TY 2022 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/1099-NEC)
(18) GUYN JIM MD........................................................................ SVP POPULATION HEALTH	50.00 .......................1.00			441,731	76,904
(19) CHING JOAN........................................................................ VP CHIEF NURSING	50.00 .......................1.00			427,485	39,302
(20) GOLDA DAVID........................................................................ VP HOSPITAL ADMIN BEND/REDMOND	50.00 .......................0.00			267,877	41,876
(21) ROBINSON DEBRA........................................................................ CNO BEND	50.00 .......................0.00			260,497	38,882
(22) SHIELDS TODD........................................................................ VP HOSPITAL ADMIN PRINEVILLE/MADRAS	50.00 .......................0.00			233,341	39,645
(23) OSTROM JULIE........................................................................ SR DIRECTOR PERIOP & CARDIO	50.00 .......................0.00			221,105	39,507
(24) POWELL MICHAEL........................................................................ CHIEF PHARMACY OFFICER	50.00 .......................0.00			218,028	38,974
(25) Orlikoff James........................................................................ Chairman	15.00 .......................0.00	X	X	44,000	0
(26) Schuette Dan........................................................................ Director	10.00 .......................0.00	X		37,500	0
(27) Handkins Shelly........................................................................ Director	5.00 .......................0.00	X		27,500	0
(28) Rhoads Ann........................................................................ Director	5.00 .......................0.00	X		25,000	0
(29) Schmid Corey........................................................................ Director	5.00 .......................0.00	X		22,500	0
(30) O'Brien Jenny........................................................................ Director	5.00 .......................0.00	X		20,000	0
(31) Terhes John MD........................................................................ Director	5.00 .......................0.00	X		12,500	0
(32) Bullock Jon........................................................................ Director	5.00 .......................0.00	X		10,000	0
(33) Jarvis Sam........................................................................ Director	5.00 .......................0.00	X		10,000	0

(A) Name and business address	(B) Description of services	(C) Compensation
CASCADE MEDICAL IMAGING LLC 1460 NE MEDICAL CENTER DR BEND,OR97701	IMAGING SERVICES	47,673,579
CENTRAL OREGON MRI LLC PO BOX 6059 BEND,OR97708	MRI SERVICES	6,140,565
MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS,MN55480	LAB SERVICES	2,879,180
BEND ANESTHESIOLOGY GROUP 150 W CIVIC CENTER DR STE 200 SANDY,UT84070	ANESTHESIOLOGY	2,625,770
OBHG OREGON PC 777 LOWNDES HILL RD BUILDING 1 GREENVILLE,SC29607	HOSPITALIST SERVICES	1,455,505
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 44

- TIN:

SCHEDULE A
(Form 990)

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

2022

Open to Public
Inspection

Name of the organization

St Charles Health System Inc

Employer identification number

93-0602940

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 5 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 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 on 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 5 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 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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

Did one or more disqualified persons (as defined on 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 on 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) 2022

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2022

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 0.015 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 0.035	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) 2022

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

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) 2022

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

- TIN:

Schedule B
(Form 990)

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

2022

Name of the organization

St Charles Health System Inc

Employer identification number

93-0602940

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) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization St Charles Health System 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) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization St Charles Health System Inc		Employer identification number 93-0602940

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) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization St Charles Health System Inc			Employer identification number 93-0602940
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) (2022)

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

- TIN:

SCHEDULE C
(Form 990)

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

2021

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 Charles Health System Inc

Employer identification number

93-0602940

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.

Cat. No. 50084S

Schedule C (Form 990) 2021

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) 2018	(b) 2019	(c) 2020	(d) 2021	(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) 2021

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)? ........

Yes

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

8,097

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

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

Yes

118,958

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

127,055

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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

Return Reference	Explanation
Part II-B, Line 1i - Other Activities Description	ST. CHARLES UNDERTAKES LIMITED LOBBYING ACTIVITIES AIMED AT INFLUENCING STATE AND FEDERAL OFFICIALS ON HEALTHCARE MATTERS AFFECTING THE PROVISION AND FINANCING OF HEALTHCARE SERVICES BY NON-PROFIT HEALTH SYSTEMS IN OREGON.
Part IV - Additional Information

Schedule C (Form 990) 2021

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

- 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

2021

Open to Public Inspection

Name of the organization

St Charles Health System Inc

Employer identification number

93-0602940

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) 2021

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 ....	6,371,633	5,634,453	5,295,153	4,702,154	4,902,009
b	Contributions ...			100,250	325	2,440
c	Net investment earnings, gains, and losses	-455,516	1,023,377	493,847	728,943	-127,411
d	Grants or scholarships ...	57,904	256,941	58,150	113,389	51,407
e	Other expenditures for facilities and programs ...			169,830
f	Administrative expenses ....	28,151	29,256	26,817	22,880	23,477
g	End of year balance ......	5,830,062	6,371,633	5,634,453	5,295,153	4,702,154

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

Board designated or quasi-endowment SchDMd Bullet

60.170 %

Permanent endowment SchDMd Bullet

28.900 %

Term endowment SchDMd Bullet

10.930 %

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)

Yes

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

Yes

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 .....	20,352,207		20,352,207
b	Buildings ....	500,739,152	235,608,375	265,130,777
c	Leasehold improvements	8,503,085	6,982,157	1,520,928
d	Equipment ....	339,975,451	262,295,503	77,679,948
e	Other .....	29,485,394	18,201,274	11,284,120
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				375,967,980

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1)JOINT VENTURES	3,754,883	C
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	14,692,428
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) 2021

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference

Explanation

Part V, Line 4: Intended uses of the endowment fund.

Endowment Funds are reported in this section because they are held by St. Charles Foundation, Inc., a related entity of SCHS. Permanently restricted endowment funds are primarily to be used for continuing education scholarships for caregivers and the professional medical community, support of SCHS' Community Benefit Programs, and in the area of greatest need. The Floyd Dement Hospital Trust Fund Testamentary Trust is administered by the Union Bank of California under a trust agreement which provides that the annual income be distributed to the Foundation for charity care to be provided to St. Charles Bend.St. Charles Foundation Board Designated endowments consist of two individual funds established for community benefit and indigent care.

Part X : FIN48 Footnote

The audited financial statements contain the following footnote: Accounting principles generally accepted in the United States of America require SCHS management to evaluate tax positions taken by the Corporation and recognize a tax liability (or asset) if the Corporation has taken an uncertain position that more likely than not would not be sustained upon examination by the IRS. Management has analyzed tax positions taken by the Corporation and has concluded that as of December 31, 2022, there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the consolidated financial statements. The Corporation is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Corporation's management believes it is no longer subject to income tax examinations for years prior to 2019.

Schedule D (Form 990) 2021

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

- 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 20a.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

St Charles Health System Inc

Employer identification number

93-0602940

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 30000.0000000 %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	33,267	13,205,238		13,205,238	1.230 %
b	Medicaid (from Worksheet 3, column a) . . . . .	208,836	254,343,008	176,134,780	78,208,228	7.290 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	242,103	267,548,246	176,134,780	91,413,466	8.520 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	6,037	756,887		756,887	0.070 %
f	Health professions education (from Worksheet 5) . . .	2,282	1,705,711	395,337	1,310,374	0.120 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	499	27,457		27,457
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	2,000	1,223,696		1,223,696	0.110 %
j	Total. Other Benefits . .	10,818	3,713,751	395,337	3,318,414	0.300 %
k	Total. Add lines 7d and 7j .	252,921	271,261,997	176,530,117	94,731,880	8.820 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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.

		(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
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	205,634	317,159	317,159	0.030 %
9	Other
10	Total	205,634	317,159	317,159	0.030 %

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. ......

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

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

Section B. Medicare

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

203,798,739

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

253,718,025

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

-49,919,286

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 %	(e) Physicians' profit % or stock ownership %
1Cascade Medical Imaging LLC	CT, Mammography and Other	70.000 %	30.000 %
2Central Oregon Magnetic Res	Magnetic Resonance Imaging	33.300 %	66.700 %
3Heart Center of the Cascade	Owns & manages a medical bu	50.000 %	50.000 %
4Cascade SurgiCenter LLC	Outpatient surgery	50.000 %	50.000 %
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2022

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?4Name, 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)						Facility reporting group
1	St Charles Bend 2500 NE NEFF RD BEND,OR97701	X	X		X	A
2	St Charles Prineville 384 SE COMBS FLAT RD PRINEVILLE,OR97754	X	X	X	X	B
3	St Charles Madras 470 NE A St Madras,OR97741	X	X	X	X	B
4	St Charles Redmond 1253 NW Canal Boulevard Redmond,OR97756	X	X		X	A

Schedule H (Form 990) 2022

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 22

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): SEE PART V SECTION C SUPPLEMENTAL 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 22

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

Yes

If "Yes" (list url): SEE PART V SECTION C SUPPLEMENTAL INFO

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

10b

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

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

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

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2022

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 300.0000%
and FPG family income limit for eligibility for discounted care of 400.0000%

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):

SEE PART V SECTION C SUPPLEMENTAL INFO

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

SEE PART V SECTION C SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V SECTION C SUPPLEMENTAL 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) 2022

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) 2022

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) 2022

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)

	B
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 22

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

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): SEE PART V SECTION C SUPPLEMENTAL 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 22

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

Yes

If "Yes" (list url): SEE PART V SECTION C SUPPLEMENTAL INFO

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

10b

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) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	B
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 300.0000%
and FPG family income limit for eligibility for discounted care of 400.0000%

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 SUPPLEMENTAL INFO

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

SEE PART V SECTION C SUPPLEMENTAL INFO

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

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) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	B
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) 2022

Page 7

Part VFacility Information (continued)

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

	B
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) 2022

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
Facility: A 1, 4 - Part V, Section B, Line 5	The CHNA was conducted using many forms of data collection and analysis including the following primary research: Surveys: DHM Research conducted telephone interviews of 700 residents throughout the communities (Crook, Deschutes and Jefferson Counties), served by a St. Charles facility to determine the health-related priorities of the population residing in Central Oregon. The survey was designed to establish a baseline of importance, priorities and needs around health and wellness, including access, quality and cost. Respondents were contacted from a list of registered voters, which included cell phones. In gathering responses, a variety of quality control measures were employed, including questionnaire pre-testing and validation. A link to the full DHM Research questionnaire and results can be found in the References page. Community Input: Community input was gathered via a collaboration between the St. Charles Health System Community Benefit department and Central Oregon Health Council. The CHNA was developed with data, input, and information from a wide variety of health and community based organizations, stakeholders and community members. The input was gathered from the Central Oregon Health Councils Community Advisory Council, a number of health-related advisory boards and groups, and via numerous community focus groups throughout the region. Individuals (such as traditional health workers/peer support specialists/community health workers) and organizations were asked to share their expertise through a health equity and social determinants of health lens. You can see a list of contributors by accessing the 2019 Central Oregon Regional Health Assessment, link is provided in the Reference page section of this CHNA. Methodologysecondary research The process began by compiling, reviewing and analyzing secondary information available including information at the local, state and national level of the populations health. All information used in this report was taken from the most recent information available from the listed resources.
Facility: B 2, 3 - Part V, Section B, Line 5	The CHNA was conducted using many forms of data collection and analysis including the following primary research: Surveys: DHM Research conducted telephone interviews of 700 residents throughout the communities (Crook, Deschutes and Jefferson Counties), served by a St. Charles facility to determine the health-related priorities of the population residing in Central Oregon. The survey was designed to establish a baseline of importance, priorities and needs around health and wellness, including access, quality and cost. Respondents were contacted from a list of registered voters, which included cell phones. In gathering responses, a variety of quality control measures were employed, including questionnaire pre-testing and validation. A link to the full DHM Research questionnaire and results can be found in the References page. Community Input: Community input was gathered via a collaboration between the St. Charles Health System Community Benefit department and Central Oregon Health Council. The CHNA was developed with data, input, and information from a wide variety of health and community based organizations, stakeholders and community members. The input was gathered from the Central Oregon Health Councils Community Advisory Council, a number of health-related advisory boards and groups, and via numerous community focus groups throughout the region. Individuals (such as traditional health workers/peer support specialists/community health workers) and organizations were asked to share their expertise through a health equity and social determinants of health lens. You can see a list of contributors by accessing the 2019 Central Oregon Regional Health Assessment, link is provided in the Reference page section of this CHNA. Methodologysecondary research The process began by compiling, reviewing and analyzing secondary information available including information at the local, state and national level of the populations health. All information used in this report was taken from the most recent information available from the listed resources.
Facility: A 1, 4 - Part V, Section B, Line 6a	St. Charles Bend & St. Charles Redmond
Facility: A 1, 4 - Part V, Section B, Line 11	To prioritize the varied health needs of Deschutes County - the defined community served by St. Charles Flagship hospital (Bend and Redmond), Jefferson County - the defined community served by St. Charles Madras and Crook County - the defined community served by St. Charles Prineville, an extensive review of existing data, community partner information and a professionally facilitated phone survey were conducted and completed as part of the CHNA research. Once the initial analysis of available secondary data was collated, the phone survey completed and input collected from key stakeholders, the Community Benefit department prioritized significant health needs as follows: St. Charles (Flagship Hospital):1. Behavioral Health: Increase Access and Coordination 2. Stable Housing and Supports 3. Substance and Alcohol Misuse Prevention and Treatment 4. Address Poverty and Enhance Self Sufficiency 5. Upstream Prevention: Promotion of Individual Well-Being 6. Promote Enhanced Physical Health Across CommunitiesSt. Charles Prineville & St. Charles Madras Hospitals:1. Stable Housing and Support2. Address Poverty and Enhance Self Sufficiency3. Upstream Prevention: Promotion of Individual Well-Being4. Substance and Alcohol Misuse Prevention and Treatment5. Behavioral Health: Increase Access and Coordination6. Promote Enhanced Physical Health Across CommunitiesCriteria determining needs to be addressed:When determining which of the above significant health needs would be selected as the health priorities to be addressed, St. Charles considered the following criteria: Severity of issue Ability to impact Community Resources St. Charles Bend and Redmond campuses available resources and expertise St. Charles Prineville campus available resources and expertise St. Charles Madras campus available resources and expertise St. Charles Health System strategic plan St. Charles Hospitals' Prioritized Need(s):The Community Health Needs Assessment (CHNA) identified that access to affordable housing, living wage jobs and mental health services would most improve the health of our community. After careful consideration, St. Charles Hospitals will focus on efforts that reduce feelings of loneliness and social isolation while fostering a sense of belonging for the 2023-2025 regional health implementation strategy (RHIS) to start addressing mental health concerns and promoting individual well-being. The CDC defines loneliness as the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated.About one in five Americans suffer from chronic loneliness, with a survey in 2020 revealing that young adults suffer the most. Older adults are also at higher risk for social isolation and loneliness due to changes in health and social connections that can come with growing older, hearing, vision, and memory loss, disability, trouble getting around and/or the loss of family and friends. Loneliness has broader implications for our mental and physical health too. Its not difficult to understand how loneliness leads to depression, a growing problem in the United States. Among older adults, loneliness increases the risk of developing dementia, slows down their walking speeds, interferes with their ability to take care of themselves, and increases their risk of heart disease and stroke. Loneliness is even associated with dying earlier. Among adolescents and young adults, loneliness increases the likelihood of headaches, stomach aches, sleep disturbances, and compulsive internet use. Chronic loneliness is said to have similar impacts on health as smoking a pack of cigarettes a day. Furthermore, according to Thomas Joiner, a leading expert on suicide, when people hold two specific psychological states in their minds simultaneously, and when they do so for long enough, they develop the desire for death. The two psychological states are perceived burdensomeness and a sense of low belongingness or social alienation. In 2017, Angus Deaton and Anne Case discovered that 158,000 Americans died through the process of addiction to alcohol, painkillers, or other drugs or by suicide and this number has grown year over year. They also attribute these statistics to social isolation or feeling disconnected. Acknowledging that mental health issues are complex and intertwined, creating opportunities for engagement and socialization outside of medical interventions is the first step to begin addressing the loneliness epidemic that was amplified by the COVID-19 pandemic. During our Regional Health Implementation Strategy (RHIS) key informant interviews, a majority of participants felt that loneliness was a major contributor to the mental and behavioral health issues in our communities. When informants were asked if they had ideas to combat loneliness and social isolation, the ideas unanimously centered on the concept of creating opportunities for individuals and families to come together and rediscover what it means to belong within their own community. Belonging is often defined as the feeling of security and support when there is a sense of acceptance, inclusion, and identity for a member of a certain group and it has been identified as a pillar in Maslows Hierarchy of Needs. Maslows Hierarchy of Needs is the idea that our needs range from the very basic, such as the things required for our survival, through to higher goals such as altruism and spirituality. Maslow included social belonging because we need friendships, family connections and emotional intimacy with others. People in different societies meet this need in different ways: for some people, their need for social belonging might be met entirely within their extended family; for others, it might be organized activities such as a church community; for others, it might be a network of friendships and romantic relationships that meet this need. Its worth noting that meeting this need can enable us to overcome a lack of our basic needs through the strength of our relationships with others. We truly are stronger together than we are alone. To that end, St. Charles Health System aims to come alongside community members, partners, and caregivers to help older adults, youth and those who are feeling lonely establish a sense of belonging.The following are the significant health needs identified in the St. Charles CHNAs that will not be addressed in this implementation strategy: Behavioral Health Stable Housing and Supports Substance and Alcohol Misuse Prevention and Treatment Address Poverty and Enhance Self Sufficiency Promote Enhanced Physical Health Across Communities To achieve real improvement, this plan will focus on issues the organization has the most ability to impact alongside our community partners. By selecting one priority, a more focused effort can be made by the caregivers at all St. Charles campuses, in collaboration with local partners, to improve the health of those the health system serves. While all of the needs listed above are important, St. Charles leaders have decided to focus Community Benefit resources and efforts on the issue of reducing loneliness and increasing belonging. Having a laser focus on this issue will ensure real progress is made. Work will also continue on each of the other identified needs listed above through internal St. Charles departments and through external community partners. In addition, focusing on belonging could ultimately positively impact these other identified needs.
Facility: B 2, 3 - Part V, Section B, Line 11	To prioritize the varied health needs of Deschutes County - the defined community served by St. Charles Flagship hospital (Bend and Redmond), Jefferson County - the defined community served by St. Charles Madras and Crook County - the defined community served by St. Charles Prineville, an extensive review of existing data, community partner information and a professionally facilitated phone survey were conducted and completed as part of the CHNA research. Once the initial analysis of available secondary data was collated, the phone survey completed and input collected from key stakeholders, the Community Benefit department prioritized significant health needs as follows: St. Charles (Flagship Hospital):1. Behavioral Health: Increase Access and Coordination 2. Stable Housing and Supports 3. Substance and Alcohol Misuse Prevention and Treatment 4. Address Poverty and Enhance Self Sufficiency 5. Upstream Prevention: Promotion of Individual Well-Being 6. Promote Enhanced Physical Health Across CommunitiesSt. Charles Prineville & St. Charles Madras Hospitals:1. Stable Housing and Support2. Address Poverty and Enhance Self Sufficiency3. Upstream Prevention: Promotion of Individual Well-Being4. Substance and Alcohol Misuse Prevention and Treatment5. Behavioral Health: Increase Access and Coordination6. Promote Enhanced Physical Health Across CommunitiesCriteria determining needs to be addressed:When determining which of the above significant health needs would be selected as the health priorities to be addressed, St. Charles considered the following criteria: Severity of issue Ability to impact Community Resources St. Charles Bend and Redmond campuses available resources and expertise St. Charles Prineville campus available resources and expertise St. Charles Madras campus available resources and expertise St. Charles Health System strategic plan St. Charles Hospitals' Prioritized Need(s):The Community Health Needs Assessment (CHNA) identified that access to affordable housing, living wage jobs and mental health services would most improve the health of our community. After careful consideration, St. Charles Hospitals will focus on efforts that reduce feelings of loneliness and social isolation while fostering a sense of belonging for the 2023-2025 regional health implementation strategy (RHIS) to start addressing mental health concerns and promoting individual well-being. The CDC defines loneliness as the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated.About one in five Americans suffer from chronic loneliness, with a survey in 2020 revealing that young adults suffer the most. Older adults are also at higher risk for social isolation and loneliness due to changes in health and social connections that can come with growing older, hearing, vision, and memory loss, disability, trouble getting around and/or the loss of family and friends. Loneliness has broader implications for our mental and physical health too. Its not difficult to understand how loneliness leads to depression, a growing problem in the United States. Among older adults, loneliness increases the risk of developing dementia, slows down their walking speeds, interferes with their ability to take care of themselves, and increases their risk of heart disease and stroke. Loneliness is even associated with dying earlier. Among adolescents and young adults, loneliness increases the likelihood of headaches, stomach aches, sleep disturbances, and compulsive internet use. Chronic loneliness is said to have similar impacts on health as smoking a pack of cigarettes a day. Furthermore, according to Thomas Joiner, a leading expert on suicide, when people hold two specific psychological states in their minds simultaneously, and when they do so for long enough, they develop the desire for death. The two psychological states are perceived burdensomeness and a sense of low belongingness or social alienation. In 2017, Angus Deaton and Anne Case discovered that 158,000 Americans died through the process of addiction to alcohol, painkillers, or other drugs or by suicide and this number has grown year over year. They also attribute these statistics to social isolation or feeling disconnected. Acknowledging that mental health issues are complex and intertwined, creating opportunities for engagement and socialization outside of medical interventions is the first step to begin addressing the loneliness epidemic that was amplified by the COVID-19 pandemic. During our Regional Health Implementation Strategy (RHIS) key informant interviews, a majority of participants felt that loneliness was a major contributor to the mental and behavioral health issues in our communities. When informants were asked if they had ideas to combat loneliness and social isolation, the ideas unanimously centered on the concept of creating opportunities for individuals and families to come together and rediscover what it means to belong within their own community. Belonging is often defined as the feeling of security and support when there is a sense of acceptance, inclusion, and identity for a member of a certain group and it has been identified as a pillar in Maslows Hierarchy of Needs. Maslows Hierarchy of Needs is the idea that our needs range from the very basic, such as the things required for our survival, through to higher goals such as altruism and spirituality. Maslow included social belonging because we need friendships, family connections and emotional intimacy with others. People in different societies meet this need in different ways: for some people, their need for social belonging might be met entirely within their extended family; for others, it might be organized activities such as a church community; for others, it might be a network of friendships and romantic relationships that meet this need. Its worth noting that meeting this need can enable us to overcome a lack of our basic needs through the strength of our relationships with others. We truly are stronger together than we are alone. To that end, St. Charles Health System aims to come alongside community members, partners, and caregivers to help older adults, youth and those who are feeling lonely establish a sense of belonging.The following are the significant health needs identified in the St. Charles CHNAs that will not be addressed in this implementation strategy: Behavioral Health Stable Housing and Supports Substance and Alcohol Misuse Prevention and Treatment Address Poverty and Enhance Self Sufficiency Promote Enhanced Physical Health Across Communities To achieve real improvement, this plan will focus on issues the organization has the most ability to impact alongside our community partners. By selecting one priority, a more focused effort can be made by the caregivers at all St. Charles campuses, in collaboration with local partners, to improve the health of those the health system serves. While all of the needs listed above are important, St. Charles leaders have decided to focus Community Benefit resources and efforts on the issue of reducing loneliness and increasing belonging. Having a laser focus on this issue will ensure real progress is made. Work will also continue on each of the other identified needs listed above through internal St. Charles departments and through external community partners. In addition, focusing on belonging could ultimately positively impact these other identified needs.
Facility: A 1, 4 - Part V, Section B, Line 16j	A REFERENCE TO THE FINANCIAL ASSISTANCE PROGRAM WAS INCLUDED ON BILLING STATEMENTS AS WELL AS VOICE MESSAGING ON CUSTOMER SERVICE PHONE LINES & PROMPTS.
Facility: B 2, 3 - Part V, Section B, Line 16j	A REFERENCE TO THE FINANCIAL ASSISTANCE PROGRAM WAS INCLUDED ON BILLING STATEMENTS AS WELL AS VOICE MESSAGING ON CUSTOMER SERVICE PHONE LINES & PROMPTS.
Facility: A 1, 4 - Part V, Section B, Line 20e	BEFORE INITIATING EAC'S, PATIENTS ARE SCREENED FOR FPL under 200%. IF FPL IS 200% OR BELOW, A FINANCIAL ASSISTANCE POLICY & FINANCIAL ASSISTANCE APPLICATION ARE MAILED TO THE GUARANTOR. IF THE GUARANTOR FAILS TO COMPLETE AND RETURN THE APPLICATION, OR FAILS TO PAY THE ACCOUNT IN FULL, OR FAILS TO SET UP A PAYMENT PLAN WITHIN 45-DAYS OF MAILING THE POLICY APPLICATION, THE ACCOUNTS ARE ASSIGNED TO A BAD DEBT AGENCY.
Facility: B 2, 3 - Part V, Section B, Line 20e	BEFORE INITIATING EAC'S, PATIENTS ARE SCREENED FOR FPL under 200%. IF FPL IS 200% OR BELOW, A FINANCIAL ASSISTANCE POLICY & FINANCIAL ASSISTANCE APPLICATION ARE MAILED TO THE GUARANTOR. IF THE GUARANTOR FAILS TO COMPLETE AND RETURN THE APPLICATION, OR FAILS TO PAY THE ACCOUNT IN FULL, OR FAILS TO SET UP A PAYMENT PLAN WITHIN 45-DAYS OF MAILING THE POLICY APPLICATION, THE ACCOUNTS ARE ASSIGNED TO A BAD DEBT AGENCY.

Schedule H (Form 990) 2022

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?
Name and address		Type of Facility (describe)
1	St Charles Heart & Lung Specialists 2500 NE Neff Rd Bend,OR97701	Heart and Lung Services
2	Cascade Medical Imaging 1460 NE Medical Center Dr Bend,OR97701	Diagnostic imaging clinic
3	St Charles Surgical Specialists Redmond 1245 NW 4th Street STE 101 Remdond,OR97756	Surgical Specialists
4	St Charles Center for Womens Health Redmond 340 NW 5th Street Ste 101 Redmond,OR97756	OB/GYN Clinic
5	St Charles Family Care Redmond 211 NW Larch Ave Redmond,OR97756	Primary Care Clinic
6	St Charles Cancer Center 2500 NE Neff Rd Bend,OR97701	Outpatient Cancer center
7	Sage View 1885 NE Purcell Blvd Bend,OR97701	Mental Health Services
8	St Charles Family Care Bend East 2600 NE Neff Rd Bend,OR97701	Primary Care Clinic
9	St Charles Family Care Prineville 384 SE Combs Flat Road Prineville,OR97754	Rural Health Clinic
10	Wound Care & Ostomy Clinic Bend 2275 NE Doctors Dr Suite 9 Bend,OR97701	Wound & Ostomy Care
11	St Charles Trauma & Acute Care 2275 NE Doctors Dr Suite 6 Bend,OR97701	Trauma and & Surgical Services
12	St Charles Urgent Care South Bend 61250 SE Coombs Place Bend,OR97702	Urgent Care Clinic
13	St Charles Hospice 2275 NE Doctors Dr Suite 5 Bend,OR97701	Hospice Care
14	St Charles Sleep Center Bend 2042 NE Williamson Ct Bend,OR97701	Sleep Lab
15	St Charles Family Care Bend South 61250 SE Coombs Place Bend,OR97702	Primary Care Clinic
16	Behavioral Health 360 NW Bond St Suite 330 Bend,OR97701	Behavioral Health clinic
17	St Charles Urgent Care La Pine 51781 Huntington Rd La Pine,OR97739	Urgent Care Clinic
18	St Charles Urgent Care Prineville 384 SE Combs Flat Road Prineville,OR97754	Urgent Care Clinic
19	St Charles Family Care Madras 480 NE A St Madras,OR97741	Primary Care Clinic
20	Cascade Surgicenter 2200 NE Neff Rd 100 Bend,OR97701	Surgery Center
21	St Charles Family Care La Pine 51781 Huntington Rd La Pine,OR97739	Primary Care Clinic
22	St Charles Rheumatology 2600 NE Neff Rd Bend,OR97701	Rheumatology Clinic
23	St Charles Neonatology 2500 NE Neff Rd Bend,OR97701	Neonatology Intensive Care Unit
24	St Charles Family Care Sisters 630 N Arrowleaf Trail Sisters,OR97759	Primary Care Clinic
25	St Charles Pulmonary Clinic Bend 2500 NE Neff Rd Bend,OR97701	Lung clinic
26	St Charles Anticoagulation Clinic Bend 2275 NE Doctors Dr Suite 7 Bend,OR97701	Anticoag Clinic
27	St Charles PEDAL Clinic 2036 NW Williamson Court Bend,OR97701	Pediatric Behavioral Health
28	St Charles Sleep Center Redmond 655 NW Jackpine Ave Redmond,OR97756	Sleep Lab
29	Central Oregon Magnetic Resonance Imaging 1460 NE Medical Center Dr Bend,OR97701	MRI Center
30	St Charles Palliative Care 2275 NE Doctors Dr Suite 5 Bend,OR97701	Palliative Care
31	St Charles East Infusion 2600 NE Neff Rd Bend,OR97701	Infusion Therapy Clinic
32	St Charles Preoperative Medicine 2275 NE Doctors Dr Suite 6 Bend,OR97701	Care for Surgery Patients
33	SCMG Imaging Redmond 211 NW Larch Ave Redmond,OR97756	Imaging Services
34	St Charles Pulmonary Clinic Redmond 655 NW Jackpine Ave Redmond,OR97756	Lung clinic
35	St Charles Infectious Disease 2965 NE Conners Ave Suite 127 Bend,OR97701	Infectious Disease Clinic
36	Sisters School Based Health Clinic 640 N Arrowleaf Trail Sisters,OR97759	School Based Clinic
37	St Charles Dietitians & Community Outreach 2036 NE Williamson Court Bend,OR97701	nutrition education and counseling
38	Sister Diagnostic Radiology 630 N Arrowleaf Trail Sister,OR97759	Radiology Services
39	St Charles Imaging Bend East 2600 NE Neff Rd Bend,OR97701	Imaging Services
40	St Charles Imaging La Pine 51781 Huntington Rd La Pine,OR97739	Imaging Services
41	St Charles Diabetes Clinic 2036 NE Williamson Court Bend,OR97701	Diabetes Clinic
42	St Charles Urgent Care East Bend 2600 NE Neff Rd Bend,OR97701	Urgent Care Clinic
43	St Charles Anticoagulation Clinic Redmond 655 NW Jackpine Ave Redmond,OR97756	Anticoag Clinic
44	St Charles Laboratory Services La Pine 51781 Huntington Rd La Pine,OR97739	Outpatient Lab
45	St Charles Preoperative Medicine LaPine 51781 Huntington Rd La Pine,OR97739	Periop Services
46	Wound Care & Ostomy Clinic Madras 470 NE A Street Madras,OR97741	Wound & Ostomy Care
47	St Charles Cancer Center Redmond 1541 NW Canal Blvd Redmond,OR97756	Outpatient Cancer Center
48	St Charles Laboratory Services Redmond 1245 NW 4th Street Redmond,OR97756	Outpatient Lab
49	Behavioral Health Redmond 916 SW 17th St Suite 202 Redmond,OR97756	Behavioral Health clinic
50	St Charles Surgical Specialists Prineville 384 SE Combs Flat Rd Suite 1200 Prineville,OR97754	Surgical Specialists
51	St Charles Surgical Specialists Madras 470 NE A St Madras,OR97741	Surgical Specialists
52	St Charles Laboratory Services Madras 470 NE A Street Madras,OR97741	Outpatient Lab
53	St Charles Preoperative Medicine Redmond 916 SW 17th St Redmond,OR97756	Periop Services
54	St Charles Heart & Lung Specialists Redmond 655 NW Jackpine Ave Redmond,OR97756	Heart and Lung Services

Schedule H (Form 990) 2022

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
Part I, Line 7 - Explanation of Costing Methodology	The costing methodology used was derived from SCHS's financial systems, which address all hospital-based patient segments and other services provided. A cost-to-charge ratio from the financial systems was used to calculate the cost of Financial Assistance in line 7a. Numbers reported in column (b) in lines 7a and 7b refer to the number of patient encounters.
Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense	When SCHS provides care to patients, it does not require collateral; however, itmaintains an estimated allowance for doubtful accounts. The primary collection risksrelate to uninsured patient accounts and patient accounts for which the primaryinsurance payor has paid, but patient responsibility amounts (generally deductiblesand copayments) remain outstanding. The reserves against accounts receivable is estimated based primarily upon SCHS historical collection experience, the age of the patient's account, management's estimate of the patient's economic ability to pay, and the effectiveness of collection efforts. Patient accounts receivable balances are routinely reviewed in conjunction with historical collection rates and other economic conditions that might ultimately affect the collectability of patientaccounts when considering the adequacy of the amounts recorded as net patient revenues. Actual write offs have historically been within management'sexpectations.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit	SCHS currently has no reasonable way to track or estimate the amount of bad debt expense attributable to charity care, and accordingly this line has been left blank.
Part III, Line 4 - Bad Debt Expense	See page 14, footnote 4 "Net Patient Service Revenue", in the attached Audited Financial Statements.
Part III, Line 8 - Explanation Of Shortfall As Community Benefit	As a response to efforts to improve the health and quality of life of people living in the community, SCHS provided approximately $50 million in unreimbursed services to patients enrolled in traditional Medicare programs. SCHS believes that the Medicare shortfall should be treated as a community benefit since it has a clear mission to serving and improving the health status of the elderly. If SCHS should cease to exist, this shortfall would have to be absorbed by another health care provider. Costs are from the Medicare Cost Report, but none of these costs are being claimed as a community benefit in Part I, line 7.SCHS had a total medicare shortfall of approximately $139M which differs from the shortfall of $50M reported in Part III Section B because Part III Section B includes only those costs allowed in the Medicare Cost Report which excludes the Medicare Advantage shortfall.
Part III, Line 9b - Provisions On Collection Practices For Qualified Patients	Collection policies are the same for all patients. Every effort is made to identify patients who may need financial assistance at the earliest point during the patients experience with St. Charles. Patients may be identified as a candidate for financial assistance at any time before, during or after services are delivered. If at any point during the collection process documentation or information is received that indicates the patient may be eligible for our financial assistance program, the account is reviewed by our financial assistance team for eligibility. Prior to sending an account to collections, patient accounts are reviewed for Federal Poverty Level(FPL). If FPL is 200% or below, a Financial Assistance policy & Financial Assistance application are mailed to the guarantor. If the guarantor fails to complete and return the application, or fails to pay the account in full, or fails to set up a payment plan within 45-days of mailing the policy application, the accounts are assigned to a bad debt agency.
Part VI, Line 2 - Needs Assessment	St. Charles Health System (SCHS) assesses the needs of each of our communities in many different ways other than the facility community health needs assessments. SCHS partners with many organizations from around the community. We collaborated with the Central Oregon Health Council (COHC) to establish a local community data website. The data is provide by Healthy Communities Institute (HCI) and COHC staff manages the website. The website will have dashboards of each community and population risk profiling data that is continuously updated and accessible to the community. This information helps SCHS to keep a finger on the pulse of each population's many health indicators, helping us to continually assess each community's needs, positive changes and/or opportunities for improvement. This information can be found at http://www.centraloregonhealthdata.org. Each year St. Charles also produces the St. Charles Health System Annual Report. This report is comprised of a summary of each of the following: Community BenefitTotalsFinancial OverviewDays cash on handOperating marginExcess marginOperating ExpensesFull time employee countEach health system facility (St. Charles Bend, St. Charles Redmond, St. Charles Prineville and St. Charles Madras) BirthsDischargesIn-patient casesOut-patient casesEmergency visitsSt. Charles Medical GroupPatient visits for each clinicsThe 2021 Annual Report is posted online on the St. Charles Health System website at https://www.stcharleshealthcare.org/about-us/st-charles-annual-report. This report and the primary data collected for its creation let us know what the trends are for different hospital stays, conditions and out-patient visits, helping to decide what services we offer and where the needs are. St. Charles also plays a significant role in local, regional and State groups in order to stay abreast of the newest information, trends, health data and best practices. SCHS has representation on the Central Oregon Health Council (COHC), the governance entity over the region's Coordinated Care Organization, PacificSource Community Solutions, County Commissions, patients, community members & local medical clinics. BY PARTICIPATING ON THIS COUNCIL, ST. CHARLES IS ABLE TO WORK WITH THE EXPERTS IN EACH OF THE THREE COUNTIES TO HEAR FIRSTHAND HOW EACH COMMUNITY IS DOING AND WHAT THEIR HEALTH NEEDS ARE. ST. CHARLES ALSO SITS ON DIFFERENT COMMITTEES FOR THE OREGON ASSOCIATION FOR HOSPITALS AND HEALTH SYSTEMS (OAHHS) AND LOCAL NON-PROFITS. BEING PART OF THESE GROUPS HELPS ST. CHARLES TO BETTER UNDERSTAND THE NEEDS OF OUR COMMUNITIES WHILE ALSO LEARNING HOW TO BETTER COLLECT, TRACK, REPORT AND IMPROVE UPON COLLECTED INFORMATION.
Part VI, Line 3 - Patient Education of Eligibility for Assistance	The Financial assistance program policy is posted on the SCHS website.Financial Counselors and registration staff in our facilities & primary care clinics offer financial assistance to patients, both upon request and when patients are uninsured.SCHS works to identify patients who may qualify for coverage through the following government programs (uninsured patients seen in our Emergency departments & those admitted to all of our facilities are automatically referred to a Financial Counseling Patient Advocate): CobraCrime Victims AssistanceEmergency Medicaid for Aliens Medicaid for pregnant women and children Medicaid, Medicare Supplemental Security Income (SSI)Temporary Aid for Needy Families (TANF) VeteransOur Financial Counseling Patient Advocate will work with these individuals through the process of qualifying for coverage or denial of coverage from all applicable government programs.Patients working with the Financial Counseling Patient Advocate have their accounts put on hold from collections. Patients will be referred to the SCHS Financial Assistance Department for follow-up.
Part VI, Line 4 - Community Information	DESCHUTES COUNTY: (ST. CHARLES BEND AND ST. CHARLES REDMOND) INFORMATION TAKEN FROM UNITED STATES CENSUS BUREAU(HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/DESCHUTESCOUNTYOREGON) UNLESS OTHERWISE NOTED:URBANLAND AREA IN SQUARE MILES (2020): 3,018POPULATION (2022): 206,549UNDER 5 YEARS: 4.7%UNDER 18 YEARS: 19.4%65 YEARS AND OVER: 20.6%FEMALE: 50.1%HOUSEHOLDS (2017-2021): 79,329PERSONS PER HOUSEHOLD (2017-2021): 2.44MEDIAN HOUSEHOLD INCOME (2017-2021): $74,082PERCENTAGE OF PERSONS BELOW POVERTY LEVEL (2017-2021): 8.7%HIGH SCHOOL GRADUATE OR HIGHER, PERCENT OF PERSONS AGE 25+ (2017-2021): 94.3%POPULATION BY RACE (2021):WHITE ALONE, NOT HISPANIC: 93.7% HISPANIC OR LATINO: 8.6%TWO OR MORE RACES: 3%AMERICAN INDIAN AND ALASKA NATIVE ALONE: 1.1% ASIAN ALONE: 1.4%BLACK OR AFRICAN AMERICAN ALONE: .6%NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER: 0.2%HEALTH CARE PROVIDER ASSETS IN DESCHUTES COUNTY (OUTSIDE OF ST. CHARLES BEND AND REDMOND): MOSAIC MEDICAL CLINIC, (BEND AND REDMOND) (FQHC) LYNCH COMMUNITY CLINIC (SCHOOL-BASED HEALTH CENTER PARTNERSHIP BETWEEN MOSAIC MEDICAL, REDMOND SCHOOL DISTRICT AND DESCHUTES COUNTY) ENSWORTH COMMUNITY SCHOOL-BASED HEALTH CENTER (PARTNERSHIP BETWEEN MOSAIC MEDICAL, BEND-LAPINE SCHOOL DISTRICT AND DESCHUTES COUNTY) BEND MEMORIAL CLINIC, (BEND, REDMOND AND SISTERS) HIGH LAKES HEALTH CARE (BEND, REDMOND AND SISTERS).CROOK COUNTY: (ST. CHARLES PRINEVILLE) INFORMATION TAKEN FROM UNITED STATES CENSUS BUREAU (HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/CROOKCOUNTYOREGON) UNLESS OTHERWISE NOTED: RURALMEDICALLY UNDERSERVED AREA (MUA)LAND AREA IN SQUARE MILES (2020): 2.979POPULATION (2022 ESTIMATE): 26,375UNDER 5 YEARS: 5.3%UNDER 18 YEARS: 19.9%65 YEARS AND OVER: 25.2%FEMALE: 49.9%HOUSEHOLDS (2017-2021): 9,951PERSONS PER HOUSEHOLD (2017-2021): 2.43 MEDIAN HOUSEHOLD INCOME (2017-2021): $64,820PERCENTAGE OF PERSONS BELOW POVERTY LEVEL (2017-2021): 12.0%HIGH SCHOOL GRADUATE OR HIGHER, PERCENT OF PERSONS AGE 25+ (2017-2021): 90.8%POPULATION BY RACE (2021):WHITE ALONE, NOT HISPANIC: 94.4% HISPANIC OR LATINO: 8%TWO OR MORE RACES: 2.6%AMERICAN INDIAN AND ALASKA NATIVE ALONE: 1.8% ASIAN ALONE: 0.7%BLACK OR AFRICAN AMERICAN ALONE: 0.5%NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER: 0.1%HEALTH CARE PROVIDER ASSETS IN CROOK COUNTY (OUTSIDE OF ST. CHARLES PRINEVILLE): MOSAIC MEDICAL (FQHC)CROOK KIDS CLINIC (SCHOOL-BASED HEALTH CENTER PARTNERSHIP BETWEEN MOSAIC MEDICAL AND CROOK COUNTY SCHOOL DISTRICT).JEFFERSON COUNTY: (ST. CHARLES MADRAS) INFORMATION TAKEN FROM UNITED STATES CENSUS BUREAU (HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/JEFFERSONCOUNTYOREGON)UNLESS OTHERWISE NOTED: RURALMEDICALLY UNDERSERVED AREA (MUA)LAND AREA IN SQUARE MILES (2020): 1,782POPULATION (2022 ESTIMATE): 25,330UNDER 5 YEARS: 5.9%UNDER 18 YEARS: 23.3%65 YEARS AND OVER: 19.7%FEMALE: 48.0%HOUSEHOLDS (2017-2021): 8,244PERSONS PER HOUSEHOLD (2017-2021): 2.79MEDIAN HOUSEHOLD INCOME (2017-2021): $59,748PERCENTAGE OF PERSONS BELOW POVERTY LEVEL (2017-2021): 15.9%HIGH SCHOOL GRADUATE OR HIGHER, PERCENT OF PERSONS AGE 25+ (2015-2019): 87.8%POPULATION BY RACE (2022):WHITE ALONE, NOT HISPANIC: 75.7% HISPANIC OR LATINO: 20.8%TWO OR MORE RACES: 3.7%AMERICAN INDIAN AND ALASKA NATIVE ALONE: 18.3%
Part VI, Line 4 - Community Building Activities	Our community building activities focused on workforce development activities which support the community by offering the expertise and resources of our hospital systems caregivers for the betterment of the community. Specifically these programs address community-wide workforce issues, potentially providing health care workers to promote the health of the community.
Part VI, Line 5 - Promotion of Community Health	SCHS provides services without charge, or at amounts less than its established rates, to patients who meet the criteria of its charity care policy. SCHS criteria for the determination of charity care include the patientsor other responsible partys annual household income, number of people in the home and amount claimed on taxes, credit history, existing medical debt obligations and other indicators of the patient's ability to pay. Generally, those individuals with an annual household income at or less than 300% of the Federal Poverty Guidelines (the Guidelines) qualify for charity care under SCHS policy. In addition, SCHS provides discounts on a sliding scale to those individuals with an annual household income of between 300% and 400% of the Guidelines. Since SCHS does not pursue collection of amounts determined to qualify as charity care, those amounts are not reported as net patient service revenue.BECAUSE MADRAS PRINEVILLE AND LA PINE ARE LOCATED IN MEDICALLY UNDERSERVED AREAS(MUAS), THE RESOURCES USED FOR PROVIDER RECRUITMENT IN THOSE COMMUNITIES ARE COUNTED AS COMMUNITY BENEFIT. ST. CHARLES ALSO ALLOWS NURSING STUDENTS, HIGH SCHOOL STUDENTS AND OTHER PROVIDERS TO PARTAKE IN JOB-SHADOWING WITH OUR PAID CAREGIVERS TO HELP THEM COMPLETE THEIR COURSE WORK AND/OR EARN CREDITS, WITHOUT RESTRICTIONS RELATED TO FUTURE EMPLOYMENT. THE ST. CHARLES HEALTH SYSTEM BOARD OF DIRECTORS IS COMPRISED OF MEMBERS FROM MULTIPLE COMMUNITIES SERVED BY THE SYSTEMBEND, PRINEVILLE, SISTERS,ETC.ALLOWING FOR DIVERSE VIEWS AND LEADERSHIP RELATED TO PROMOTING THE HEALTH OF THE COMMUNITY. VARIOUS COMMUNITY CLASSES ARE OFFERED VIRTUALLY OR IN PERSON FOR EACH CAMPUS, INCLUDING CHILDBIRTH EDUCATION, HEALTH HEART EDUCATION, ETC. IN ORDER TO CONTINUE TO PROMOTE HEALTH IN THE COMMUNITY AND ELIMINATE BARRIERS, SCHOLARSHIPS ARE AVAILABLE FOR THOSE WHO ARE UNABLE TO PAY BUT WOULD STILL LIKE TO PARTICIPATE IN ANY OF THESE CLASSES. DUE TO COVID-19, WE SHIFTED RESOURCES AND ASSETS TO COLLABORATING WITH OUR LOCAL PARTNERS TO HELP TACKLE THE ISSUES THAT HAVE ARISED BECAUSE OF THE PANDEMIC. BEING THE ONLY HEALTH CARE SYSTEM IN CENTRAL OREGON, MANY NON-PROFIT COMMUNITYORGANIZATIONS COME TO ST. CHARLES NEEDING FUNDS AND OTHER DONATIONS, SUCH AS IN-KIND SUPPORT. DURING 2021 ST. CHARLES FACILITY CAREGIVERS PROVIDED HUNDREDS OF HOURS OF IN-KIND SUPPORT TO THESE ORGANIZATIONS WHO SHARE IN ST. CHARLES VISION OF CREATING AMERICAS HEALTHIEST COMMUNITY, TOGETHER. IN-KIND SUPPORT ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO MEMBERSHIP ON NON-PROFIT COMMUNITY ORGANIZATION BOARDS, BELOW FAIRMARKET VALUE RENT FEES, FREE CLEANING AND LANDSCAPING SERVICES AND HOURS SPENT COORDINATING EVENTS PROMOTING HEALTH IMPROVEMENT FOR VULNERABLE AND LOW-INCOME COMMUNITY MEMBERS.
Part VI, Line 7 - States Filing of Community Benefit Report	OR
Part VI - Additional Information	URL of CHNA and Implementation Strategy:https://www.stcharleshealthcare.org/community-health/community-health-needs-assessmentWebsite where FAP, FAP application, and plain language summary was widely available:https://www.stcharleshealthcare.org/patients/billing-and-insurance/patient-financial-assistance

Schedule H (Form 990) 2022

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

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

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

2022

Open to Public
Inspection

Name of the organization
St Charles Health System Inc

Employer identification number
93-0602940

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	(h) Purpose of grant or assistance
(1) CASA OF CENTRAL OR 1029 NW 14TH ST STE 100 BEND,OR97703	93-1062982	501(C)(3)	9,500	YOUTH FOSTER CARE
(2) CO COMMUNITY COLLEGE 2600 NW COLLEGE WAY BEND,OR97701	93-0505827	MUNI CORP	7,500	COLLEGE NURSING PROGRAM
(3) CO COUNCIL ON AGING 373 NE Greenwood Ave BEND,OR97701	93-0661229	501(C)(3)	15,000	MEALS ON WHEELS PROGRAM
(4) CO VETERANS RANCH 65920 61st St BEND,OR97703	37-1755279	501(C)(3)	20,000	IMPROVE QUALITY OF LIFE FOR VETS
(5) FAMILY ACCESS NETWORK 2125 NE DAGGETT LN BEND,OR97701	20-3534560	501(C)(3)	8,500	Access to basic needs for children
(6) FAMILY KITCHEN 469 NW WALL ST BEND,OR97701	93-0427371	501(C)(3)	10,000	FREE COMMUNITY MEALS
(7) GIVING PLATE 61445 S HWY 97 S BEND,OR97702	80-0553186	501(C)(3)	10,000	COMMUNITY FOOD BANK
(8) J BAR J YOUTH SERVICES 62895 Hamby Rd BEND,OR97701	93-0677650	501(C)(3)	10,000	FACILITY SERVING YOUTH OFFENDERS
(9) JEFFERSON CNTY FAITH BASED 278 Southeast 8th Street MADRAS,OR97741	46-1018517	501(C)(3)	10,000	COMMUNITY IMPROVEMENT
(10) KIDS CLUB JEFFERSON COUNTY 410 SW 4TH ST MADRAS,OR97741	46-1018517	501(C)(3)	10,000	KIDS OPPORTUNITIES AND ACTIVITIES
(11) LA PINE COMMUNITY KITCHEN 16480 FINLEY BUTTE RD LA PINE,OR97739	20-2087631	501(C)(3)	6,900	Provide food & clothing
(12) LEADERSHIP BEND FOUNDATION 777 nw Wall St STE 200 BEND,OR97701	93-1224982	501(C)(3)	11,500	Community leadership development
(13) MADRAS AQUATIC CENTER SPECIAL 1195 SE Kemper Way MADRAS,OR97441	20-5757201	SPECIAL DISTRICT	28,790	After school and summer programs
(14) PRINEVILLE SNR CENTER TRUST 180 NE BLEKNAP ST PRINEVILLE,OR97754	93-1326625	501(C)(3)	7,000	SERVICES FOR SENIORS
(15) REDMOND OASIS VILLAGE PROJECT PO BOX 553 PRINEVILLE,OR97754	93-1326625	501(C)(3)	8,475	Alcohol Misuse Prevention
(16) RONALD MCDONALD HOUSE 1700 NE PURCELL BLVD BEND,OR97701	93-1125838	501(C)(3)	9,000	LODGING FOR FAMILIES
(17) SAMARA LEARNING CENTER 230 NE 9TH ST BEND,OR97701	46-5701194	501(C)(3)	7,000	DIVERSITY TRAINING
(18) SAVING GRACE 1004 NW MILWAUKEE AVE 100 BEND,OR97701	93-0797194	501(C)(3)	10,000	Family Violence Abuse & Services
(19) SERENITY LANE PO BOX 8549 COBURG,OR97408	93-0606316	501(C)(3)	10,500	ALCOHOL MISUSE PREVENTION
(20) SHEPHERDS HOUSE PO Box 5484 BEND,OR97708	75-3207723	501(C)(3)	10,550	Homeless shelter and services
(21) SISTERS COLD WEATHER SHELTER PO BOX 1782 SISTERS,OR97759	93-0716745	501(C)(3)	7,500	BASIC NEEDS
(22) SISTERS RODEO ASSN 67637 HWY 220 SISTERS,OR97759	93-0716745	501(c)(4)	6,000	Community Event Sponsorship
(23) ST CHARLES FOUNDATION 2500 NE Neff Rd BEND,OR97701	94-3076293	501(c)(3)	15,695	To support fundraising activities
(24) STOKE AWARENESS OREGON 695 SW Mill View Way BEND,OR97701	82-4216575	501(C)(3)	5,750	Support for Seniors in the Communit
(25) TOUR DES CHUTES 70 SW Century Dr STE 100-273 BEND,OR97702	20-2006038	501(C)(3)	10,000	SUPPORTS CANCER CARE

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) 2022

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

Schedule I (Form 990) 2022

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

St Charles Health System Inc

Employer identification number

93-0602940

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 .....

Yes

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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) 2022

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1Absalon Jeffrey MD CHIEF PHYSICIAN EXECUTIVE	(i) (ii)	348,995 -------------	50,000 -------------	424,625 -------------	61,935 -------------	17,028 -------------	902,583 -------------	207,173 -------------
2Adams Aaron CEO Bend & Redmond	(i) (ii)	159,988 -------------	-------------	447,467 -------------	11,200 -------------	9,959 -------------	628,614 -------------	-------------
3BERRY REBECCA VP HUMAN RESOURCES	(i) (ii)	302,703 -------------	100,000 -------------	64,207 -------------	50,777 -------------	19,057 -------------	536,744 -------------	31,223 -------------
4Binder Darren Secretary	(i) (ii)	370,045 -------------	100,000 -------------	100,621 -------------	65,747 -------------	29,580 -------------	665,993 -------------	68,478 -------------
5BRICKHOUSE JEREMIAH SVP/CIO	(i) (ii)	347,636 -------------	102,500 -------------	52,241 -------------	60,944 -------------	26,059 -------------	589,380 -------------	39,764 -------------
6CHING JOAN VP CHIEF NURSING	(i) (ii)	325,269 -------------	100,000 -------------	2,216 -------------	18,300 -------------	21,002 -------------	466,787 -------------	-------------
7Clover Todd MD Physician	(i) (ii)	686,091 -------------	83,303 -------------	21,272 -------------	18,300 -------------	29,787 -------------	838,753 -------------	-------------
8Dixon Jennifer MD Physician	(i) (ii)	828,738 -------------	-------------	21,045 -------------	18,300 -------------	22,090 -------------	890,173 -------------	-------------
9FREEMAN RICHARD PRESIDENT SCMG	(i) (ii)	87,233 -------------	-------------	465,800 -------------	8,498 -------------	5,338 -------------	566,869 -------------	-------------
10GOLDA DAVID VP HOSPITAL ADMIN BEND/REDMOND	(i) (ii)	259,662 -------------	280 -------------	7,935 -------------	16,561 -------------	25,315 -------------	309,753 -------------	-------------
11Gordon Steve President	(i) (ii)	516,732 -------------	-------------	120,947 -------------	-------------	8,477 -------------	646,156 -------------	-------------
12Gulvin Joshua MD Physician	(i) (ii)	669,996 -------------	83,998 -------------	26,025 -------------	18,300 -------------	29,610 -------------	827,929 -------------	-------------
13GUYN JIM MD SVP POPULATION HEALTH	(i) (ii)	293,173 -------------	100,000 -------------	48,558 -------------	56,569 -------------	20,335 -------------	518,635 -------------	38,269 -------------
14HALLETT MARK Chief Clinical Officer	(i) (ii)	490,115 -------------	2,500 -------------	59,698 -------------	52,800 -------------	21,112 -------------	626,225 -------------	-------------
15MARCHIANDO ROD SVP IMPROVEMENT & STRATEGY	(i) (ii)	174,982 -------------	50,000 -------------	298,199 -------------	39,028 -------------	16,914 -------------	579,123 -------------	99,287 -------------
16Martin William MD Physician	(i) (ii)	627,501 -------------	80,107 -------------	21,327 -------------	18,300 -------------	29,809 -------------	777,044 -------------	-------------
17OSTROM JULIE SR DIRECTOR PERIOP & CARDIO	(i) (ii)	210,218 -------------	2,500 -------------	8,387 -------------	13,808 -------------	25,699 -------------	260,612 -------------	-------------
18POWELL MICHAEL CHIEF PHARMACY OFFICER	(i) (ii)	212,366 -------------	-------------	5,662 -------------	13,630 -------------	25,344 -------------	257,002 -------------	-------------
19ROBINSON DEBRA CNO BEND	(i) (ii)	248,492 -------------	500 -------------	11,505 -------------	15,920 -------------	22,962 -------------	299,379 -------------	-------------
20SHIELDS TODD VP HOSPITAL ADMIN PRINEVILLE/MADRAS	(i) (ii)	225,192 -------------	-------------	8,149 -------------	14,578 -------------	25,067 -------------	272,986 -------------	-------------
21SIMMONS IMAN SVP COO	(i) (ii)	484,783 -------------	102,500 -------------	80,390 -------------	78,823 -------------	26,217 -------------	772,713 -------------	55,731 -------------
22Slater Matthew MD Physician	(i) (ii)	869,709 -------------	-------------	18,238 -------------	18,300 -------------	22,193 -------------	928,440 -------------	-------------
23Sluka Joseph President	(i) (ii)	710,204 -------------	52,407 -------------	363,134 -------------	114,117 -------------	16,840 -------------	1,256,702 -------------	205,159 -------------
24Swafford Matthew Senior VP/CFO	(i) (ii)	505,445 -------------	100,000 -------------	8,458 -------------	80,101 -------------	29,523 -------------	723,527 -------------	-------------

Schedule J (Form 990) 2022

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
Part I, Line 1a: Relevant information in regards to selections on 1a.
Part I, Line 7: Non-Fixed payments not listed above	The St. Charles Board of Directors approved a discretionary bonus to recognize the executive team for their extraordinary work and efforts in leading during the COVID-19 pandemic and to ensure retention. Other key employees received bonuses for recognition of services above and beyond to St. Charles, referral bonuses, or wellness bonuses.

Schedule J (Form 990) 2022

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
St Charles Health System Inc

Employer identification number
93-0602940

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	HOSPITAL FACILITY AUTHORI	93-0991182	000000000	05-17-2022	75,260,000	SEE PART VI		X		X		X
B	HOSPITAL FACILITY AUTHORI	93-0991182	250336DY7	10-12-2016	114,801,653	SEE PART VI		X		X		X
C	HOSPITAL FACILITY AUTHORI	93-0991182	250336EY6	10-22-2020	51,302,850	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................			7,055,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	75,260,000		115,768,627		51,343,229
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............			2,334
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	260,000		1,200,176
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			68,596,617
11 Other spent proceeds .............	75,000,000		45,969,500
12 Other unspent proceeds .............					51,343,229
13 Year of substantial completion .............			2020
	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 2020, a current refunding issue)? ........	X			X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X	X			X
16 Has the final allocation of proceeds been made? ..........	X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X			X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X	X			X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?			X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X			X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X
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 ....	0.700 %
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 .............	0.700 %
7 Does the bond issue meet the private security or payment test? ...	X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X			X	X
b Exception to rebate? ........	X			X		X
c No rebate due? .........		X	X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference

Explanation

Part VI

Column A: Part I (f) - The Bonds were issued for the purpose of making a loan to the Borrower. The proceeds were used to (i) refinance the Authority's Series 2014 Bonds originally issued on 4/1/2014, and (ii) to pay costs of issuance.Column A: Part III, line 7 - As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private security or payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, Line 6. The organization has not undertaken an analysis of the private security or payment test with respect to the bonds, as the level of private business use and/or unrelated trade or business use reported in Part III, Line 6 is not in excess of amounts permitted under Section 145 of the Code.Column A: Part IV, Line 2(b) - The current refunding portion of the bonds met the 6-month exception to rebate.Column B: Part I(f) - The Series 2016A Bonds were issued to finance capital projects, advance refunded the Borrower's 2005B Bonds which were issued on December 21, 2005 and to pay costs of issuance relating to the Column B: Part II, Line 3 - The total proceeds shown in Part II, Line 3 differs from the Issue Price shown in Part I, (e) due to interest earnings on invested proceeds.Column B: Part III, line 7 - As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private security or payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, Line 6. The organization has not undertaken an analysis of the private security or payment test with respect to the bonds, as the level of private business use and/or unrelated trade or business use reported in Part III, Line 6 is not in excess of amounts permitted under Section 145 of the Code.Column B: Part IV, Line 2C - The rebate computation for Series 2016A dated November 28, 2021 was completed by BLX Group LLC and states no rebate due.Column C: Part I (f) - The Bonds were issued to pay costs of capital improvements to the Borrower's health care system.Column C: Part II, Line 3 - The total proceeds shown in Part II, Line 3 differs from the Issue Price shown in Part I, (e) due to interest earnings on invested proceeds.Column C: Part III, line 7 - As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private security or payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, Line 6. The organization has not undertaken an analysis of the private security or payment test with respect to the bonds, as the level of private business use and/or unrelated trade or business use reported in Part III, Line 6 is not in excess of amounts permitted under Section 145 of the Code.

Schedule K (Form 990) 2021

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

St Charles Health System Inc

Employer identification number

93-0602940

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

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

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

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

Part II

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

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






Total ............... $

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) David Liedman	Employee	65,875	Compensation		No

Part V

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

Return Reference	Explanation
Schedule L, Part V Supplemental Information	Part IV: David Liedman was employed at St. Charles Health System Inc. He is a family member of an officer of St. Charles, who is listed on Form 990, Part VII.

Schedule L (Form 990) 2021

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

St Charles Health System Inc

Employer identification number

93-0602940

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .	X	45	32,551	COST OR STATED
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

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

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

32a

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

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

32a

If "Yes," describe in Part II.

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

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2022)

Page 2

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

Return Reference	Explanation

Schedule M (Form 990) (2022)

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

St Charles Health System Inc

Employer identification number

93-0602940

Return Reference	Explanation
Form 990, Part III, Line 4d	OTHER PROGRAM SERVICES 4: Behavioral Health, Psychiatric Emergency and rents from affiliates. OTHER PROGRAM SERVICES 5: ST CHARLES PRINEVILLE CAH OTHER PROGRAM SERVICES 6: ST CHARLES CLINICSST CHARLES CLINICS INCLUDES A GROUP OF MEDICAL CLINICS OWNED AND OPERATED BY ST. CHARLES HEALTH SYSTEM. THESE CLINICS ARE LOCATED THROUGHOUT THE REGION AND PROVIDE OUTPATIENT SERVICES SUCH AS CANCER CARE, OB/GYN, PULMONARY CARE, SLEEP DISORDER RESOURCES, HEART SERVICES AND PRIMARY CARE. SCMG PROVIDED OVER 156,600 VISITS IN BEND CLINICS, 72,400 VISITS IN REDMOND CLINICS, 8,400 VISITS IN THE SISTERS CLINIC, 26,500 VISITS IN PRINEVILLE CLINICS, 12,800 IN THE MADRAS CLINICS AND 9,600 IN LA PINE CLINICS IN 2022. SCMG ALSO OPERATES THREE IMMEDIATE CARE CLINICS TO PROVIDE LOW-COST URGENT CARE SERVICES TO THE COMMUNITY; THE URGENT CARE CLINICS PROVIDED SERVICES FOR MORE THAN 48,000 PATIENT VISITS IN 2022. OTHER PROGRAM SERVICES 7: Home Health/Hospice OTHER PROGRAM SERVICES 8: Net Gain/(Loss)on sale of inventory OTHER PROGRAM SERVICES 9: Healthcare JV Income/(Loss) OTHER PROGRAM SERVICES 10: OTHER PROGRAM SERVICES 11: Medical Records & Dues OTHER PROGRAM SERVICES 12: Supply Sales & Service Fees OTHER PROGRAM SERVICES 13: Education Programs OTHER PROGRAM SERVICES 14: Other Fees OTHER PROGRAM SERVICES 15: Interest OTHER PROGRAM SERVICES 16: Reimbursed Salaries
Form 990, Part VI, Section A, Line 4	In 2022, the Board approved its Tenth Amended and Restaed Bylaws to clarify the staggering of director terms and to add an evaluative term for new directors. The Board also approved its Eleventh Amended and restated Bylays which decreased the minimum number of directors from 10 to 9.
Form 990, Part VI, Section B, Line 11b	The 990 was prepared internally and reviewed by an external consultant. It was also reviewed by the organization's VP Finance and CFO. It was provided to the Audit & Compliance Committee to provide them an opportunity to review before filing.
Form 990, Part VI, Section B, Line 12c	The policy covers any SCHS director, principal officer, or member of a committee (hereinafter referred to as fiduciary) with powers delegated by the SCHS Board of Directors (the Board) who has a direct or indirect financial interest in SCHS or any entity within SCHS. This policy is intended to ensure that the business conducted by SCHS is free from the influence of actual or potential conflicts of interests by any SCHS fiduciary. Each fiduciary shall annually complete the Conflict of Interest Questionnaire. This completed form is automatically submitted to the SCHS VP Chief Compliance Officer who will evaluate the completed forms and present a report to the Governance Committee . The fiduciary is also required to update his/her responses to the Conflict of Interest Questionnaire should any new information regarding an actual or potential conflict of interest for that fiduciary arise. In addition, should a subsequent conflict arise after the submission of the previously completed Conflict of Interest Questionnaire each fiduciary shall orally disclose, prior to the Boards or the relevant committees consideration of a proposed transaction or arrangement, the existence of any financial interest that he or she may have with respect to the transaction or arrangement. The board will then review the transaction or arrangement to determine if it is in SCHS's best interest, for its own benefit, and whether it is fair and reasonable. In conformity with the above determination, it shall make its decision as to whether to enter into the transaction or arrangement.
Form 990, Part VI, Section B, Line 15a	SCHS utilizes an independent outside consultant to provide comparability data regarding compensation for the CEO and top management officials. The analysis covers all elements of total compensation. The CEO's compensation is reviewed and approved by the Board of Directors following a compensation review. The most recent study for the CEO and top management officials was performed in November of 2021.
Form 990, Part VI, Section B, Line 15b	SCHS utilizes an independent outside consultant to provide comparability data regarding compensation for the Key Employees. The analysis covers all elements of total compensation. The compensation is reviewed by the Board of Directors following a compensation review. The evaluation and review process is prescribed in an internal policy and the process is documented. The most recent study for the key employees was performed in November of 2021.SCHS utilized an independent outside consultant to determine the pros and cons of establishing board compensation. In February 2010 the consultant presented its findings to the St. Charles board governance committee advising that board members not be involved in determining any level of compensation for the board. An external committee was selected to review the consultants analysis along with management recommendations and agreed that compensation for the SCHS board of directors is warranted and will assist in retaining and recruiting highly qualified board members.
Form 990, Part VI, Section C, Line 19	Governing documents are available upon request. The Conflict of Interest policy is available to employees through a shared document management system. Financial reports are shared with employees monthly. Audited financial statements are available to the public upon request and on the internet at https://emma.msrb.org/Home/Index.
Form 990, Part XI, Line 9	DISTRIBUTIONS PAID TO NONCONTROLLING JOINT VENTURE OWNERS = -$11186350
Form 990, Part XI, Line 9	JOINT VENTURE ASSET ADJUSTMENT = $57437

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

St Charles Health System Inc

Employer identification number

93-0602940

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) Cascade Medical Buildings LLC 2200 NE Neff Rd Bend,OR97701 27-0037327	Real Estate Rental	OR	1,418,373	28,508,815	St Charles Health System Inc

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 CHARLES FOUNDATION 2500 NE NEFF ROAD BEND,OR97701 94-3076293	RAISES FUNDS FOR SCHS & CMNTY PROGRAMS	OR	501(C)(3)	7	SCHS	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(k) Percentage ownership
(1) CASCADE MEDICAL IMAGING LLC 1460 NE MEDICAL CENTER DRIVE BEND,OR97701 85-0484640	IMAGING SERVICES	OR	SCHS	RELATED	23,867,861	2,896,292		No		Yes		70.000 %
(2) HEART CENTER OF THE CASCADES 2500 NE NEFF RD BEND,OR97701 38-3724947	MEDICAL BUILDING	OR	NA	RELATED	359,810	159,395		No		Yes		50.000 %

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	(h) Percentage ownership	(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	(h) Percentage ownership	Yes	No
(1) CHARITABLE REMAINDER TRUST 2500 NE NEFF RD BEND,OR97701	CRUT	OR	NA	TRUST					No

Schedule R (Form 990) 2021

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

Yes

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ST CHARLES FOUNDATION	b	15,695	BOOK VALUE
(2) ST CHARLES FOUNDATION	c	1,371,544	BOOK VALUE
(3) ST CHARLES FOUNDATION	o	395,129	BOOK VALUE
(4) ST CHARLES FOUNDATION	p	104,304	BOOK VALUE
(5) CASCADE MEDICAL IMAGING LLC	j	210,682	BOOK VALUE
(6) CASCADE MEDICAL IMAGING LLC	l	1,309	BOOK VALUE
(7) CASCADE MEDICAL IMAGING LLC	m	48,601,117	BOOK VALUE
(8) CASCADE MEDICAL IMAGING LLC	p	195,145	BOOK VALUE
(9) CASCADE MEDICAL IMAGING LLC	q	4,893,375	BOOK VALUE
(10) CASCADE MEDICAL IMAGING LLC	s	26,101,484	CASH
(11) HEART CENTER OF THE CASCADES	d	3,226,000	BOOK VALUE
(12) HEART CENTER OF THE CASCADES	j	113,600	BOOK VALUE
(13) HEART CENTER OF THE CASCADES	k	1,722,853	BOOK VALUE
(14) HEART CENTER OF THE CASCADES	m	331,930	BOOK VALUE
(15) HEART CENTER OF THE CASCADES	s	240,000	CASH

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

Additional Data

Software ID:	22015553
Software Version:	2022v5.0

1	Briefly describe the organization’s mission or most significant activities: Mission: In a spirit of love and compassion, better health, better care, better value. Vision: Creating America's healthiest community, together.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	5,459
6	Total number of volunteers (estimate if necessary) .............	6	578
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	8,849,704
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,409,554	1,881,259
9	Program service revenue (Part VIII, line 2g) .........	973,937,481	1,025,909,044
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	12,931,650	59,533,284
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	15,860,506	11,817,541
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,005,139,191	1,099,141,128
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	661,782	420,671
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	567,949,933	633,617,332
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 499,434
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	436,413,605	439,355,295
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,005,025,320	1,073,393,298
19	Revenue less expenses. Subtract line 18 from line 12.......	113,871	25,747,830
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,474,240,242	1,282,243,802
21	Total liabilities (Part X, line 26).............	612,639,784	552,201,940
22	Net assets or fund balances. Subtract line 21 from line 20.....	861,600,458	730,041,862

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 573,075,317 including grants of $ 420,671 ) (Revenue $ 734,118,082 )
	St Charles - Bend CampusSCMC'S BEND CAMPUS PROVIDED SERVICES FOR 17,030 INPATIENTS, 2,139 BIRTHS, 16,499 SURGICAL CASES, 46,478 EMERGENCY ROOM VISITS, AND 127,581 OTHER OUTPATIENT VISITS IN 2022. AS ONE OF THE PACIFIC NORTHWEST'S LEADING REGIONAL HEALTH CARE FACILITIES, ST. CHARLES BEND PROVIDES SERVICES TYPICALLY FOUND IN MARKETS MANY TIMES ITS SIZE. FOR 100 YEARS, ST. CHARLES BEND HAS TAKEN RESPONSIBILITY FOR THE HEALTH AND WELL-BEING OF GENERATIONS OF OREGONIANS, DEVELOPING INTO A LEVEL II REGIONAL TRAUMA CENTER WITH SPECIALIZED PARTNERSHIPS IN HEART, CANCER, ORTHOPEDICS AND NEUROSURGERY.

4b	(Code: ) (Expenses $ 105,779,985 including grants of $ ) (Revenue $ 66,449,711 )
	ST CHARLES CLINICSST CHARLES CLINICS INCLUDES A GROUP OF MEDICAL CLINICS OWNED AND OPERATED BY ST. CHARLES HEALTH SYSTEM. THESE CLINICS ARE LOCATED THROUGHOUT THE REGION AND PROVIDE OUTPATIENT SERVICES SUCH AS CANCER CARE, OB/GYN, PULMONARY CARE, SLEEP DISORDER RESOURCES, HEART SERVICES AND PRIMARY CARE. SCMG PROVIDED OVER 156,600 VISITS IN BEND CLINICS, 72,400 VISITS IN REDMOND CLINICS, 8,400 VISITS IN THE SISTERS CLINIC, 26,500 VISITS IN PRINEVILLE CLINICS, 12,800 IN THE MADRAS CLINICS AND 9,600 IN LA PINE CLINICS IN 2022. SCMG ALSO OPERATES THREE IMMEDIATE CARE CLINICS TO PROVIDE LOW-COST URGENT CARE SERVICES TO THE COMMUNITY; THE URGENT CARE CLINICS PROVIDED SERVICES FOR MORE THAN 48,000 PATIENT VISITS IN 2022.

4c	(Code: ) (Expenses $ 86,127,044 including grants of $ ) (Revenue $ 87,542,962 )
	St Charles - Redmond CampusSCMC'S REDMOND CAMPUS PROVIDED SERVICES FOR 2,166 INPATIENTS, 4,636 SURGICAL CASES, 23,131 EMERGENCY ROOM VISITS, AND 47,836 OTHER OUTPATIENT VISITS IN 2022. AT ST. CHARLES REDMOND, THE PATIENT EXPERIENCE REMAINS AT THE CENTER OF ALL WE DO AND EACH PATIENT IS EMPOWERED TO PLAY AN ACTIVE ROLE IN HIS OR HER OWN CARE AND HEALING. SURGERIES ARE PERFORMED IN FOUR OF OREGON'S NEWEST AND MOST ADVANCED SURGICAL SUITES. PATIENTS AND THEIR FAMILIES ENJOY THE COMFORT OF STATE-OF-THE-ART PATIENT ROOMS. EVERYONE RECEIVES THE LEVEL OF CARE THAT IS EXPECTED OF A LEADING REGIONAL HEALTH CARE FACILITY.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 102,082,044 including grants of $ ) (Revenue $ 140,623,610 )
4e	Total program service expenses867,064,390

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) Sluka Joseph...................................................................... President	50.00 ................. 1.00	X	1,125,745	0	130,957
(2) Slater Matthew MD...................................................................... Physician	50.00 ................. 0.00		887,947	0	40,493
(3) Absalon Jeffrey MD...................................................................... CHIEF PHYSICIAN EXECUTIVE	50.00 ................. 0.00		823,620	0	78,963
(4) Dixon Jennifer MD...................................................................... Physician	50.00 ................. 0.00		849,783	0	40,390
(5) Clover Todd MD...................................................................... Physician	50.00 ................. 0.00		790,666	0	48,087
(6) Gulvin Joshua MD...................................................................... Physician	50.00 ................. 0.00		780,019	0	47,910
(7) Martin William MD...................................................................... Physician	50.00 ................. 0.00		728,935	0	48,109
(8) SIMMONS IMAN...................................................................... SVP COO	50.00 ................. 1.00		667,673	0	105,040
(9) Swafford Matthew...................................................................... Senior VP/CFO	50.00 ................. 0.00	X	613,903	0	109,624
(10) Binder Darren...................................................................... Secretary	50.00 ................. 1.00	X	570,666	0	95,327
(11) Gordon Steve...................................................................... President	50.00 ................. 1.00	X	637,679	0	8,477
(12) Adams Aaron...................................................................... CEO Bend & Redmond	50.00 ................. 0.00		607,455	0	21,159
(13) HALLETT MARK...................................................................... Chief Clinical Officer	50.00 ................. 0.00		552,313	0	73,912
(14) BRICKHOUSE JEREMIAH...................................................................... SVP/CIO	50.00 ................. 1.00		502,377	0	87,003
(15) MARCHIANDO ROD...................................................................... SVP IMPROVEMENT & STRATEGY	20.00 ................. 20.00		523,181	0	55,942
(16) FREEMAN RICHARD...................................................................... PRESIDENT SCMG	50.00 ................. 0.00		553,033	0	13,836
(17) BERRY REBECCA...................................................................... VP HUMAN RESOURCES	50.00 ................. 0.00		466,910	0	69,834

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	13,960,969	1,390,153

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	1,371,544
e	Government grants (contributions)		1e	489,114

f	All other contributions, gifts, grants, and similar amounts not included above		1f	20,601

g	Noncash contributions included in lines 1a - 1f:$		1g	32,551

h Total. Add lines 1a-1f.......		1,881,259

		Business Code
2a	ST CHARLES BEND CAMPUS	900099	734,118,082	734,118,082
b	ST CHARLES CLINICS	621110	66,449,711	66,449,711
c	ST CHARLES MADRAS CAH	900099	56,567,280	56,567,280
d	ST CHARLES PRINEVILLE CAH	900099	52,348,336	52,348,336
e	ST CHARLES REDMOND CAMPUS	900099	87,542,962	87,542,962
f	All other program service revenue.		28,882,673	28,882,673
g	Total. Add lines 2a–2f .....		1,025,909,044

3 Investment income (including dividends, interest, and othersimilar amounts) ......			214,177			214,177
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		143,682	6a
b	Less: rental expenses		1,169	6b
c	Rental income or (loss)		142,513	6c
d	Net rental income or (loss).......			142,513			142,513
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,824,200	668,204,479	7a
b	Less: cost or other basis and sales expenses	1,504,000	609,205,572	7b
c	Gain or (loss)	320,200	58,998,907	7c
d	Net gain or (loss).........			59,319,107			59,319,107
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	339,436
b	Less: cost of goods sold ..		10b	207,548
c	Net income or (loss) from sales of inventory..			131,888	131,888
Business Code			Miscellaneous Revenue
11a	Healthcare JV Income		900099	1,727,162	1,727,162
b	IT Support		540000	8,849,704		8,849,704
c	Medical Records & Dues		900099	265,799	265,799
d	All other revenue ....			700,475	700,475
e	Total. Add lines 11a–11d ......			11,543,140
12	Total revenue. See instructions.....			1,099,141,128	1,028,734,368	8,849,704	59,675,797

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	420,671	420,671
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 ...........	11,088,785		11,088,785
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........	503,671,117	423,982,243	79,401,291	287,583
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	18,067,909	15,394,931	2,659,322	13,656
9	Other employee benefits .......	71,616,195	51,582,989	19,958,257	74,949
10	Payroll taxes ...........	29,173,326	23,430,106	5,723,962	19,258
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	5,547,229	294	5,546,935
c	Accounting ...........	292,714		292,714
d	Lobbying ...........	70,000		70,000
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	2,204,107		2,204,107
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	94,732,096	74,571,646	20,102,079	58,371
12	Advertising and promotion ....	571,627	93,616	477,971	40
13	Office expenses .......	7,451,330	6,123,520	1,320,664	7,146
14	Information technology ......	24,824,129	291,292	24,529,545	3,292
15	Royalties ..	0
16	Occupancy ...........	10,221,416	8,404,565	1,816,851
17	Travel ............	1,194,369	936,011	255,860	2,498
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	1,036,594	459,827	559,412	17,355
20	Interest ...........	11,767,628	166,183	11,601,445
21	Payments to affiliates .......	1,947,335	753,591	1,191,392	2,352
22	Depreciation, depletion, and amortization ..	40,186,302	28,878,205	11,308,097
23	Insurance ...	3,116,372	2,269	3,114,103
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	164,034,057	164,780,540	-746,483
b	PROVIDER TAX EXPENSE	47,999,115	47,999,115
c	MAINTENTANCE AND REPAIRS	9,780,464	8,025,633	1,754,831
d	PATIENT SUPPORT	5,966,239	5,425,924	540,315
e	All other expenses	6,412,172	5,341,219	1,058,019	12,934
25	Total functional expenses. Add lines 1 through 24e	1,073,393,298	867,064,390	205,829,474	499,434
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 ........			84,941,955	1	32,297,191
2	Savings and temporary cash investments .........			39,783,995	2	59,788,018
3	Pledges and grants receivable, net ......				3	0
4	Accounts receivable, net .............			124,967,770	4	124,132,362
5	Loans and other receivables from 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 .......
					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) ...
					6	0
7	Notes and loans receivable, net ...........				7	0
8	Inventories for sale or use ............			17,078,842	8	17,069,644
9	Prepaid expenses and deferred charges ......			11,921,558	9	15,638,658
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	899,055,289
b	Less: accumulated depreciation	10b	523,087,309	404,044,209	10c	375,967,980
11	Investments—publicly traded securities .			714,991,766	11	578,755,147
12	Investments—other securities. See Part IV, line 11 .....			57,600,066	12	57,581,065
13	Investments—program-related. See Part IV, line 11 ..			3,742,636	13	3,754,883
14	Intangible assets ...............			4,555,930	14	4,544,402
15	Other assets. See Part IV, line 11 ...........			10,611,515	15	12,714,452
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,474,240,242	16	1,282,243,802

17	Accounts payable and accrued expenses .....	136,465,358	17	140,729,527
18	Grants payable ...		18
19	Deferred revenue .........	65,803,857	19	6,328,516
20	Tax-exempt bond liabilities .........	369,522,227	20	362,597,544
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
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 .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	25,492,308	23	27,853,925
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	15,356,034	25	14,692,428
26	Total liabilities. Add lines 17 through 25..	612,639,784	26	552,201,940

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	861,600,458	27	730,041,862
28	Net assets with donor restrictions ...........		28
	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 ...........	861,600,458	32	730,041,862
33	Total liabilities and net assets/fund balances ........	1,474,240,242	33	1,282,243,802