 3K WALK, 5K, 10K AND 15K RUN WITH 60 PLUS VOLUNTEERS HELPING TO MAKE OUR EVENT RUN SMOOTHLY. THANKS TO OUR MANY GENEROUS SPONSORS, DONATIONS FROM EMPLOYEES AND COMMUNITY MEMBERS AND THE FEES FROM REGISTRATIONS WE WERE ABLE TO RAISE CLOSE TO $70,000. THE PROCEEDS FROM THIS EVENT HELP TO SUPPORT THREE IMPORTANT AREAS OF OUR HEALTHCARE SYSTEM, THE MARGUERITE D'YOUVILLE FUND FOR THE NEEDY, THE NUTRITION CENTER AND THE RESIDENT ACTIVITY FUND AT ST. MARY'S D'YOUVILLE PAVILION. ST. MARY'S NUTRITION CENTER: COOKING CLASSES POVERTY AND POOR NUTRITION ARE SIGNIFICANT PUBLIC HEALTH ISSUES IN THE AREA WE SERVE. ST. MARY'S SUBSIDIZES THE ST. MARY'S NUTRITION CENTER TO ADDRESS THESE NEEDS. THE LONG-TERM GOAL OF THE NUTRITION CENTER IS TO BUILD A VIABLE, JUST FOOD SYSTEM, WHILE SUPPORTING LOCAL LEADERS, STRENGTHENING COMMUNITY TIES, AND ENGAGING YOUTH AS AGENTS OF CHANGE. THE NUTRITION CENTER OPERATES ON THE BELIEF THAT EQUITY IN OUR FOOD SYSTEM IS DEEPLY TIED TO INEQUITY WITHIN OUR COMMUNITY, AND THAT A WHOLE-PERSON, AND WHOLE-COMMUNITY, APPROACH IS CRITICAL TO CREATING LONG-TERM CHANGE IN ORDER TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY. LOCATED IN A PREVIOUSLY VACANT, BUT BEAUTIFUL, HISTORIC SCHOOL BUILDING IN THE MIDST OF DOWNTOWN LEWISTON, MAINE'S MOST ECONOMICALLY CHALLENGED NEIGHBORHOODS, THE NUTRITION CENTER SERVES FAMILIES, YOUTH, ADULTS, ELDERS AND REFUGEES ACROSS THE CITY'S MANY DIVERSE COMMUNITIES WITH A FOCUS ON THOSE WHO HAVE LIMITED INCOMES AND AN INCREASED RISK FOR FOOD INSECURITY. IN 2018 COMMUNITY COOKING CLASSES FEATURED THE THEME "EAT THE WORLD." EACH COOKING CLASS FEATURED A DIFFERENT COUNTRY AND A CHEF NATIVE TO THAT COUNTRY LED THE CLASS. TEN SESSIONS WERE HELD IN 2018 WITH ATTENDANCE RANGING FROM 12-45 PEOPLE AT EACH SESSION. CUISINE INCLUDED FOOD FROM SUDAN, IRAQ, MOROCCO, SENEGAL, NIGERIA, ANGOLA, AND YEMEN.
PART VI, LINE 6:	ST. MARY'S HEALTH SYSTEM, A MEMBER OF COVENANT HEALTH, INCLUDES ST. MARY'S REGIONAL MEDICAL CENTER, A 233-LICENSED BED ACUTE CARE FACILITY; COMMUNITY CLINICAL SERVICES, WITH PRIMARY CARE AND BEHAVIORAL PHYSICIANS, AND NURSE PRACTITIONERS; ST. MARY'S D'YOUVILLE PAVILION, ONE OF THE LARGEST NURSING HOMES NORTH OF BOSTON, WITH 210 BEDS DEDICATED TO LONG-TERM CARE, A SECURE ALZHEIMER'S UNIT, A REHAB SPECIALITY CARE SUITE, AND A STATE OF THE ART REHAB CENTER; ST. MARY'S RESIDENCES, AN INDEPENDENT LIVING CENTER.OUR MISSION IS TO CONTINUE THE HEALING MINISTRY OF THE CATHOLIC CHURCH IN THE SPIRIT OF ST. MARGUERITE D'YOUVILLE BY PROVIDING PREVENTIVE, CURATIVE, RESTORATIVE, AND SUPPORTIVE SERVICES WITH COMPASSION AND RESPECT FOR EVERYONE. WE TAKE SERIOUSLY THE "PREVENTIVE" ASPECT OF THE MISSION STATEMENT BY OFFERING PREVENTION AND WELLNESS PROGRAMS FOR THE COMMUNITY, OFFER HEALTH SCREENINGS AND WORKING TO PROVIDE ACCESS TO HEALTHY FOOD THROUGH THE NUTRITION CENTER. THE NURSING HOME OFFERS EDUCATION TO THE COMMUNITY ABOUT FALL PREVENTION, GRIEF SUPPORT AND CAREGIVER SUPPORT. HEALTH SYSTEM LEADERSHIP PARTICIPATE IN VARIOUS COMMUNITY GROUPS TO CONDUCT HEALTH CARE NEEDS ASSESSMENTS AND TO DEVELOP COMMUNITY INTERVENTIONS TO IMPROVE HEALTH.
PART VI, LINE 7, REPORTS FILED WITH STATES	ME

Schedule H (Form 990) 2018

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number

01-0211551

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

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

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 nonfixed
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) 2018

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)
1MICHAEL KELLEY MD DIRECTOR	(i) (ii)	502,955 ------------- 0	0 ------------- 0	0 ------------- 0	2,700 ------------- 0	22,624 ------------- 0	528,279 ------------- 0	0 ------------- 0
2STEVE JORGENSEN BEG 72418 PRESIDENT (EX-OFFICIO)	(i) (ii)	0 ------------- 205,229	0 ------------- 0	0 ------------- 0	0 ------------- 992	0 ------------- 7,909	0 ------------- 214,130	0 ------------- 0
3MICHAEL HENDRIX TREASURER & CFO	(i) (ii)	0 ------------- 265,755	0 ------------- 0	0 ------------- 0	0 ------------- 2,414	0 ------------- 31,445	0 ------------- 299,614	0 ------------- 0
4PHILIP HICKEY CEO POST ACUTE	(i) (ii)	213,442 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	8,936 ------------- 0	222,378 ------------- 0	0 ------------- 0
5CHRISTOPHER T BOWE CHIEF MEDICAL OFFICER	(i) (ii)	397,423 ------------- 0	0 ------------- 0	0 ------------- 0	144 ------------- 0	25,597 ------------- 0	423,164 ------------- 0	0 ------------- 0
6KAREN J CLARK VP PATIENT CARE SERVICES	(i) (ii)	213,076 ------------- 0	0 ------------- 0	0 ------------- 0	1,956 ------------- 0	24,781 ------------- 0	239,813 ------------- 0	0 ------------- 0
7MICHAEL T NEWMAN PHYSICIAN	(i) (ii)	917,260 ------------- 0	0 ------------- 0	0 ------------- 0	2,700 ------------- 0	31,401 ------------- 0	951,361 ------------- 0	0 ------------- 0
8JOSEPH E STRAUSS PHYSICIAN	(i) (ii)	831,148 ------------- 0	0 ------------- 0	0 ------------- 0	2,657 ------------- 0	30,580 ------------- 0	864,385 ------------- 0	0 ------------- 0
9JEFFREY N DAVILA PHYSICIAN	(i) (ii)	719,293 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	2,004 ------------- 0	721,297 ------------- 0	0 ------------- 0
10GREGORY POMEROY PHYSICIAN	(i) (ii)	575,508 ------------- 0	0 ------------- 0	0 ------------- 0	2,691 ------------- 0	19,130 ------------- 0	597,329 ------------- 0	0 ------------- 0
11MICHAEL PARKER PHYSICIAN	(i) (ii)	557,483 ------------- 0	0 ------------- 0	0 ------------- 0	2,700 ------------- 0	17,834 ------------- 0	578,017 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation

Schedule J (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number
01-0211551

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MHHEFA REVENUE BOND SERIES 2007A	01-0314384	560425V80	11-01-2007	6,685,000	CONSTRUCTION		X		X		X
B	MHHEFA REVENUE BOND SERIES 2010B	01-0314384	560427JA5	06-24-2010	7,825,000	REFINANCING OF 1999 & 2001 TAX-EXEMPT BONDS		X		X		X
C	MHHEFA REVENUE BOND SERIES 2014A	01-0314384	560427W77	07-24-2014	8,490,000	REFINANCING OF 2004A BONDS		X		X		X
D	MHHEFA REVENUE BOND SERIES 2014	01-0314384	560427U61	07-24-2014	2,450,000	REFINANCING OF 2004 BONDS		X		X		X
	MHHEFA REVENUE BOND SERIES 2017B	01-0314384	00056042R	03-21-2017	6,000,000	CONSTRUCTION		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	6,853,065		9,077,696		9,406,745		2,661,384
4 Gross proceeds in reserve funds .............	444,500		603,175		1,615,380		616,000
5 Capitalized interest from proceeds .............	414,069
6 Proceeds in refunding escrows ...............					1,560,850		2,993,216
7 Issuance costs from proceeds ...............	89,925		96,465		52,292		19,344
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	6,318,640
11 Other spent proceeds .............
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2010		2014		2014
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X	X			X	X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X	X			X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

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

Part Ⅳ

Arbitrage

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

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?	X		X		X		X
b Name of provider ..........	FSA		FSA		FSA		FSA
c Term of GIC .........	3000.0000000000 %		2000.0000000000 %		900.0000000000 %		900.0000000000 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........	X		X		X		X
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference

Explanation

SCHEDULE K. PART IV, LINE 7 AND PART V:

ALL BONDS ARE CAREFULLY AND CONSISTENTLY MONITORED FOR POTENTIAL VIOLATIONS OF FEDERAL TAX REQUIREMENTS, BUT THE PROCEDURES WERE NOT WRITTEN AS OF THE END OF THE YEAR COVERED BY THIS TAX RETURN. HOWEVER, THE ORGANIZATION IS IN THE PROCESS OF ADOPTING FORMAL POLICIES THAT SET FORTH THE ORGANIZATION'S METHODOLOGY FOR ENSURING POST-ISSUANCE COMPLIANCE WITH IRS REQUIREMENTS PERTAINING TO TAX-EXEMPT DEBT AND CONTAIN SPECIFIC LANGUAGE REGARDING ORGANIZATIONAL RESPONSIBILITY, RECORD RETENTION, PRIVATE BUSINESS USE, ARBITRAGE REBATE, AND REMEDIAL ACTION. ALTHOUGH FORMAL POLICIES ARE NOT IN PLACE IN REGARDS TO THE REMEDIATION OF OUR BONDS, THE MONITORING REQUIREMENTS OF SECTION 148, AND PROCEDURES TO ENSURE THAT VIOLATIONS ARE TIMELY IDENTIFIED AND CORRECTED, THE ORGANIZATION HAS COMPLIANCE CHECKS IN PLACE THAT SUBSTANTIATE THESE REQUIREMENTS.

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number
01-0211551

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MHHEFA REVENUE BOND SERIES 2007A	01-0314384	560425V80	11-01-2007	6,685,000	CONSTRUCTION		X		X		X
B	MHHEFA REVENUE BOND SERIES 2010B	01-0314384	560427JA5	06-24-2010	7,825,000	REFINANCING OF 1999 & 2001 TAX-EXEMPT BONDS		X		X		X
C	MHHEFA REVENUE BOND SERIES 2014A	01-0314384	560427W77	07-24-2014	8,490,000	REFINANCING OF 2004A BONDS		X		X		X
D	MHHEFA REVENUE BOND SERIES 2014	01-0314384	560427U61	07-24-2014	2,450,000	REFINANCING OF 2004 BONDS		X		X		X
	MHHEFA REVENUE BOND SERIES 2017B	01-0314384	00056042R	03-21-2017	6,000,000	CONSTRUCTION		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	6,853,065		9,077,696		9,406,745		2,661,384
4 Gross proceeds in reserve funds .............	444,500		603,175		1,615,380		616,000
5 Capitalized interest from proceeds .............	414,069
6 Proceeds in refunding escrows ...............					1,560,850		2,993,216
7 Issuance costs from proceeds ...............	89,925		96,465		52,292		19,344
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	6,318,640
11 Other spent proceeds .............
12 Other unspent proceeds .............
13 Year of substantial completion .............	2007		2010		2014		2014
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X	X			X	X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X	X			X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

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

Part Ⅳ

Arbitrage

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

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?	X		X		X		X
b Name of provider ..........	FSA		FSA		FSA		FSA
c Term of GIC .........	3000.0000000000 %		2000.0000000000 %		900.0000000000 %		900.0000000000 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........	X		X		X		X
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference

Explanation

SCHEDULE K. PART IV, LINE 7 AND PART V:

Schedule K (Form 990) 2018

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number

01-0211551

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 3	PETER HOLDEN WAS THE INTERIM PRESIDENT BEGINNING SEPTEMBER 2017. LEADERS FOR TODAY WAS PAID $442,295 FOR HIS SERVICES FROM JAN 2018 THRU JULY 2018. SERVICES WERE TERMINATED IN JULY 2018 WHEN STEVEN JORGENSEN JOINED THE ORGANIZATION AS PRESIDENT.
FORM 990, PART VI, SECTION A, LINE 6	THE ORGANIZATION HAS A SOLE CORPORATE MEMBER, COVENANT HEALTH, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE CORPORATE MEMBER MAY APPOINT OR REMOVE ONE OR MORE OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	CERTIAN DECISIONS OF THE BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 IS PROVIDED TO THE BOARD MEMBERS AND WAS REVIEWED AT THE OCTOBER 2019 MEETING.
FORM 990, PART VI, SECTION B, LINE 12C	THIS PROCESS IS THE RESPONSIBILITY OF ORGANIZATIONAL INTEGRITY OFFICER. A FORM IS USUALLY SUBMITTED TO ALL BOARD MEMBERS, BOARD COMMITTEE MEMBERS, AND CERTAIN EMPLOYEES IN KEY POSITIONS ANNUALLY TO BE COMPLETED. REMINDERS ARE USUALLY SENT TO MAKE CERTAIN ALL CONFLICT OF INTEREST FORMS ARE RETURNED.
FORM 990, PART VI, SECTION B, LINE 15	EVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH'S BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003, THE COMPENSATION COMMITTEE HAS ENGAGED A HUMAN RESOURCES CONSULTING FIRM TO CONDUCT THIS ANALYSIS. OBJECTIVES ARE TO ASSESS THE COMPOSITENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS OF THE SENIOR LEADERSHIP TEAM; DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS AND ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF THERE ARE ANY, ARE COMPETITIVE AND REASONABLE.
FORM 990, PART VI, SECTION C, LINE 18	FORM 990 IS AVAILABLE ON THE WEBSITE OF COVENANT HEALTH INC., A RELATED ORGANIZATION (WWW.COVENANTHEALTH.NET).
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON EACH INDIVIDUAL REQUEST.
FORM 990, PART IX, LINE 11G	PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 3,282,623. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,282,623. CONTRACT NURSING PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,187,613. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,187,613. CONTRACTED LABOR - MGMT ADMIN: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,019,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,019,500. INTERCOMPANY MANAGEMENT SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 24,892,613. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,892,613. CONTRACTED LABOR - PROGRAM SERVICES: PROGRAM SERVICE EXPENSES 8,057,644. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,057,644. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 969,545. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 969,545. COLLECTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 279,787. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 279,787. OUTSIDE WORK: PROGRAM SERVICE EXPENSES 3,819,047. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,819,047. LANGUAGE INTERPRETER SERVICES: PROGRAM SERVICE EXPENSES 482,322. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 482,322. MEDICAL TRANSPORT: PROGRAM SERVICE EXPENSES 1,923,462. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,923,462. LOCUM PHYSICIANS: PROGRAM SERVICE EXPENSES 780,539. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 780,539. RADIOLOGY/IMAGING SERVICES: PROGRAM SERVICE EXPENSES 482,231. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 482,231. PATIENT REGISTRATION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 400,685. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 400,685. PURCHASED SERVICES - GENERAL: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 424,331. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 424,331. RADIOLOGY ONCOLOGY SERVICES: PROGRAM SERVICE EXPENSES 102,422. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 102,422. MEDICAL TESTING: PROGRAM SERVICE EXPENSES 912,980. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 912,980.
FORM 990, PART XI, LINE 9:	TRANSFER FROM AFFILIATES -1,259,022. TRANSFER FOR PPE 139,623. OTHER CHANGE RESTRICTED ASSETS -23,089,770.
FORM 990 PART XI, LINE 2C	THE AUDIT COMMITTEE OF COVENANT HEALTH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT AUDITOR.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ST MARY'S REGIONAL MEDICAL CENTER

Employer identification number

01-0211551

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)ST MARY'S HEALTH SYSTEM PO BOX 7291 CAMPUS AVENUE LEWISTON,ME04240 22-2504349	PARENT COMPANY	ME	501(C)(3)	12A	COVENANT HEALTH		No
(2)COMMUNITY CLINICAL SERVICES PO BOX 7291 CAMPUS AVENUE LEWISTON,ME04240 01-0409788	PHYSICIAN PRACTICE	ME	501(C)(3)	10	ST MARY'S HEALTH SYSTEM		No
(3)ST MARY'S RESIDENCES PO BOX 7291 CAMPUS AVENUE LEWISTON,ME04240 22-2504356	LOW INCOME HOUSING	ME	501(C)(3)	10	ST MARY'S HEALTH SYSTEM		No
(4)COVENANT HEALTH 100 AMES POND DRIVE TEWKSBURY,MA01876 22-2484505	HEALTHCARE MANAGEMENT AND RESOURCE ADMINISTRATION	MA	501(C)(3)	10	ST MARY'S HEALTH SYSTEM		No
(5)ST JOSEPH HOSPITAL 360 BROADWAY BANGOR,ME04401 01-0212435	AFFILIATED HOSPITAL	ME	501(C)(3)	10	STJOSEPH HEALTHCARE FOUNDATION		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

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

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

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) CAMPUS HOLDING PO BOX 7291 CAMPUS AVENUE LEWISTON,ME04240 01-0406049	HOLDING COMPANY	ME	N/A	C				No

Schedule R (Form 990) 2018

Page 3

Part V

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

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

Yes

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

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

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

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2018

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) 2018

Page 5

Part VII

Supplemental Information

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

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: ST. MARY'S REGIONAL MEDICAL CENTER IS A 233-LICENSED BED ACUTE CARE FACILITY THAT OFFERS THE BEST OF MEDICAL TECHNOLOGY, PREVENTIVE SERVICES AND A "WHOLE PERSON APPROACH" IN MEETING THE NEEDS OF THE ANDROSCOGGIN COUNTY AREA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	1,858
6	Total number of volunteers (estimate if necessary) .............	6	144
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	163,736

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	26,312,432	1,469,384
9	Program service revenue (Part VIII, line 2g) .........	203,298,869	206,534,258
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,184,715	492,949
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	73,506	-1,076
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	230,869,522	208,495,515
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	105,417,810	108,053,214
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)....	100,236,559	124,815,760
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	205,654,369	232,868,974
19	Revenue less expenses. Subtract line 18 from line 12.......	25,215,153	-24,373,459
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	182,429,066	148,573,306
21	Total liabilities (Part X, line 26).............	63,847,284	79,197,702
22	Net assets or fund balances. Subtract line 21 from line 20.....	118,581,782	69,375,604

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 32,647,920 including grants of $ ) (Revenue $ 36,718,401 )
	SURGICAL CARE: PROVIDES ALL SERVICES (EXCEPT OPEN HEART) TO PATIENTS RANGING FROM INFANT TO GERIATRICS WHO NEED SURGICAL INTERVENTION. TOTAL PATIENT DAYS = 8,496

4b	(Code: ) (Expenses $ 9,467,499 including grants of $ ) (Revenue $ 10,647,889 )
	BEHAVIORAL HEALTH: ST. MARY'S OFFERS THE MOST ADVANCED BEHAVIORAL HEALTHCARE DIAGNOSTIC AND TREATMENT SERVICES FOR CHILDREN, ADOLESCENTS AND ADULTS IN BOTH INPATIENT AND OUTPATIENT PROGRAMS. INPATIENT AND OUTPATIENT TREATMENTS INCLUDE COMPREHENSIVE PSYCHIATRIC ASSESSMENT AND EVALUATIONS, EDUCATION, INDIVIDUAL AND GROUP THERAPY, INDIVIDUALIZED BIO-PSYCHOSOCIAL TREATMENT PLAN AND DISCHARGE AND AFTERCARE PLANNING.TOTAL PATIENT DAYS = 15,317

4c	(Code: ) (Expenses $ 10,461,590 including grants of $ ) (Revenue $ 11,765,921 )
	EMERGENCY CARE: ST. MARY'S REGIONAL MEDICAL CENTER OFFERS A 24-HOUR PER DAY LEVEL II EMERGENCY CARE FACILITY. SERVICES PROVIDED INCLUDE MEDICAL AND BEHAVIORAL SERVICES. TOTAL VISITS = 28,394

	(Code: ) (Expenses $ 116,954,252 including grants of $ ) (Revenue $ 147,402,047 )
	PHYSICIAN SERVICES, ORTHOPEDICS, CHEMICAL DEPENDENCY SERVICES, OB/GYN WOMEN'S HEALTH SERVICES, NURSERY, ICU, PACU, INFUSION THERAPY, URGENT CARE, FAMILY PRACTICE SERVICES, ENDOSCOPY, NEUROLOGY, LAB SERVICES, DIAGNOSTIC RADIOLOGY, MRI, MAMMOGRAPHY, ULTRASOUND, NUCLEAR MEDICINE, CT SCANS, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, RESPIRATORY THERAPY, PULMONARY REHAB, DIAGNOSTIC CARDIOLOGY, CATH LAB, PHARMACY, AMBULANCE SERVICES, PHYSIATRY SERVICES, UROLOGY, SLEEP LAB, DIABETES CENTER SERVICES, WOUND & HYPERBARIC CENTER SERVICES, GASTROENTEROLOGY, RHEUMATOLOGY,WEIGHT MANAGEMENT SERVICES, AND SKILLED NURSING FACILITY/NURSING HOME SERVICES.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 116,954,252 including grants of $ ) (Revenue $ 147,402,047 )
4e	Total program service expenses169,531,261

(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)				(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) JOAN DAIGNEAULT BEG 72418........................................................................ SECRETARY	40.00 .......................0.20	X	X			45,897	0	970
(19) MONIQUE SHRADER END 72018........................................................................ SECRETARY	40.00 .......................0.20	X	X			51,949	0	13,525
(20) PHILIP HICKEY........................................................................ CEO POST ACUTE	40.00 .......................			X		213,442	0	8,936
(21) CHRISTOPHER T BOWE........................................................................ CHIEF MEDICAL OFFICER	40.00 .......................			X		397,423	0	25,741
(22) KAREN J CLARK........................................................................ VP PATIENT CARE SERVICES	40.00 .......................			X		213,076	0	26,737
(23) MICHAEL T NEWMAN........................................................................ PHYSICIAN	40.00 .......................				X	917,260	0	34,101
(24) JOSEPH E STRAUSS........................................................................ PHYSICIAN	40.00 .......................				X	831,148	0	33,237
(25) JEFFREY N DAVILA........................................................................ PHYSICIAN	40.00 .......................				X	719,293	0	2,004
(26) GREGORY POMEROY........................................................................ PHYSICIAN	40.00 .......................				X	575,508	0	21,821
(27) MICHAEL PARKER........................................................................ PHYSICIAN	40.00 .......................				X	557,483	0	20,534

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,025,434	470,984	255,690

1a	Federated campaigns..		1a	12,442
b	Membership dues..		1b
c	Fundraising events..		1c	60,900
d	Related organizations		1d	12,250
e	Government grants (contributions)		1e	8,763

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,375,029

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		1,469,384

		Business Code
2a	NET PATIENT SERVICE REVENUE	621300	190,668,099	190,668,099
b	SERVICES TO AFFILIATES	621300	8,312,709	8,312,709
c	OTHER OPERATING INCOME	621300	7,553,450	7,553,450
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		206,534,258

3 Investment income (including dividends, interest, and othersimilar amounts) ......			319,549			319,549
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	173,400
b	Less: cost or other basis and sales expenses	0
c	Gain or (loss)	173,400
d	Net gain or (loss).....			173,400			173,400
8a	Gross income from fundraising events (not including $ 60,900of contributions reported on line 1c). See Part IV, line 18 ....
	a		9,007
b	Less: direct expenses ...b		10,083
c	Net income or (loss) from fundraising events..			-1,076			-1,076
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			208,495,515	206,534,258	0	491,873

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to domestic individuals. See Part IV, line 22
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	1,525,975	951,443	574,532
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	90,162,036	68,772,973	21,389,063
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	487,685	360,887	126,798
9	Other employee benefits .......	10,044,378	7,432,840	2,611,538
10	Payroll taxes ...........	5,833,140	4,316,524	1,516,616
11	Fees for services (non-employees):
a	Management ......	1,974,573	1,461,184	513,389
b	Legal .........	384,882		384,882
c	Accounting ...........	83,639		83,639
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	55,017,344	27,000,428	28,016,916
12	Advertising and promotion ....	51,089		51,089
13	Office expenses .......	5,227,128	3,868,075	1,359,053
14	Information technology ......	1,536,555	1,137,051	399,504
15	Royalties ..
16	Occupancy ...........	5,002,459	3,701,820	1,300,639
17	Travel ............	519,229	384,229	135,000
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	1,370,909	1,014,473	356,436
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	5,528,668	4,091,214	1,437,454
23	Insurance ...	2,981,516	2,206,322	775,194
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/PHARMACY SUPPLI	23,545,192	23,545,192
b	BAD DEBT EXPENSE	12,547,179	12,547,179
c	PROVIDER TAX	4,544,056	4,544,056
d	EQUIPMENT RENTAL & REPA	2,421,224	1,105,461	1,315,763
e	All other expenses	2,080,118	1,089,910	990,208
25	Total functional expenses. Add lines 1 through 24e	232,868,974	169,531,261	63,337,713	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 ........			2,860,100	1	11,788,673
2	Savings and temporary cash investments .........			2,549,271	2	3,787,257
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			23,303,523	4	27,200,907
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			1,824,785	8	1,633,052
9	Prepaid expenses and deferred charges ......			1,619,887	9	3,095,222
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	152,602,575
b	Less: accumulated depreciation	10b	93,781,720	59,511,341	10c	58,820,855
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			90,760,159	15	42,247,340
16	Total assets. Add lines 1 through 15 (must equal line 34)...			182,429,066	16	148,573,306

17	Accounts payable and accrued expenses .....	19,941,788	17	24,018,165
18	Grants payable ...		18
19	Deferred revenue .........	676,272	19	731,394
20	Tax-exempt bond liabilities .........	42,577,122	20	40,833,947
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	502,235	23	318,632
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	149,867	25	13,295,564
26	Total liabilities. Add lines 17 through 25..	63,847,284	26	79,197,702

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	88,583,731	27	61,569,936
28	Temporarily restricted net assets ...........	6,201,269	28	7,098,639
29	Permanently restricted net assets	23,796,782	29	707,029
	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 ...........	118,581,782	33	69,375,604
34	Total liabilities and net assets/fund balances ........	182,429,066	34	148,573,306