TY 2019 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) CHRIS BARBER...................................................................... PRESIDENT/CEO	1.0 ................. 40.0		X		0	669,486	38,816
(2) DON HOWARD...................................................................... INTENSIVIST	40.0 ................. 0.0			X	692,302	0	13,794
(3) CHITHARANJAN DUVOOR...................................................................... ENDOCRINOLOGIST	40.0 ................. 0.0			X	497,735	0	21,703
(4) MONA PARIKH...................................................................... INTENSIVIST	40.0 ................. 0.0			X	467,526	0	30,326
(5) JORDAN JANIK...................................................................... HOSPITALIST	40.0 ................. 0.0			X	439,432	0	25,925
(6) MICHELLE SCHOFIELD...................................................................... PSYCHIATRIST	40.0 ................. 0.0			X	431,572	0	25,167
(7) MICHAEL GIVENS...................................................................... ADMINISTRATOR	40.0 ................. 0.0		X		301,877	0	15,616
(8) BEN BARYLSKE...................................................................... CFO	1.0 ................. 40.0		X		0	229,154	14,726
(9) MOTHER JOHANNA MARIE MELYNK...................................................................... CHAIRPERSON	1.0 ................. 1.0	X	X		0	0	0
(10) SISTER ANNE MARIE FERRICHER...................................................................... MEMBER	1.0 ................. 0.0	X			0	0	0
(11) BRIAN HYNEMANN...................................................................... MEMBER	1.0 ................. 0.0	X			0	0	0
(12) GUY PATTESON...................................................................... PRESIDENT ADVISORY BOARD	1.0 ................. 1.0	X			0	0	0
(13) JOHN FREEMAN...................................................................... MEMBER	1.0 ................. 0.0	X			0	0	0
(14) LINDA WOFFORD...................................................................... MEMBER	1.0 ................. 0.0	X			0	0	0
(15) SISTER MARIE CHRISTI CAVANAUGH...................................................................... MEMBER	1.0 ................. 1.0	X			0	0	0
(16) MATT GARNER...................................................................... MEMBER	1.0 ................. 0.0	X			0	0	0
(17) RANDY MCNEIL...................................................................... MEMBER	1.0 ................. 0.0	X			0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
NABHOLZ CLIENT SERVICE, PO BOX 2090 CONWAY,AR72033	CONSTRUCTION	42,184,008
CLAYRIDGE EMERGENCY STAFFING, 911 LAKECREST DRIVE JONESBORO,AR72404	PHYSICIAN SERVICES	7,747,358
THERAPY PROVIDERS, PO BOX 9174 JONESBORO,AR72403	PHYSICAL THERAPY	8,476,543
GUARDIAN HEALTHCARE PROVIDERS, PO BOX 306098 NASHVILLE,TN37230	NURSING SERVICES	2,220,107
MEDDATA INCORPORATED, PO BOX 8403 CAROL STREAM,IL601978403	BILLING & COLLECTION	1,049,879
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 101

- 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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

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) 2019

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

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) 2019

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) 2019

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) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, 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 2019. 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 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

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

2019

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization ST BERNARDS HOSPITAL INC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization ST BERNARDS HOSPITAL INC		Employer identification number 71-0290019

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization ST BERNARDS HOSPITAL INC			Employer identification number 71-0290019
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) (2019)

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

2019

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 BERNARDS HOSPITAL INC

Employer identification number

71-0290019

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) 2019

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) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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|No

(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? .......................

Yes

8,250

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

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

Yes

41,564

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

49,814

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
FORM 990, SCHEDULE C, PAGE 3, PART II-B, LINE 1I	PERCENTAGE OF DUES TO VARIOUS PROFESSIONAL ASSOCIATIONS ALLOCABLE TO LOBBYING EXPENSES $41,564.

Schedule C (Form 990 or 990EZ) 2019

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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

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 FASB 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 FASB 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 FASB 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) 2019

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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

Part V

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

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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

Part VI

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

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

1a	Land .....	8,621,184		8,621,184
b	Buildings ....	216,744,862	84,881,018	131,863,844
c	Leasehold improvements	7,658,502	3,853,183	3,805,319
d	Equipment ....	150,004,934	108,790,547	41,214,387
e	Other .....	1,492,352	0	1,492,352
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				186,997,086

Schedule D (Form 990) 2019

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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	57,963,201
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) 2019

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	444,471,409
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	33,446
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	33,446
3	Subtract line 2e from line 1..................			3	444,437,963
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	31,453,829
c	Add lines 4a and 4b....................			4c	31,453,829
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	475,891,792

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	398,904,417
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	398,904,417
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	31,453,829
c	Add lines 4a and 4b.....................			4c	31,453,829
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	430,358,246

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
FORM 990, SCHEDULE D, PART XI, LINE 4B	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
FORM 990, SCHEDULE D, PART XI, LINE 4B	PROVISION FOR UNCOLLECTIBLE ACCOUNTS $31,453,829
FORM 990, SCHEDULE D, PART XII, LINE 4B	PROVISION FOR UNCOLLECTIBLE ACCOUNTS $31,453,829

Schedule D (Form 990) 2019

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

2019

Open to Public Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		76,427	7,747,730		7,747,730	1.940 %
b	Medicaid (from Worksheet 3, column a) . . . . .
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		76,427	7,747,730		7,747,730	1.940 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	10	6,624	148,329	11,192	137,137	0.030 %
f	Health professions education (from Worksheet 5) . . .	3	15	3,208,129		3,208,129	0.800 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	5	34,779	2,132,696		2,132,696	0.530 %
j	Total. Other Benefits . .	18	41,418	5,489,154	11,192	5,477,962	1.360 %
k	Total. Add lines 7d and 7j .	18	117,845	13,236,884	11,192	13,225,692	3.300 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	2	433	2,679,841	2,679,841	0.670 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	2	433	2,679,841	2,679,841	0.670 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

31,453,829

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. ......

15,726,915

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

Section B. Medicare

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

130,871,145

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

126,444,234

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

4,426,911

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 2019

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?3Name, 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)								Other (describe)	Facility reporting group
1	ST BERNARDS MEDICAL CENTER 225 EAST WASHINGTON JONESBORO,AR72401 WWW.STBERNARDS.INFO/ AR4053	X	X	X	X	X	X	FAST TRACK ER	A
2	ST BERNARDS MED CTR BEHAV HEALTH 225 EAST WASHINGTON JONESBORO,AR72401 WWW.STBERNARDS.INFO/ AR4645	X						ADULT PSYCH	A
3	ENCOMPASS HEALTH REHAB HOSPITAL 1201 FLEMING AVENUE JONESBORO,AR72401 WWW.ENCOMPASSHEALTH.COM AR5517	X						REHABILITATION	B

Schedule H (Form 990) 2019

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)

	A
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 18

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

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.STBERNARDS.INFO

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

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

If "Yes" (list url):

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

10b

Yes

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
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 100%
and FPG family income limit for eligibility for discounted care of 300.%

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.STBERNARDS.INFO

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

WWW.STBERNARDS.INFO

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

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) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
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 (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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) 2019

Page 7

Part VFacility Information (continued)

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

	A
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) 2019

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)

	ENCOMPASS HEALTH REHAB HOSPITAL
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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 18

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

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):

Other website (list url): WWW.STBERNARDS.INFO

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 18

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

If "Yes" (list url):

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

10b

Yes

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ENCOMPASS HEALTH REHAB HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 400.%

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

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):

SEE PART V, SECTION C

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

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

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

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

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

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) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	ENCOMPASS HEALTH REHAB HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

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 (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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) 2019

Page 7

Part VFacility Information (continued)

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

	ENCOMPASS HEALTH REHAB HOSPITAL
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 prospective Medicare or Medicaid method

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) 2019

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, 20a, 20b, 20c, 20d, 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
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5	INTERVIEWING KEY INFORMANTS (COMMUNITY STAKEHOLDERS THAT REPRESENT THE BROAD INTEREST OF THE COMMUNITY WITH KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH) IS A TECHNIQUE EMPLOYED TO ASSESS PUBLIC PERCEPTIONS OF THE COUNTY'S HEALTH STATUS AND UNMET NEEDS. THESE INTERVIEWS ARE INTENDED TO ASCERTAIN OPINIONS AMONG INDIVIDUALS LIKELY TO BE KNOWLEDGEABLABOUT THE COMMUNITY AND INFLUENTIAL OVER THE OPINIONS OF OTHERS ABOUT HEALTH CONCERNS IN THE COMMUNITY. INTERVIEWS WITH 71 KEY INFORMANTS WERE CONDUCTED. INFORMANTS WERE DETERMINED BASED ON THEIR SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH OR THEIR INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS. ALL INTERVIEWS WERE CONDUCTED BY MEDICAL CENTER PERSONNEL USING A STANDARD QUESTIONNAIRE.
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 6A	CHNA WAS CONDUCTED WITH ENCOMPASS HEALTH REHABILITATION HOSPITAL OF JONESBORO.
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11	ALTHOUGH ST. BERNARDS MEDICAL CENTER (SBMC) RECOGNIZES THE IMPORTANCE OF ALL THE NEEDS IDENTIFIED BY THE COMMUNITY, SBMC WILL NOT DIRECTLY DESIGN STRATEGIES FOR ALL THESE NEEDS IN THE IMPLEMENTATION PLAN. PRIORITY WAS GIVEN TO THE FIVE TOP IDENTIFIED NEEDS AS WELL AS THE HEALTH NEEDS IN WHICH THE MEDICAL CENTER IS MOST CAPABLE OF DIRECTLY INFLUENCING. THE REMAINING IDENTIFIED NEEDS WERE DIVIDED INTO NEEDS ST. BERNARDS WILL CONTINUE TO ADDRESS THROUGH PROGRAMS AND SERVICES OFFERED BY THE MEDICAL CENTER. NEEDS ST. BERNARDS WILL NOT DIRECTLY ADDRESS BUT WILL COLLABORATE AND SUPPORT ORGANIZATIONS WITHIN THE COMMUNITY IN ORDER TO ADDRESS THESE NEEDS AND NEEDS ST. BERNARDS WILL NOT BE ADDRESSING. SEE THE ATTACHED IMPLEMENTATION STRATEGY FOR A MORE DETAILED APPROACH. THE TOP FIVE SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENT CHNA CONDUCTED ARE: 1. OBESITY: THE HOSPITAL WILL CONTINUE TO PROVIDE A VARIETY OF FREE COMMUNITY HEALTH SCREENINGS. EDUCATION SESSIONS WILL BE PROVIDED TO HELP EDUCATE PARTICIPANTS ON WAYS TO MANAGE CHRONIC ILLNESSES & GUIDELINES FOR WEIGHT LOSS MANAGEMENT. THE MEDICAL CENTER WILL CONTINUE TO PROVIDE PROGRAMS THAT WILL HELP COMBAT OBESITY. 2. DIABETES: COMPREHENSIVE DIABETES EDUCATION WILL BE AVAILABLE. THE HOSPITAL WILL RECRUIT AN ENDOCRINOLOGIST TO PROVIDE CARE TO THE DIABETIC POPULATION. THE DIABETES EMPOWERMENT EDUCATION PROGRAM (DEEP) WAS IMPLEMENTED IN JULY 2016 TO HELP DIABETICS & CAREGIVERS. 3. HEART DISEASE: CPR AND AED EDUCATION WILL BE AVAILABLE TO THE COMMUNITY. THE HEART ATTACK TREATMENT PROGRAM WILL PROVIDE SIGNS AND SYMPTOMS EDUCATION TO PATIENTS. 4. CANCER: DIFFERENT TYPES OF CANCER SCREENING WILL BE AVAILABLE TO PATIENTS. CONTINUED SUPPORT FOR THE LOCAL CANCER EVENTS WILL HELP PROMOTE CANCER AWARENESS AND EDUCATION. 5. DEPRESSION: DEPRESSION SCREENINGS WILL BE PROVIDED FOR FREE TO INDIVIDUALS THAT ATTEND A COMMUNITY SCREENING. AFTER COMPLETION OF THE DEPRESSION SCREENING THE PARTICIPANT CAN CONTACT ST BERNARDS BEHAVIORAL HEALTH TO DETERMINE THE TYPE OF CARE THEY ARE IN NEED OF. ST BERNARDS WILL PARTNER WITH LOCAL FACILITIES TO PROVIDE FREE EDUCATIONAL SEMINARS ON MENTAL HEALTH. ST. BERNARDS HAS CHOSEN NOT TO ADDRESS THE FOLLOWING NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSTMENT BECAUSE OTHER ORGANIZATIONS ARE BETTER EQUIPPED TO ADDRESS THESE: -HEALTH EDUCATION -CHILDREN IN POVERTY -PREVENTABLE HOSPITAL STAYS/UNINTENTIONAL INJURIES -ACCESS TO HEALTH FOODS
FORM 990, SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, & 16C	WWW.ENCOMPASSHEALTH.COM/LOCATIONS/JONESBOROREHAB/FINANCIAL-ASSISTANCE
FORM 990, SCHEDULE H, PART V, SECTION B, LINE 20E	THE FOLLOWING STATEMENT APPLIES TO ALL LICENSED HOSPITAL FACILITIES LISTED IN PART V, SECTION A. HOSPITAL FACILITIES INCLUDE A COPY OF THE FINANCIAL ASSISTANCE POLICY IN THE DISCHARGE PACKET GIVEN TO SELF PAY PATIENTS.

Schedule H (Form 990) 2019

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?45
Name and address		Type of Facility (describe)
1	ST BERNARD'S IMAGING CENTER 1144 EAST MATTHEWS JONESBORO,AR72401	IMAGING CENTER
2	REFERENCE LAB 1150 EAST MATTHEWS JONESBORO,AR72401	REFERENCE LAB
3	DIALYSIS 540 EAST WASHINGTON JONESBORO,AR72401	DIALYSIS
4	ST BERNARD'S BEHAVIORAL HEALTH UNIT 2712 EAST JOHNSON AVE JONESBORO,AR72401	BEHAVIORAL HEALTH
5	PHYSICAL THERAPY 225 EAST WASHINGTON JONESBORO,AR72401	PHYSICAL THERAPY
6	ST BERNARD'S WOUND HEALING CENTER 505 EAST MATTHEWS SUITE 201 JONESBORO,AR72401	WOUND HEALING
7	ST BERNARD'S HOME HEALTH 1726 MARIE CIRCLE JONESBORO,AR72401	HOME HEALTH
8	ST BERNARD'S HOSPICE 1726 MARIE CIRCLE JONESBORO,AR72401	HOSPICE
9	ST BERNARDS SENIOR HEALTH CLINIC 303 EAST MATTHEWS SUITE 202 JONESBORO,AR72401	SENIOR HEALTH
10	PHYSICAL THERAPY SPORTS MEDICINE 1416 EAST MATTHEWS JONESBORO,AR72401	PHYSICAL THERAPY
11	DIALYSIS - WYNNE 310 S FALLS BLVD WYNNE,AR72396	DIALYSIS
12	FLO AND PHIL JONES HOSPICE HOUSE 1148 EAST MATTHEWS JONESBORO,AR72401	HOSPICE HOUSE
13	PHYSICAL THERAPY ASUSPORTS MEDICINE 333 STADIUM BLVD JONESBORO,AR72401	PHYSICAL THERAPY
14	PHYSICAL THERAPY SOUTHWEST DRIVE 3109 SOUTHWEST DRIVE JONESBORO,AR72401	PHYSICAL THERAPY
15	PHYSICAL THERAPY PARAGOULD 400 LINWOOD PARAGOULD,AR72450	PHYSICAL THERAPY
16	PHYSICAL THERAPY SPEECH THERAPY 225 EAST WASHINGTON JONESBORO,AR72401	SPEECH THERAPY
17	PHYSICAL THERAPY - OCCUPATIONAL 4334 EAST HIGHLAND SUITE C JONESBORO,AR72401	OCCUPATIONAL THERAPY
18	PHYSICAL THERAPY TRUMANN 1300 INDUSTRIAL DR TRUMANN,AR72472	PHYSICAL THERAPY
19	PHYSICAL THERAPY INDUSTRIAL REHAB 4334 EAST HIGHLAND SUITE C JONESBORO,AR72401	PHYSICAL THERAPY
20	PRE-ADMISSION TESTING 105 EAST MATTHEWS JONESBORO,AR72401	TESTING FACILITY
21	PHYSICAL THERAPY MANILA 3644 W STATE HWY 18 MANILA,AR72442	PHYSICAL THERAPY
22	ST BERNARDS BEHAVIORAL COUNSELING CTR 615A EAST MATTHEWS JONESBORO,AR72401	COUNSELING CENTER
23	CARDIAC REHABILITATION 1416 EAST MATTHEWS JONESBORO,AR72401	CARDIAC REHAB
24	DIABETES MANAGEMENT CENTER 1416 EAST MATTHEWS JONESBORO,AR72401	DIABETES MANAGEMENT
25	ST BERNARD'S PET CENTER LLC PO BOX 13267 MAUMELLE,AR72113	PET SCANNING
26	WOUND HEALING - PARAGOULD 4000 LINWOOD PARAGOULD,AR72450	WOUND HEALING
27	WOUND HEALING - WALNUT RIDGE 1309 WEST MAIN ST WALNUT RIDGE,AR72476	WOUND HEALING
28	INFUSION CENTER- PARAGOULD 4000 LINWOOD PARAGOULD,AR72450	INFUSION
29	PRE-ADMISSION TESTING - PMP 4000 LINWOOD PARAGOULD,AR72450	TESTING FACILITY
30	LABS- MANILA 3644 W STATE HWY 18 MANILA,AR72442	LAB
31	RADIOLOGY-MANILA 3644 W STATE HWY 18 MANILA,AR72442	IMAGING/RADIOLOGY
32	PRE-ADMISSION TESTING-MANILA 3644 W STATE HWY 18 MANILA,AR72442	TESTING FACILITY
33	WOUND HEALING CENTER- MANILA 3644 W STATE HWY 18 MANILA,AR72442	WOUND HEALING
34	NONINVASIVE CARDIOLOGY - PARAGOULD 314 SOUTH 12TH ST PARAGOULD,AR72450	NONINVASIVE CARDIOLOGY
35	NUCLEAR MED - PARAGOULD 314 SOUTH 12TH ST PARAGOULD,AR72450	NUCLEAR MEDICINE
36	DIALYSIS - HEALTHSOUTH 1201 FLEMING AVE JONESBORO,AR72401	DIALYSIS
37	PHYSICAL THERAPY - VILLA 2217 W PARKER RD JONESBORO,AR72404	PHYSICAL THERAPY
38	ST BERNARD'S WOMEN'S CLINIC 4334 EAST HIGHLAND DRIVE JONESBORO,AR72401	WOMEN'S CLINIC
39	IMOSTEOPATHIC RESIDENCY CLINIC 300 CARSON STREET JONESBORO,AR72401	RESIDENCY CLINIC
40	WOUND HEALING - WYNNE 310 S FALLS BLVD WYNNE,AR72396	WOUND HEALING
41	SLEEP CENTER 105 E MATTHEWS STE B JONESBORO,AR72401	SLEEP CENTER
42	WOUND HEALING-FRMC 2801 MEDICAL CENTER DRIVE POCAHONTAS,AR72455	WOUND HEALING
43	DIALYSIS - OSCEOLA 1332 W KEISER OSCEOLA,AR72370	DIALYSIS
44	GI CLINIC 1007 E MATTHEWS JONESBORO,AR72401	GASTROENTEROLOGY CLINIC
45	UROLOGY CLINIC 303 E MATTHEWS JONESBORO,AR72401	UROLOGY CLINIC

Schedule H (Form 990) 2019

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
FORM 990, SCHEDULE H, PART I, LINE 7, COLUMN F	BAD DEBT EXPENSE IN THE AMOUNT OF $31,453,829 IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) ("TOTAL FUNCTIONAL EXPENSES"), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN.
FORM 990, SCHEDULE H, PART I, LINE 7	THE AMOUNTS ON LINE 7A WERE CALCULATED USING THE COST TO CHARGE RATIO.
FORM 990, SCHEDULE H, PART II, LINE 3	DISASTER PREPAREDNESS DRILLS AND PLANNING.
FORM 990, SCHEDULE H, PART III, LINE 2	ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND CO-PAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE 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 OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
FORM 990, SCHEDULE H, PART III, LINE 3	DETERMINED BY ANALYZING ACCOUNTS THAT HAVE BEEN DENIED FINANCIAL ASSISTANCE DUE TO A LACK OF DOCUMENTATION. MANY TIMES WE ARE UNABLE TO GET PATIENTS WHO WE THINK WOULD QUALIFY FOR CHARITY TO COMPLETE OUR CHARITY APPLICATION. OFTEN TIMES WE DON'T CLASSIFY SOMEONE AS CHARITY WHO WOULD EASILY QUALIFY IF THEY WOULD JUST COMPLETE THE PAPER WORK. SOMETIMES, DUE TO FAULTY ADDRESSES, WE CANNOT CONTACT THESE PATIENTS TO ATTEMPT TO QUALIFY THEM AS CHARITY. THERE IS A SIGNIFICANT AMOUNT OF BAD DEBT THAT IS, IN REALITY, CHARITY.
FORM 990, SCHEDULE H, PART III, LINE 4	SEE ATTACHED AUDIT REPORT FOOTNOTE #2.
FORM 990, SCHEDULE H, PART III, LINE 8	THE AMOUNTS WERE PULLED FROM THE MOST RECENT "AS FILED" MEDICARE COST REPORT. THE ORGANIZATION FOLLOWS CHA COMMUNITY BENEFIT GUIDELINES AND DOES NOT COUNT MEDICARE SHORTFALL AS COMMUNITY BENEFIT.
FORM 990, SCHEDULE H, PART III, LINE 9B	ACCOUNTS WHICH ARE DEEMED UNCOLLECTIBLE ARE REFERRED TO AN OUTSIDE AGENCY FOR COLLECTING. AN ACCOUNT IS CONSIDERED UNCOLLECTIBLE WHEN THE GUARANTOR HAS HAD SUFFICIENT NOTICE AND TIME TO PAY A BILL OR MAKE ARRANGEMENTS TO PAY A BILL, BUT HAS FAILED TO DO SO. MEDICARE BAD DEBT IS DEFINED ACCORDING TO CENTERS FOR MEDICARE AND MEDICAID SERVICES GUIDELINES. ONCE A PATIENT IS DETERMINED TO BE FAP-ELIGIBLE, WHETHER UNDER PRESUMPTIVE ELIGIBILITY OR THROUGH THE FAP APPLICATION PROCESS, ALL EXTRAORDINARY COLLECTION ACTIONS WHICH HAVE PREVIOUSLY BEEN TAKEN CEASE. THE INDIVIDUAL IS PROVIDED WITH A BILLING STATEMENT WHICH INCLUDES THE AMOUNT THE INDIVIDUAL OWES FOR THE CARE AS A FAP-ELIGIBLE INDIVIDUAL. THE INDIVIDUAL IS REFUNDED ANY AMOUNT HE OR SHE HAS PAID FOR CARE WHICH EXCEEDS THE AMOUNT HE OR SHE IS DETERMINED TO BE PERSONALLY RESPONSIBLE FOR PAYING AS A FAP-ELIGIBLE INDIVIDUAL. THE HOSPITAL ALSO TAKES ALL REASONABLY AVAILABLE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS PREVIOUSLY TAKEN.
FORM 990, SCHEDULE H, PART VI, LINE 2	ST. BERNARDS HOSPITAL ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES BY REVIEWING DATA GATHERED THROUGHOUT THE CHNA ASSESSMENT. THE ASSESSMENT INCLUDES DATA ON LEADING CAUSES OF DEATH, RANKINGS OF HEALTH OUTCOMES AND FACTORS, AND SURVEYS AND INTERVIEWS WITH INDIVIDUALS WITHIN THE COMMUNITIES SERVED. ST. BERNARDS HEALTHCARE ADDRESSES COMMUNITY HEALTH NEEDS BY IMPLEMENTING HEALTH PROMOTION, PREVENTION INTERVENTION, AND HEALTHCARE SERVICES TO THE UNINSURED, UNDERINSURED, AND UNDERSERVED POPULATIONS IN OUR PRIMARY SERVICE AREAS.
FORM 990, SCHEDULE H, PART VI, LINE 3	ALL REGISTRATION AREAS HAVE OUR FINANCIAL ASSISTANCE NOTICE EITHER ON THE REGISTRATION DESK, ON THE WALL AT REGISTRATION OR IN A DISPLAY CASE IN REGISTRATION. THIS INCLUDES, GENERAL ADMISSIONS, RADIOLOGY, ER (ALSO EVERY ROOM IN THE ER), DIALYSIS, RADIATION ONCOLOGY AND HEARTCARE CENTER, IMAGING CENTER AND WOUND CENTER. UPON REGISTRATION, IF REGISTERED AS A SELF PAY, A FINANCIAL APPLICATION AUTOMATICALLY PRINTS AND IS GIVEN TO THE PATIENT. APPLICATIONS ALONG WITH SBHC ENVELOPES ARE DISPLAYED AT THE DESK FOR ANYONE TO PICK UP. INFORMATION AND TELEPHONE NUMBERS ARE ON THE BACK OF ALL OUR STATEMENTS AND LETTERS THAT GO OUT TO PATIENTS. A THIRD PARTY LOOKS AT ALL INPATIENTS THAT ARE SELF PAY AND CONTACTS THE PATIENT TO SEE IF THEY WOULD BE ELIGIBLE FOR MEDICAID, CHARITY, OR ANY OTHER ASSISTANCE. OUR FINANCIAL ASSISTANCE APPLICATION AND PHONE NUMBER ARE ALSO AVAILABLE ON OUR WEB SITE WWW.STBERNARDS.INFO AND FINANCIAL ASSISTANCE INFORMATION IS PRINTED ON EACH STATEMENT MAILED TO PATIENTS. A REASONABLE EFFORT TO ORALLY NOTIFY PATIENTS REGARDING FINANCIAL ASSISTANCE AND HOW IT MAY BE OBTAINED IS ALSO MADE.
FORM 990, SCHEDULE H, PART VI, LINE 4	ST. BERNARDS HEALTHCARE (SBHC), A NOT-FOR-PROFIT HEALTH SYSTEM, IS GUIDED BY A COMMUNITY-BASED CHARITABLE MISSION. ALTHOUGH THE ORGANIZATION'S FIRST PRIORITY IS TO PROVIDE QUALITY HEALTHCARE, AS A CORPORATE LEADER, SBHC RECOGNIZES THE POSITIVE AND CRITICAL IMPACT OF ITS COMMUNITY HEALTH INITIATIVES FOR THE RESIDENTS OF NORTHEAST ARKANSAS AND SOUTHEAST MISSOURI. THE SERVICE AREA IS DEFINED AS 23 COUNTIES, 17 IN ARKANSAS AND SIX IN MISSOURI. THE COUNTIES HAVE BEEN DIVIDED INTO PRIMARY, SECONDARY AND TERTIARY SERVICES BASED ON ADMISSIONS BY COUNTY. OF THE 23 COUNTIES, 18 COUNTIES ARE HEALTH PROFESSIONAL SHORTAGE AREAS AND 22 COUNTIES INCLUDE MEDICALLY UNDERSERVED AREAS OR MEDICALLY UNDERSERVED POPULATIONS. ACCORDING TO 2018 PROJECTIONS BASED ON THE MOST RECENT U.S. CENSUS BUREAU ESTIMATES, ABOUT 291,000 PEOPLE LIVE IN THE EIGHT COUNTIES INCLUDED IN THE COMMUNITY. JONESBORO, ARKANSAS IS THE LARGEST CITY IN THE COMMUNITY WITH A POPULATION OF APPROXIMATELY 76,000 PEOPLE. THE AVERAGE MEDIAN HOUSEHOLD INCOME IN THE MEDICAL CENTER'S COMMUNITY IS $39,034, COMPARED TO $43,813 FOR THE STATE OF ARKANSAS AND $57,6524 FOR THE UNITED STATES. BOTH THE SECONDARY AND TERTIARY SERVICE AREAS FALL BELOW THAT OF THE PRIMARY SERVICE AREA. LOWER THAN AVERAGE, MEDIAN HOUSEHOLD INCOME SUGGESTS THAT MANY MEMBERS OF THE COMMUNITY MAY HAVE DIFFICULTY OBTAINING HEALTH CARE, ESPECIALLY PREVENTATIVE CARE.
FORM 990, SCHEDULE H, PART VI, LINE 5	THE HOSPITAL COORDINATES THE ARKANSAS HOSPITAL PREPAREDNESS PROGRAM FOR THE NORTHEAST REGION OF THE STATE. THE PURPOSE IS TO ENHANCE THE CAPACITIES AND CAPABILITIES OF HEALTHCARE SYSTEMS AND FOR EXERCISING AND IMPROVING PREPAREDNESS PLANS FOR ALL-HAZARDS INCLUDING PANDEMIC INFLUENZA. THE COUNTIES WITHIN THE REGION ARE CLAY, CRAIGHEAD, CRITTENDEN, CROSS, GREENE, LAWRENCE, LEE, MISSISSIPPI, MONROE, PHILLIPS, POINSETT, PRAIRIE, RANDOLPH AND ST. FRANCIS COUNTIES. THE REGION PARTICIPATES IN TESTING AND USING THE TANDBERGS VIDEO CONFERENCING SYSTEM. THE REGION WORKS WITH ADH TO COORDINATE AND ENSURE MAINTENANCE OF THE LINE FOR THE TANDBERGS. THE REGION USES EMSYSTEMS EMRESOURCE FOR HOSPITAL BED TRACKING. ST BERNARDS PROVIDES A BIOTERRORISM PREPAREDNESS COORDINATOR WHO SERVES AS A CENTRAL POINT OF CONTACT FOR EMERGENCY PREPAREDNESS ACTIVITIES OF THE ARKANSAS DEPARTMENT OF HEALTH & HUMAN SERVICES. THE HOSPITAL CONDUCTS BIOTERRORISM TRAINING AND EDUCATION ACTIVITIES FOR HOSPITAL STAFF AND OTHER EMERGENCY MEDICAL RESPONDERS. THE HOSPITAL PARTICIPATES IN REGIONAL DRILLS AND TESTING OF HAM & AWIN RADIOS AND THE FACILITY MUST BE 100% NIMS COMPLIANT. THE HOSPITAL COORDINATES WITH LOCAL OEM, EMS, PUBLIC HEALTH, COMMUNITY HEALTH CENTERS, LONG TERM HEALTH CARE, INCLUDING NURSING HOMES, AND OTHERS AS APPROPRIATE.
FORM 990, SCHEDULE H, PART VI, LINE 6	SBHC SYSTEM FOCUSES ITS ENERGIES AND RESOURCES ON PARTNERSHIPS THAT HAVE THE GREATEST POTENTIAL FOR A POSITIVE IMPROVEMENT IN THE HEALTH AND QUALITY OF LIFE FOR INDIVIDUALS AND COMMUNITIES. AREAS WHERE CONSIDERABLE ACTIVITY IS EXPENDED INCLUDE: - COMMUNITY HEALTH EDUCATION,PREVENTION, EARLY DETECTION, AND INTERVENTION ACTIVITIES THAT WOULD REDUCE THE INCIDENCE AND SERIOUSNESS OF ILLNESS, THEREBY MINIMIZING THE NEED FOR PREVENTABLE AND EXPENSIVE MEDICAL INTERVENTIONS. - CHRONIC DISEASE MANAGEMENT ACTIVITIES, WHICH, WHEN DONE EFFECTIVELY, MINIMIZE THE NEED FOR MEDICAL INTERVENTIONS. - PROACTIVE HEALTH GRANT PROGRAMS THAT FUND COMMUNITY BASED HEALTH PROGRAMS AND INITIATIVES. - INCREASING ACCESS TO HEALTH COVERAGE FOR ELIGIBLE RESIDENTS IN PROGRAMS SUCH AS AR KIDS FIRST. - INCREASING ACCESS TO HEALTHCARE SERVICES FOR THOSE IN NEED REGARDLESS OF ABILITY TO PAY. - COLLABORATIVE PARTNERSHIPS THAT SUPPORT THE PURPOSE OF INCREASING INDIVIDUAL AND COMMUNITY CAPACITY TO ACHIEVE THE HEALTHY COMMUNITY VISION. - HEALTH RESEARCH, EDUCATION AND TRAINING PROGRAMS. - DONATIONS OF FOOD, SURPLUS EQUIPMENT AND STAFF TIME TO ORGANIZATIONS ADDRESSING THE HEALTH NEEDS OF THE COMMUNITY. - PARTNERSHIPS WHICH MOTIVATE RESIDENTS TO GIVE BACK TO THEIR COMMUNITIES TO MOVE THE COMMUNITY CLOSER TO THE HEALTHY COMMUNITY VISION.
FORM 990, SCHEDULE H, PART I, LINE 3C	ELIGIBILITY FOR FINANCIAL ASSISTANCE IS SUBJECT TO A REVIEW OF ASSETS, INCOME AND REASONABLE EXPENSES FOR THE PURPOSES OF: -ESTABLISHING PROOF OF INCOME AND INDIGENCE, -STANDARDIZING AND EQUALIZING THE PROCESS OF GRANTING ASSISTANCE, AND -ASSURING THAT ALL RELEVANT CONSIDERATIONS ARE MADE IN REVIEWING THE REQUEST FOR ASSISTANCE. PRESUMPTIVE ELIGIBILITY WILL ALSO BE CONSIDERED IN INSTANCES WHEN AN INCOMPLETE OF NO APPLICATION IS AVAILABLE. SBMC WILL BASE THIS DETERMINATION ON THE FOLLOWING: -MEANS TESTED PUBLIC PROGRAM ELIGIBILITY -PATIENT IS DECEASED WITH NO KNOWN ESTATE -TRANSIENT, HOMELESS PERSONS -INTERNATIONAL STUDENT WITH NO SUPPORT GROUP -PERSONS WITH UNKNOWN IDENTITY

Schedule H (Form 990) 2019

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
ST BERNARDS HOSPITAL INC

Employer identification number
71-0290019

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) AHEC - UAMS 311 E MATTHEWS JONESBORO,AR72401	71-6046242	501(C)(3)	1,485,000		N/A	N/A	RESIDENCY PROGRAM
(2) ARKANSAS METHODIST MEDICAL CENTER PO BOX 339 PARAGOULD,AR72451	71-0230218	501(C)(3)	149,185		N/A	N/A	ACCESS IMPROVEMENT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

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

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

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

Part IV

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

Return Reference	Explanation
FORM 990, SCHEDULE I, PART I, LINE 2	THE ORGANIZATION MAKES ONE TIME GRANTS TO ORGANIZATIONS QUALIFYING AS A CHARITY IN THE U.S. BASED ON APPLICATIONS RECEIVED BY THE ORGANIZATION. GRANTS ARE FOR A SPECIFIC PURPOSE OR USE AND POST GRANT MONITORING IS PERFORMED ON AN AS NEEDED BASIS.

Schedule I (Form 990) 2019

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

Complete if the organization answered "Yes" 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

2019

Open to Public Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

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 on 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 on Line 1a? ..

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed 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? .........

Yes

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

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

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

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

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

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

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

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

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

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any 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) 2019

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)
1CHRIS BARBER PRESIDENT/CEO	(i) (ii)	0 ------------- 639,066	0 ------------- 80	0 ------------- 30,340	0 ------------- 25,000	0 ------------- 13,816	0 ------------- 708,302	0 ------------- 0
2MICHAEL GIVENS ADMINISTRATOR	(i) (ii)	296,459 ------------- 0	80 ------------- 0	5,338 ------------- 0	0 ------------- 0	15,616 ------------- 0	317,493 ------------- 0	0 ------------- 0
3BEN BARYLSKE CFO	(i) (ii)	0 ------------- 223,398	0 ------------- 80	0 ------------- 5,676	0 ------------- 1,760	0 ------------- 12,966	0 ------------- 243,880	0 ------------- 0
4CHITHARANJAN DUVOOR ENDOCRINOLOGIST	(i) (ii)	447,572 ------------- 0	46,799 ------------- 0	3,364 ------------- 0	9,584 ------------- 0	12,119 ------------- 0	519,438 ------------- 0	0 ------------- 0
5DON HOWARD INTENSIVIST	(i) (ii)	574,028 ------------- 0	19,240 ------------- 0	99,034 ------------- 0	0 ------------- 0	13,794 ------------- 0	706,096 ------------- 0	0 ------------- 0
6JORDAN JANIK HOSPITALIST	(i) (ii)	379,556 ------------- 0	11,795 ------------- 0	48,081 ------------- 0	12,131 ------------- 0	13,794 ------------- 0	465,357 ------------- 0	0 ------------- 0
7MICHELLE SCHOFIELD PSYCHIATRIST	(i) (ii)	315,058 ------------- 0	92,770 ------------- 0	23,744 ------------- 0	8,973 ------------- 0	16,194 ------------- 0	456,739 ------------- 0	0 ------------- 0
8MONA PARIKH INTENSIVIST	(i) (ii)	399,788 ------------- 0	63,940 ------------- 0	3,798 ------------- 0	11,532 ------------- 0	18,794 ------------- 0	497,852 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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
FORM 990, SCHEDULE J, PART I, LINE 1A	MICHAEL GIVENS - GROSS-UPS OF $37.48 FOR GROUP TERM LIFE.
FORM 990, SCHEDULE J, PART I, LINE 1B	ALL EXPENSES ARE INCLUDED IN THE EMPLOYEES W-2 WAGES.
FORM 990, SCHEDULE J, PART I, LINE 4B	CHRIS BARBER RECEIVED $19,000 IN CONTRIBUTIONS TO A 457(F) PLAN.
FORM 990, SCHEDULE J, PART II, COLUMN D	THE INCREASE OF THE ACTUARIAL VALUE OF THE DEFINED BENEFIT PENSION PLAN IS NOT CALCULATED ON AN INDIVIDUAL EMPLOYEE BASIS BUT RATHER ON THE EMPLOYEE GROUP TAKEN AS A WHOLE. THE INCREASE IN EACH INDIVIDUAL'S BALANCE WOULD HAVE TO BE ESTIMATED USING ASSUMPTIONS UNIQUE TO THAT INDIVIDUAL RATHER THAN THE PLAN AS A WHOLE. THIS INFORMATION IS NOT AVAILABLE AT THIS TIME. HOWEVER, WE BELIEVE THE INCREASE TO EACH INDIVIDUAL'S ACCOUNT WOULD NOT MATERIALLY CHANGE THE COMPENSATION REPORTED. WE WILL WORK WITH OUR ACTUARY TO DETERMINE THE ANNUAL INCREASE IN FUTURE PERIODS.

Schedule J (Form 990) 2019

Additional Data

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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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
ST BERNARDS HOSPITAL INC

Employer identification number
71-0290019

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	CITY OF JONESBORO ARKANSAS	71-6013749		08-01-2016	40,000,000	HOSPITAL REVENUE CONSTRUCTION BOND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	0
2 Amount of bonds legally defeased ..............	0
3 Total proceeds of issue ..................	40,000,000
4 Gross proceeds in reserve funds .............	0
5 Capitalized interest from proceeds .............	0
6 Proceeds in refunding escrows ...............	0
7 Issuance costs from proceeds ...............	305,000
8 Credit enhancement from proceeds .............	0
9 Working capital expenditures from proceeds .............	0
10 Capital expenditures from proceeds .............	0
11 Other spent proceeds .............	40,000,000
12 Other unspent proceeds .............	0
13 Year of substantial completion .............	2018
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X

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

Cat. No. 50193E

Schedule K (Form 990) 2019

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
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
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 ....	0 %
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
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
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? .............		X
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

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
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
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........	0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2019

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
b Name of provider ..........	0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	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

Part Ⅵ

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

Return Reference	Explanation

Schedule K (Form 990) 2019

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

2019

Open to Public
Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

Return Reference	Explanation
FORM 990, PART III, LINE 1	ST. BERNARDS MEDICAL CENTER (SBMC) BEGAN SERVING THE CITIZENS OF NORTHEAST ARKANSAS IN THE YEAR 1900. THROUGH ITS MISSION OF PROVIDING CHRIST-LIKE-HEALING TO THE COMMUNITY THROUGH EDUCATION, TREATMENT, AND HEALTH SERVICES IT IS THE SAFETY NET PROVIDER FOR A 23 COUNTY AREA THAT INCLUDES SOUTHEAST MISSOURI. IN ACCORDANCE WITH ITS STATED MISSION AND VALUES OF PROVIDING CHRIST-LIKE HEALING SBMC IS COMMITTED TO PROVIDING HEALTHCARE SERVICES REGARDLESS OF A PERSON'S ABILITY TO PAY. cha care is a CORE COMPONENT OF THE MISSION OF THE OLIVETAN BENEDICTINE SISTERS AND ITS HEALTHCARE MINISTRY. IN THE FISCAL YEAR WHICH ENDED SEPTEMBER 30, 2020, SBMC PROVIDED $7,747,730 IN CHARITY CARE. THE TOTAL AMount OF QUANTIFIABLE COMMUNITY BENEFITS PROVIDED BY ST. BERNARDS MEDICAL CENTER WAS $15,905,533 IN FISCAL YEAR 2020 THROUGH 163,664 ENCOUNTERS WITH INDIVIDUALS INVOLVING HEALTH SCREENINGS, EDUCATION, DONATIONS, AND VOLUNTEER ACTIVITIES. IN PROVIDING EDUCATION, TREATMENT AND HEALTHCARE SERVICES SBMC BELIEVES FINANCIAL MATTERS ARE SECONDARY TO THE RENDERING OF THESE SERVICES. NO PERSON WHO SEEKS THESE SERVICES WILL BE TURNED AWAY. SBMC PROVIDES DIRECT FINANCIAL ASSISTANCE (CHARITY) USING A SLIDING SCALE BASED UPON INCOME LEVELS OF THE CURRENT FEDERAL INCOME POVERTY GUIDELINES AS ESTABLISHED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. PATIENTS WHO HAVE NO INSURANCE WILL RECEIVE A DISCOUNT FROM CHARGES AND SBMC DOES NOT TAKE LEGAL ACTION AGAINST ANY DEBTOR FOR SERVICES PROVIDED THROUGH ITS MISSION. IN FISCAL YEAR 2020 SBMC PROVIDED 91,788 PATIENT DAYS OF CARE. 38,121 PATIENT DAYS WERE PROVIDED TO THE ELDERLY WHILE 16,728 WERE PROVIDED TO THE MEDICALLY INDIGENT OR WHO HAD MEDICAID COVERAGE. 46,852 PATIENTS WERE SEEN IN THE SBMC EMERGENCY ROOM DURING THE SAME TIME PERIOD. TODAY, AS WELL INTO THE FUTURE SBMC WILL CONTINUE TO PUT PATIENTS AND COMMUNITY NEEDS FIRST BY FOCUSING ON QUALITY, SAFETY, COST CONTROL, SERVICE, AND DIVERSITY.
FORM 990, PART VI, SECTION A, LINES 6, 7A & 7B	ST. BERNARDS HEALTHCARE, INC. IS THE SOLE MEMBER OF ST. BERNARDS MEDICAL CENTER. THE MEMBER RESERVES POWER OVER THE FOLLOWING ACTS: A. ANY AGGREGATE BORROWING BY THE CORPORATION OF FUNDS IN EXCESS OF $1 MILLION FOR ANY SINGLE TRANSACTION OR PROJECT. B. ANY PURCHASE, SALE, LEASE, DISPOSITION, EXCHANGE, GIFT PLEDGE, OR MORTGAGE OF REAL ESTATE PROPERTY VALUED IN EXCESS OF $1 MILLION. C. ANY VARIANCE WITH CONGREGATIONL POLICY, PHILOSOPHY, OR ETHICS OF THE MEMBER. D. ANY AMENDMENT, ALTERATION, OR REPEAL OF THE BYLAWS. E. THE POWER OF THE MEMBER TO REMOVE ANY MEMBER OF THE GOVERNING BOARD IF IN THE SOLE DISCRETION OF MEMBER THE GOVERNING BOARD MEMBER ACTS AT VARIANCE WITH CONGREGATIONAL POLICY, PHILOSOPHY, OR THE ETHICS OF THE MEMBER. ALL OF THE DESCRIBED MATTERS SHALL BE SUBJECT TO APPROVAL BY A MAJORITY VOTE OF THE MEMBERS OF THE COUNCIL OF OLIVETAN BENEDICTINE SISTERS,INC.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS REVIEWED BY THE FOLLOWING PERSONS OR GROUPS: CONTROLLER OF ST. BERNARDS HEALTHCARE, INC., VICE PRESIDENT OF FINANCE OF ST. BERNARDS HEALTHCARE, INC.
FORM 990, PART VI, SECTION B, LINE 12C	DIRECTORS AND ABOVE ANNUALLY SUBMIT A WRITTEN STATEMENT DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST. MANAGEMENT INVESTIGATES ANY POTENTIAL CONFLICTS AND TAKES APPROPRIATE ACTION DEPENDING ON THE NATURE OF THE CONFLICT. LEGAL COUNSEL ALSO REVIEWS ANY POTENTIAL CONFLICTS OF INTEREST AND ADVISES MANAGEMENT.
FORM 990, PART VI, SECTION B, LINES 15A & 15B	THE BOARD OF DIRECTORS SELECTS DIRECTORS TO SERVE ON THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE APPROVES THE INITIAL SALARY AND ANY SUBSEQUENT SALARY ADJUSTMENTS OF ALL MANAGEMENT. THE COMPENSATION COMMITTEE OBTAINS AN INDEPENDENT SALARY SURVEY FROM INTEGRATED HEALTHCARE STRATEGIES (ARTHUR J GALLAGHER AND COMPANY) ON AN ANNUAL BASIS FOR USE IN DETERMINING THE APPROPRIATE SALARY RANGES FOR MANAGEMENT. THE COMPENSATION COMMITTEE PRESENTS THE INFORMATION TO THE BOARD FOR APPROVAL. THE LAST REVIEW WAS CONDUCTED IN 2019.
FORM 990, PART VI, SECTION B, LINE 16B	ALL OPERATING AGREEMENTS OF JOINT VENTURE ARRANGEMENTS IN WHICH THE ORGANIZATION PARTICIPATES CONTAIN A CLAUSE THAT SAFEGUARDS THE ORGANIZATION'S EXEMPT STATUS.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9	TRANSFER TO AFFILIATE (28,652,181) CHANGE IN PENSION LIABILITY 2,094,434 CHANGE IN INTEREST IN NET ASSETS OF ST. BERNARDS DEVELOPMENT FOUNDATION, INC. (711,766) ---------------------------------------------------------- TOTAL (27,269,513)
FORM 990, PART V, LINE 1A	ST. BERNARDS HOSPITAL, INC. DOES NOT REPORT ANY 1099 FILINGS ON PART V, LINE 1A. ALL 1099S ARE FILED BY THE HOSPITAL SYSTEM'S COMMON PAYMASTER, ST. BERNARDS HEALTHCARE, INC.
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED SERVICES TOTAL FEES:25877966
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT LABOR TOTAL FEES:18247377
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICAL THERAPY TOTAL FEES:7505504
FORM 990 PART IX LINE 11G	DESCRIPTION:JANITORIAL SERVICES TOTAL FEES:415958

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

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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

2019

Open to Public Inspection

Name of the organization

ST BERNARDS HOSPITAL INC

Employer identification number

71-0290019

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)	(e) End-of-year assets	(f) Direct controlling entity
(1) SBMACO LLC 225 EAST WASHINGTON JONESBORO,AR72401 82-1692298	HEALTHCARE	AR	1	SBM

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 BERNARDS HEALTHCARE INC (SBHCI) 225 EAST WASHINGTON JONESBORO,AR72401 71-0853900	SUPPORT	AR	501(C)(3)	12A	OBS		No
(2)OLIVETAN BENEDICTINE SISTERS INC PO DRAWER 130 JONESBORO,AR72403 71-0654621	CONVENT	AR	501(C)(3)	N/A	NA		No
(3)ST BERNARDS COMM HOSPITAL PO BOX 590 WYNNE,AR72396 71-0835247	HEALTHCARE	AR	501(C)(3)	3	SBHCI	Yes
(4)ST BERNARDS VILLAGE INC 225 EAST WASHINGTON JONESBORO,AR72401 71-0805203	HOUSING	AR	501(C)(3)	10	SBHCI	Yes
(5)BENEDICTINE MANOR I 225 EAST WASHINGTON JONESBORO,AR72401 20-8030553	HOUSING	AR	501(C)(3)	10	VILLAGE	Yes
(6)BENEDICTINE MANOR II 225 EAST WASHINGTON JONESBORO,AR72401 20-8030603	HOUSING	AR	501(C)(3)	10	VILLAGE	Yes
(7)JONESBORO REAL ESTATE HOLDINGS INC 225 EAST WASHINGTON JONESBORO,AR72401 71-0835010	REAL ESTATE	AR	501(C)(2)		SBHCI	Yes
(8)TOTAL LIFE HEALTHCARE 225 EAST WASHINGTON JONESBORO,AR72401 26-0262745	HEALTHCARE	AR	501(C)(3)	10	SBHCI	Yes
(9)ST BERNARDS DEVELOPMENT FOUNDATION 400 EAST STREET JONESBORO,AR72401 71-0563245	SUPPORT	AR	501(C)(3)	7	OBS		No
(10)MATTHEWS MEDICAL MILE 225 EAST WASHINGTON JONESBORO,AR72401 27-3865388	ADVERTISING	AR	501(C)(3)	10	SBHCI	Yes
(11)AUX TO ST BERNARDS MEDICAL CENTER 225 EAST WASHINGTON JONESBORO,AR72401 71-0493824	FUNDRAISING	AR	501(C)(3)	12A	SBHI	Yes
(12)FIVE RIVERS MEDICAL CENTER INC 2801 MEDICAL CENTER DR POCAHONTAS,AR72455 27-3970823	HEALTHCARE	AR	501(C)(3)	3	SBHCI	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) PET CENTER LLC PO BOX 13267 MAUMELLE,AR72113 71-0876911	P.E.T. SCANS	AR	SBHI	RELATED	352,757	276,097		No		Yes		51.000 %
(2) ALLCARE OF ARKANSAS 225 EAST WASHINGTON JONESBORO,AR72401 20-3315907	HEALTHCARE	AR	NA					No			No
(3) OUTPATNT SRGRY CTR 1100 E MATTHEWS JONESBORO,AR72401 74-3052826	HEALTHCARE	AR	NA					No			No
(4) PAIN CENTER LLC 505 EAST MATTHEWS STE 103 JONESBORO,AR72401 33-1048492	PAIN MANAGEMENT	AR	NA					No			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) REGIONAL HEALTHCARE HOLDINGS INC PO BOX 9320 JONESBORO,AR72403 73-1650896	HOLDING COMPANY	AR	NA	C CORP			Yes
(2) JONESBORO ANESTHESIA INC 221 HUGHES STE C JONESBORO,AR72401 02-0644209	ANESTHESIOLOGY	AR	NA	C CORP			Yes
(3) HEART SURGERY ASSOCIATION PO BOX 9320 JONESBORO,AR72403 20-0120406	HEALTHCARE	AR	NA	C CORP			Yes
(4) JONESBORO NEUROSURGERY CLINIC PO BOX 9320 JONESBORO,AR72403 20-5938180	NEUROSURGERY	AR	NA	C CORP			Yes
(5) DOCTORS HEALTH GROUP PO BOX 9320 JONESBORO,AR72403 71-0788355	HEALTHCARE	AR	NA	C CORP			Yes
(6) REGIONAL HEALTHCARE SERVICES PO BOX 9320 JONESBORO,AR72403 71-0780305	HEALTHCARE	AR	NA	C CORP			Yes
(7) SURGICAL ASSOCIATES OF JONESBORO PO BOX 9320 JONESBORO,AR72403 26-3827817	HEALTHCARE	AR	NA	C CORP			Yes
(8) HEALTHCARE MEDICAL GROUP INC PO BOX 9320 JONESBORO,AR72401 71-0792539	HEALTHCARE	AR	NA	C CORP			Yes
(9) THE HEARTCARE CENTER 225 EAST WASHINGTON JONESBORO,AR72401 20-2061837	HEALTHCARE	AR	NA	C CORP			Yes
(10) JONESBORO PLASTIC SURGERY 800 S MAIN STREET JONESBORO,AR72401 27-1450995	PLASTIC SURGERY	AR	NA	C CORP			Yes
(11) OB-GYN ASSOC OF JONESBORO 800 S MAIN STREET JONESBORO,AR72401 27-2717909	OB-GYN	AR	NA	C CORP			Yes
(12) CARDIOLOGY ASSOCIATES OF JONESBORO 800 S MAIN STREET JONESBORO,AR72401 27-3757274	CARDIOLOGY	AR	NA	C CORP			Yes
(13) ST BERNARDS CLINICS INC 800 S MAIN STREET JONESBORO,AR72401 27-3722124	HEALTHCARE	AR	NA	C CORP			Yes
(14) CANCER CARE ASSOCIATES 800 S MAIN STREET JONESBORO,AR72401 80-0864692	HEALTHCARE	AR	NA	C CORP			Yes
(15) ST BERNARDS ORTHOPEDIC ASSOCIATES INC 800 S MAIN STREET JONESBORO,AR72401 46-2738617	HEALTHCARE	AR	NA	C CORP			Yes
(16) ST BERNARDS UROLOGY ASSOCIATES INC 800 S MAIN STREET JONESBORO,AR72401 46-4039608	HEALTHCARE	AR	NA	C CORP			Yes
(17) FIVE RIVERS MEDICAL CENTER FOUNDATION 2801 MEDICAL CENTER DRIVE POCAHONTAS,AR72455 30-0926076	SUPPORT	AR	NA	C CORP			Yes

Schedule R (Form 990) 2019

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

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

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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) 2019

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) 2019

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) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE CHRIST-LIKE HEALING TO THE COMMUNITY THROUGH EDUCATION, TREATMENT, AND HEALTH SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	2,901
6	Total number of volunteers (estimate if necessary) .............	6	731
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	4,862,581
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	1,110,077

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,374,397	9,437,284
9	Program service revenue (Part VIII, line 2g) .........	414,762,011	447,499,717
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,174,104	1,037,142
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	17,260,646	17,917,649
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	435,571,158	475,891,792
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,780,060	1,634,342
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)	151,788,302	167,025,192
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 337,163
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	243,072,721	261,698,712
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	396,641,083	430,358,246
19	Revenue less expenses. Subtract line 18 from line 12.......	38,930,075	45,533,546
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	293,884,656	378,551,172
21	Total liabilities (Part X, line 26).............	126,460,803	192,829,840
22	Net assets or fund balances. Subtract line 21 from line 20.....	167,423,853	185,721,332

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 335,384,155 including grants of $ 1,634,342 ) (Revenue $ 447,059,600 )
	SINCE 1900, ST BERNARDS HAS SERVED AS OUR COMMUNITY'S TRUSTED PROVIDER OF COMPREHENSIVE, COMPASSIONATE HEALTHCARE. WITH OUR DEDICATED AND EXPERIENCED EMPLOYEES, ADVANCED TECHNOLOGY, AND THE LARGEST MEDICAL STAFF IN THE REGION, ST BERNARDS IS THE MEDICAL CENTER OF CHOICE. TODAY, AS WELL AS IN THE FUTURE, ST BERNARDS WILL CONTINUE TO PUT PATIENTS AND COMMUNITY NEEDS FIRST BY FOCUSING ON QUALITY, SAFETY, COST CONTROL, SERVICE, AND DIVERSITY. DURING FISCAL YEAR 2020, $15,905,533 WAS SPENT FOR COMMUNITY BENEFIT AND 163,664 PERSONS WERE SERVED THROUGH HEALTH SCREENINGS, DONATIONS, EDUCATIONAL CLASSES, AND VOLUNTEER EFFORTS.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses335,384,155

(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) STEVE COX........................................................................ MEMBER	1.0 .......................1.0	X		0	0	0
(19) SISTER THERESE MARIE KINTZLEY........................................................................ MEMBER	1.0 .......................1.0	X		0	0	0
(20) JEFF STIDMAN........................................................................ MEMBER	1.0 .......................0.0	X		0	0	0
(21) SISTER MARY BETH HACKLEY........................................................................ SECRETARY	1.0 .......................1.0	X	X	0	0	0
(22) NEIL CROWSON........................................................................ DIRECTOR	1.0 .......................1.0	X		0	0	0
(23) SISTER CECILA NGUYEN........................................................................ MEMBER	1.0 .......................1.0	X		0	0	0
(24) SISTER LAURA CATHCART........................................................................ CHAIRPERSON	1.0 .......................1.0	X	X	0	0	0
(25) SISTER MARILYN DOSS........................................................................ MEMBER	1.0 .......................1.0	X		0	0	0
(26) SCOTT DICKSON........................................................................ CHIEF OF STAFF	1.0 .......................0.0	X	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,830,444	898,640	186,073

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	353,609
e	Government grants (contributions)		1e	8,926,847

f	All other contributions, gifts, grants, and similar amounts not included above		1f	156,828

g	Noncash contributions included in lines 1a - 1f:$		1g	849

h Total. Add lines 1a-1f.......		9,437,284

		Business Code
2a	PATIENT REVENUE	622110	414,041,783	414,041,783
b	MEDICAID ASSESSMENT FEE	622110	25,375,662	25,375,662
c	REFERENCE LAB	621500	4,503,118		4,503,118
d	COVID DIRECT WORKER PAYMENTS	622110	3,435,085	3,435,085
e	MEDICAL OFFICE BUILDING RENT REVEUE	531120	135,368	135,368
f	All other program service revenue.		8,701	8,701
g	Total. Add lines 2a–2f .....		447,499,717

3 Investment income (including dividends, interest, and othersimilar amounts) ......			850,590			850,590
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		3,600	6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	3,600	6c
d	Net rental income or (loss).......			3,600			3,600
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	223,750	5,074,704	7a
b	Less: cost or other basis and sales expenses		5,111,902	7b
c	Gain or (loss)	223,750	-37,198	7c
d	Net gain or (loss).........			186,552			186,552
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	PHARMACY REVENUE		446110	10,017,930			10,017,930
b	ENCOMPASS HEALTH REHAB HOSP K-1		621610	3,845,506	3,803,727		41,779
c	CAFETERIA/FOOD		722310	2,704,814			2,704,814
d	All other revenue ....			1,345,799	259,274	359,463	727,062
e	Total. Add lines 11a–11d ......			17,914,049
12	Total revenue. See instructions.....			475,891,792	447,059,600	4,862,581	14,532,327

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,634,342	1,634,342
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	313,045		313,045
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	132,194,440	86,527,700	45,666,740
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	10,015,422	6,555,582	3,459,840
9	Other employee benefits .......	14,985,098	9,808,477	5,176,621
10	Payroll taxes ...........	9,517,187	6,229,462	3,287,725
11	Fees for services (non-employees):
a	Management ......	3,035,881	1,987,132	1,048,749
b	Legal .........	337,356	220,816	116,540
c	Accounting ...........	277,909	181,905	96,004
d	Lobbying ...........	49,814	32,606	17,208
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	236,280	154,657	81,623
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	52,046,805	34,067,169	17,979,636	0
12	Advertising and promotion ....	465,146	83,771	44,212	337,163
13	Office expenses .......	7,273,748	4,761,022	2,512,726
14	Information technology ......	2,880,392	1,885,357	995,035
15	Royalties ..	0
16	Occupancy ...........	7,636,719	4,998,605	2,638,114
17	Travel ............	776,663	508,364	268,299
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	88,151	57,699	30,452
20	Interest ...........	1,227,738	803,614	424,124
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	15,528,010	10,163,839	5,364,171
23	Insurance ...	2,026,929	1,326,724	700,205
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	116,831,282	116,831,282
b	BAD DEBT EXPENSE	31,453,829	31,453,829
c	PATIENT CARE SERVICES	6,743,196	6,743,196
d	EQUIPMENT RENT	4,845,440	3,171,576	1,673,864
e	All other expenses	7,937,424	5,195,429	2,741,995
25	Total functional expenses. Add lines 1 through 24e	430,358,246	335,384,155	94,636,928	337,163
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 ........			58,103,613	1	122,217,798
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			35,715,159	4	37,242,789
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			2,759,791	8	3,161,125
9	Prepaid expenses and deferred charges ......			1,733,253	9	4,996,005
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	384,521,834
b	Less: accumulated depreciation	10b	197,524,748	170,690,074	10c	186,997,086
11	Investments—publicly traded securities .			13,999,311	11	14,248,562
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			10,883,455	15	9,687,807
16	Total assets. Add lines 1 through 15 (must equal line 33)...			293,884,656	16	378,551,172

17	Accounts payable and accrued expenses .....	28,646,382	17	28,487,468
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	9,166,923
20	Tax-exempt bond liabilities .........	40,000,000	20	40,000,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	57,212,248
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	57,814,421	25	57,963,201
26	Total liabilities. Add lines 17 through 25..	126,460,803	26	192,829,840

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	161,138,022	27	180,147,267
28	Net assets with donor restrictions ...........	6,285,831	28	5,574,065
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	167,423,853	32	185,721,332
33	Total liabilities and net assets/fund balances ........	293,884,656	33	378,551,172