TY 2023 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)	(F) Estimated amount of other compensation from the organization and related organizations
(1) BRYAN JOHNSON...................................................................... INTERIM PRESIDENT, MONTANA REGION (PARTIAL)	6.00 ................. 49.00	X	X			0	684,612	282,612
(2) JENNIFER ALDERFER...................................................................... PRESIDENT, MONTANA REGION - PART YEAR (PARTIAL)	9.00 ................. 44.00	X	X			0	756,683	42,121
(3) JAMES DOYLE...................................................................... PRESIDENT SJB	50.00 ................. 0.00		X			453,264	0	176,214
(4) JAMES RITCHEY...................................................................... FORMER KEY EMPLOYEE	0.00 ................. 50.00				X	0	434,421	181,079
(5) MARWAN MASSOUH MD...................................................................... FORMER HIGHEST COMPENSATED	0.00 ................. 50.00				X	0	554,246	36,817
(6) JENNIFER DAVENPORT MD...................................................................... VP CMO SJB/ASSOCIATE CMO MT (PARTIAL)	50.00 ................. 1.00			X		399,681	0	182,178
(7) MOHAN NANDALUR MD...................................................................... FORMER HIGHEST COMPENSATED	0.00 ................. 50.00				X	0	521,725	23,523
(8) PAMELA PALAGI...................................................................... VP FINANCE REGION MT	9.00 ................. 41.00		X			0	386,020	148,363
(9) KATIE ROEDOCKER...................................................................... VP COO/CNO SJB	50.00 ................. 0.00			X		362,780	0	127,960
(10) ADAM SCHAFER...................................................................... VP NETWORK DEVELOPMENT REGION MT	9.00 ................. 41.00			X		0	273,752	122,709
(11) SUSAN PETERSEN MD...................................................................... DIRECTOR	1.00 ................. 52.00	X				0	330,406	15,404
(12) TRACY NEARY...................................................................... VP MISSION INTEGRATION REGION MT	9.00 ................. 41.00			X		0	227,988	111,563
(13) JOEL DYE MD...................................................................... FORMER HIGHEST COMPENSATED	0.00 ................. 50.00				X	0	293,643	44,249
(14) LUC HIBBS MD...................................................................... FORMER HIGHEST COMPENSATED	0.00 ................. 50.00				X	0	296,303	38,595
(15) DAVID SILK MD...................................................................... FORMER HIGHEST COMPENSATED	0.00 ................. 50.00				X	0	290,364	44,011
(16) ALAN MAYER MD...................................................................... FORMER HIGHEST COMPENSATED	0.00 ................. 50.00				X	0	296,689	37,618
(17) JAMES BARRY OSER MD...................................................................... FORMER HIGHEST COMPENSATED	0.00 ................. 50.00				X	0	315,555	17,590

(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) TRISHA PALMER........................................................................ DIRECTOR OF HUMAN RESOURCES	50.00 .......................0.00			X	208,164	68,207
(19) DANAE APLAS........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00			X	234,497	25,293
(20) RISIK RASK........................................................................ DIRECTOR PHARMACY	50.00 .......................0.00			X	182,016	46,094
(21) TONYA GRIM........................................................................ DIRECTOR HEALTH INFORMATICS NURSING_SJB	50.00 .......................0.00			X	168,062	57,107
(22) JEFFREY NEIL........................................................................ PHARMACIST	50.00 .......................0.00			X	180,559	39,327
(23) CHRISTOPHER EDWARDS........................................................................ VICE CHAIR	1.00 .......................2.00	X	X		0	0
(24) KAREN FAGG........................................................................ DIRECTOR	1.00 .......................4.00	X			0	0
(25) DANETTE GLEASON........................................................................ CHAIR	1.00 .......................2.00	X	X		0	0
(26) SISTER EILEEN HURLEY........................................................................ DIRECTOR	1.00 .......................2.00	X			0	0
(27) SISTER JUDITH JACKSON........................................................................ DIRECTOR	1.00 .......................2.00	X			0	0
(28) MJ JANSSEN........................................................................ DIRECTOR	1.00 .......................2.00	X			0	0
(29) BERNARD MCCARTHY........................................................................ DIRECTOR	1.00 .......................2.00	X			0	0
(30) CHARLES NOTBOHM........................................................................ SECRETARY	1.00 .......................2.00	X	X		0	0
(31) COLLEEN O'LEARY........................................................................ DIRECTOR	1.00 .......................2.00	X			0	0
(32) NGUYEN-VU PHAM........................................................................ DIRECTOR	1.00 .......................4.00	X			0	0
(33) BECKY RENO........................................................................ DIRECTOR	1.00 .......................2.00	X			0	0
(34) MAJEL RUSSELL........................................................................ DIRECTOR	1.00 .......................2.00	X			0	0
(35) CINDY SORICH........................................................................ DIRECTOR	1.00 .......................2.00	X			0	0
(36) MISTY STEADMAN........................................................................ DIRECTOR	1.00 .......................2.00	X			0	0

- 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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

ST JAMES HEALTHCARE

Employer identification number

81-0231785

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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

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) 2023

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) 2023

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) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

- 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

2023

Name of the organization

ST JAMES HEALTHCARE

Employer identification number

81-0231785

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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization ST JAMES HEALTHCARE

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) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization ST JAMES HEALTHCARE		Employer identification number 81-0231785

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization ST JAMES HEALTHCARE			Employer identification number 81-0231785
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) (2023)

Additional Data

Software ID:
Software Version:

- 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

right arrow

Complete if the organization is described below. 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

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 JAMES HEALTHCARE

Employer identification number

81-0231785

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 .................................................................... right arrow

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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) 2022

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 right arrow

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 right arrow

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) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

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

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

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

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

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

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

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

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

Yes

13,428

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

13,428

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	ST. JAMES HEALTHCARE PAID MEMBERSHIP DUES TO THE MONTANA HOSPITAL ASSOCIATION OF WHICH $579 IS ATTRIBUTED TO LOBBYING. LOBBYING EXPENSES OF $12,849 WERE DERIVED FROM FEES FOR ADVOCACY SERVICES RELATED TO MONTANA LEGISLATIVE ACTIVITIES.

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
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 JAMES HEALTHCARE

Employer identification number

81-0231785

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

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 ....	1,734,169	1,499,543	4,368,820	4,773,804	4,194,521
b	Contributions ...	878,858	714,391	472,377	1,819,711	729,022
c	Net investment earnings, gains, and losses	30,621	-30,367	10,491	14,882	9,111
d	Grants or scholarships ...			25,874
e	Other expenditures for facilities and programs ...	813,556	449,398	3,326,271	2,239,577	158,850
f	Administrative expenses ....
g	End of year balance ......	1,830,092	1,734,169	1,499,543	4,368,820	4,773,804

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

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

26.800 %

Term endowment right arrow

73.200 %

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 .....	1,245,204		1,245,204
b	Buildings ....	70,811,612	4,497,441	66,314,171
c	Leasehold improvements	1,260,850	220,648	1,040,202
d	Equipment ....	24,461,665	6,661,647	17,800,018
e	Other .....	852,758		852,758
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				87,252,353

Schedule D (Form 990) 2022

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)
(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)INTERCOMPANY RECEIVABLE				20,564,849
(2)3RD PARTY SETTLEMENTS				12,870,944
(3)LEASED ASSETS				235,222
(4)RENT RECEIVABLE				73,203
(5)OTHER ASSETS				135,835
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				33,880,053

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
OPERATING LEASE	236,780
FINANCING LEASE	9,831
ENVIRONMENTAL REMEDITION LIABILITY	800,000






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	1,046,611
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) 2022

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:	ST. JAMES HEALTHCARE FOUNDATION'S TEMPORARY ENDOWMENT FUNDS AND EARNINGS FROM THE PERMANENT ENDOWMENT FUNDS SUPPORT ST. JAMES HEALTHCARE IN AREAS INCLUDING ASSOCIATE EDUCATION, CARDIOVASCULAR, CHARITY CARE, COMMUNITY HEALTH & WELLNESS, GREATEST NEED, MOM/BABY & PEDIATRICS, NEUROSCIENCES, ONCOLOGY, SPIRITUAL CARE, WOMEN'S SERVICES, AND OTHER SERVICES AND PROGRAMS.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ST JAMES HEALTHCARE

Employer identification number

81-0231785

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 25000.0000000000 %

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

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

Yes

200% 250% 300% 350% 400% Other 50000.0000000000 %

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	2,012,972		2,012,972	1.340 %
b	Medicaid (from Worksheet 3, column a) . . . . .	22,727,637	21,802,566	925,071	0.620 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	1,075,050	955,129	119,921	0.080 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	25,815,659	22,757,695	3,057,964	2.040 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,080,554	329,996	750,558	0.500 %
f	Health professions education (from Worksheet 5) . . .	319,932		319,932	0.210 %
g	Subsidized health services (from Worksheet 6) . . . .	8,029,266	4,971,693	3,057,573	2.040 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	4,634,520		4,634,520	3.090 %
j	Total. Other Benefits . .	14,064,272	5,301,689	8,762,583	5.840 %
k	Total. Add lines 7d and 7j .	39,879,931	28,059,384	11,820,547	7.880 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support			10,331		10,331	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total			10,331		10,331	0.010 %

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. ......

1,577,119

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).....

45,974,591

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

59,028,503

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

-13,053,912

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 %
11 SUMMIT SURGERY CENTER	OUTPATIENT SURGERY CENTER	89.860 %	10.140 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	ST JAMES HEALTHCARE 400 SOUTH CLARK ST BUTTE,MT59701 WEBSITE: SEE PART VI 13287	X	X	X

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	ST JAMES HEALTHCARE
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 23

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

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

Yes

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

Yes

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

Hospital facility’s website (list url): SEE PART V, SECTION C

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 23

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

Yes

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

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ST JAMES HEALTHCARE
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 250.000000000000%
and FPG family income limit for eligibility for discounted care of 500.000000000000%

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

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

SEE PART V, SECTION C

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

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

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

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

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) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	ST JAMES HEALTHCARE
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) 2023

Page 7

Part VFacility Information (continued)

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

	ST JAMES HEALTHCARE
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) 2023

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
ST. JAMES HEALTHCARE	PART V, SECTION B, LINE 5: THE 2023 CHNA WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS (PRC) ON BEHALF OF ST. JAMES HEALTHCARE (REFERRED TO HEREAFTER AS ST. JAMES) AND THE BUTTE-SILVER BOW HEALTH DEPARTMENT. THE 2023 CHNA WAS A FOLLOW-UP TO SIMILAR STUDIES CONDUCTED IN 2020, 2017, 2014, AND 2011. AN ADVISORY GROUP INCLUDING REPRESENTATIVES FROM ST. JAMES, BUTTE SILVER-BOW PUBLIC HEALTH DEPARTMENT, AND SOUTHWEST MONTANA COMMUNITY HEALTH CENTER PROVIDED INPUT THROUGHOUT THE CHNA PROCESS INCLUDING SURVEY QUESTION SELECTION AND IDENTIFYING KEY INFORMANTS. THE CHNA INCORPORATED: 1) PRIMARY QUALITATIVE DATA (A 400 HOUSEHOLD TELEPHONE COMMUNITY HEALTH SURVEY), 2) SECONDARY QUANTITATIVE DATA (EXISTING PUBLIC HEALTH DATA) AND 3) PRIMARY QUALITATIVE DATA (KEY INFORMANT ONLINE SURVEYS). THE COMMUNITY HEALTH NEEDS ASSESSMENT INCORPORATED PRIMARY RESEARCH THROUGH A COMMUNITY HEALTH SURVEY WHICH RANDOMLY SAMPLED 400 INDIVIDUALS AGED 18 AND OLDER IN THE PRIMARY SERVICE AREA. THE SAMPLE DESIGN AND QUALITY CONTROL PROCEDURES USED IN THE DATA COLLECTION ENSURE THAT THE SAMPLE IS REPRESENTATIVE OF THE COMMUNITY. THE 2023 CHNA WAS A FOLLOW-UP TO SIMILAR SURVEYS CONDUCTED IN 2020, 2017, AND 2014 WHICH ALLOWED FOR TRENDING OVER TIME. IN ADDITION, AN ONLINE KEY INFORMANT SURVEY WAS CONDUCTED TO SOLICIT INPUT FROM KEY INFORMANTS WHO WERE SELECTED BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK AND THE CONCERNS OF THE COMMUNITY OVERALL. IN ALL, 117 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY, INCLUDING REPRESENTATIVES FROM HEALTHCARE, PUBLIC HEALTH, EDUCATION, SOCIAL SERVICES, GOVERNMENT, LAW ENFORCEMENT, AND THE FAITH COMMUNITY. ON NOVEMBER 17, 2022, ST. JAMES AND THE BUTTE-SILVER BOW HEALTH DEPARTMENT HOSTED A COMMUNITY FORUM WITH COMMUNITY STAKEHOLDERS REPRESENTING A CROSS-SECTION OF COMMUNITY-BASED ORGANIZATIONS TO EVALUATE, DISCUSS AND PRIORITIZE HEALTH ISSUES FOR THE COMMUNITY, BASED ON FINDINGS OF THE 2023 CHNA.
ST. JAMES HEALTHCARE	PART V, SECTION B, LINE 6B: THE 2023 CHNA WAS CONDUCTED WITH THE BUTTE-SILVER BOW HEALTH DEPARTMENT AND INCLUDED INPUT FROM SOUTHWEST MONTANA COMMUNITY HEALTH CENTER. IN ADDITION, 117 REPRESENTATIVES FROM VARIOUS COMMUNITY ORGANIZATIONS PROVIDED INPUT IN THE KEY INFORMANT SURVEY. ST. JAMES HEALTHCARE:PART V, SECTION B, LINE 7A: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/ABOUT/WHO-WE-ARE/CHNA-REPORTS
ST. JAMES HEALTHCARE	PART V, SECTION B, LINE 7D: A PRESS CONFERENCE WAS HELD ON MARCH 23, 2023, BY ST. JAMES AND THE BUTTE-SILVER BOW HEALTH DEPARTMENT TO PUBLICIZE THE CHNA AND PROVIDE A SUMMARY OF KEY FINDINGS.ST. JAMES HEALTHCARE:PART V, SECTION B, LINE 10A: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/ABOUT/WHO-WE-ARE/CHNA-REPORTS
ST. JAMES HEALTHCARE	PART V, SECTION B, LINE 11: THE 2023 CHNA IDENTIFIED 14 AREAS OF OPPORTUNITY AFTER CONSIDERATION OF VARIOUS CRITERIA INCLUDING: STANDING IN COMPARISON TO BENCHMARK DATA (PARTICULARLY NATIONAL DATA); IDENTIFIED TRENDS; THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS; THE MAGNITUDE OF THE ISSUE IN TERMS OF PERSONS AFFECTED; AND THE POTENTIAL HEALTH IMPACT OF A GIVEN ISSUE. IN ALPHABETICAL ORDER, THEY ARE:1. ACCESS TO HEALTHCARE SERVICES2. CANCER3. DIABETES4. ENVIRONMENTAL HEALTH5. HEART DISEASE AND STROKE6. INFANT HEALTH AND FAMILY PLANNING7. INJURY AND VIOLENCE8. MENTAL HEALTH9. NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT10. POTENTIALLY DISABLING CONDITIONS11. RESPIRATORY DISEASE12. SEXUAL HEALTH13. SUBSTANCE ABUSE14. TOBACCO USEA GROUP OF COMMUNITY STAKEHOLDERS, REPRESENTING A CROSS-SECTION OF COMMUNITY-BASED AGENCIES AND ORGANIZATIONS, WAS CONVENED TO EVALUATE, DISCUSS, AND PRIORITIZE HEALTH ISSUES FOR THE COMMUNITY. PARTICIPANTS EVALUATED EACH OF THE 14 IDENTIFIED AREAS OF OPPORTUNITY ALONG TWO CRITERIA: SCOPE AND SEVERITY, AND ABILITY TO IMPACT. THIS PROCESS YIELDED A PRIORITIZED LIST OF COMMUNITY NEEDS WITH THE TOP FOUR IDENTIFIED NEEDS AS: 1. SUBSTANCE USE2. MENTAL HEALTH3. NUTRITION, PHYSICAL ACTIVITY/WEIGHT4. HEART DISEASE AND STROKEFOLLOWING THE COMMUNITY'S PRIOIRITIZATION, ST. JAMES'S COMMUNITY BENEFIT COMMITTEE OF THE MONTANA MARKET BOARD OF DIRECTORS AND ST. JAMES'S LEADERSHIP TEAM REVIEWED THE DATA AND PRIORITIZED BASED ON THE FOLLOWING CRITERIA: ABILITY TO IMPACT, SCOPE AND SEVERITY OF THE ISSUE, COMMUNITY PRIORITIZATION OF ISSUES, POTENTIAL COMMUNITY PARTNERS, AND ALIGNMENT WITH CURRENT EFFORTS AND STRATEGIES. FROM THIS PROCESS, FOUR PRIORITY NEEDS WERE IDENTIFIED:1. ACCESS TO HEALTHCARE SERVICES2. BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE)3. HEART DISEASE AND STROKE4. SOCIAL DETERMINANTS OF HEALTHACCESS TO HEALTHCARE SERVICES:ST. JAMES IS LOCATED IN A HEALTHCARE PROVIDER SHORTAGE AREA. A THIRD OF BUTTE-SILVER BOW RESIDENTS (32.2%) REPORTED DIFFICULTY OR DELAY IN OBTAINING HEALTHCARE SERVICES IN THE PAST YEAR. 74.6% OF RESIDENTS REPORTED A ROUTINE CHECK-UP IN THE PAST YEAR. BUTTE-SILVER BOW HAS A HIGHER RATE OF LOW BIRTHWEIGHT BIRTHS COMPARED TO THE STATE OF MONTANA. IN 2023, ST. JAMES EXPANDED ACCESS TO HEALTHCARE SERVICES BY PROVIDING OUTREACH CLINICS FOR FOUR COMMUNITIES IN PEDIATRIC CARDIOLOGY, UROLOGY, AND OB/GYN. VIRTUAL HEALTH IS ALSO A KEY STRATEGY TO OVERCOME BARRIERS TO ACCESS. IN 2023, 1,636 VIRTUAL HEALTH VISITS WERE CONDUCTED. A MOBILE MAMMOGRAPHY COACH WAS LAUNCHED TO INCREASE ACCESS TO PREVENTIVE SCREENINGS FOR 270 PATIENTS IN OVER 20 LOCATIONS ACROSS SOUTHWESTERN MONTANA. IN 2023, ST. JAMES RECRUITED 28 PROVIDERS IN 11 SPECIALTIES INCLUDING ANESTHESIA, EAR/NOSE/THROAT, EMERGENCY MEDICINE, INTERNAL MEDICINE, INTERVENTIONAL CARDIOLOGY, NEUROLOGY, OBGYN, ORTHOPEDICS, PRIMARY CARE, RADIOLOGY, AND SPORTS MEDICINE TO SERVE THIS HEALTHCARE PROFESSIONAL SHORTAGE AREA. CAPACITY FOR HEALTHCARE WAS ALSO INCREASED THROUGH THE TRAINING OF STUDENTS IN THE MEDICAL FIELD INCLUDING 145 NURSING STUDENTS, 4 DIETARY STUDENTS, 3 PHARMACY STUDENTS, 3 PHYSICAL THERAPY STUDENTS, 1 LABORATORY TECHNICIAN STUDENT, 3 RESPIRATORY THERAPY STUDENTS, AND 9 RADIOLOGY STUDENTS. BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE):MOST BUTTE-SILVER BOW RESIDENTS RATE THEIR OVERALL MENTAL HEALTH FAVORABLY, BUT 15.2% OF ADULTS BELIEVE THEIR MENTAL HEALTH IS FAIR OR POOR. 30% OF ADULTS HAVE BEEN DIAGNOSED AS HAVING A DEPRESSIVE DISORDER, HIGHER THAN THE U.S. PREVALENCE (20.6%). NEARLY 40% OF RESPONDENTS REPORTED SYMPTOMS OF CHRONIC DEPRESSION. DISPARITIES WERE NOTED BY LOW-INCOME RESIDENTS WITH 49% OF LOW-INCOME RESIDENTS REPORTING SYMPTOMS OF CHRONIC DEPRESSION. SUICIDE RATES IN BUTTE-SILVER BOW WERE CONSIDERABLY HIGHER THAN THE STATE RATE AND NEARLY THREE TIMES THS U.S. RATE WITH 31 SUICIDES PER 100,000 POPULATION. 19.4% OF OVERALL SURVEY RESPONDENTS REPORTED HAVING CONSIDERED SUICIDE. A THIRD OF RESIDENTS UNDER THE AGE OF 40 REPORTED SUICIDAL IDEATION. 45.1% OF BUTTE-SILVER BOW COUNTY RESIDENTS REPORTED THEIR LIVES HAD BEEN NEGATIVELY IMPACTED BY SUBSTANCE USE EITHER BY THEMSELVES OR SOMEONE ELSE.TO ADDRESS THESE HIGH RATES OF SUICIDAL IDEATION AND CHRONIC DEPRESSION, ST. JAMES PROVIDED 4 EVIDENCE-BASED QPR SUICIDE PREVENTION GATEKEEPER TRAININGS TO THE MONTANA CHEMICAL DEPENDENCY CENTER. MENTAL HEALTH AND SUBSTANCE USE SCREENINGS WERE PROVIDED TO EXPECTANT MOTHERS DURING PRENATAL VISITS. THE FIRST 1,000 DAYS MEADOWLARK INITIATIVE PROVIDED PRENATAL SCREENING FOR SUBSTANCE USE AND MENTAL HEALTH NEEDS TO 89% OF EXPECTANT MOTHERS. IN ADDITION, INTEGRATED BEHAVIORAL HEALTH SPECIALISTS ARE EMBEDDED IN PRIMARY CARE CLINICS TO PROVIDE INCREASED ACCESS TO MENTAL HEALTH TREATMENTS AND REDUCE BARRIERS RELATED TO STIGMA. ST. JAMES COLLABORATED WITH COMMUNITY PARTNERS TO ADDRESS BEHAVIORAL HEALTH NEEDS IN THE COMMUNITY PROVIDING IN-KIND AND/OR FINANCIAL SUPPORT TO FOUR COMMUNITY ORGANIZATIONS. ST. JAMES LED COMMUNITY EFFORTS TO ADDRESS SUBSTANCE USE AND THE OPIOID CRISIS, PARTICULARLY FOR RESIDENTS OF CHILDBEARING AND CHILDREARING AGES, THROUGH THE HRSA GRANT-FUNDED RURAL COMMUNITIES OPIOID RESPONSE PROGRAM PROJECT. IN ADDITION, ST. JAMES PROMOTED MT211 AS A TOOL FOR COMMUNITY MEMBERS SEEKING RESOURCES. IN 2023, 1,116 INDIVIDUALS WERE CONNECTED TO MENTAL HEALTH AND OTHER RESOURCES THROUGH MT211. HEART DISEASE AND STROKE: WHILE NOT A PRIORITY FOCUS AREA FOR COMMUNITY HEALTH IMPROVEMENT UNTIL 2024, ST. JAMES ADDRESSES HEART DISEASE AND STROKE THROUGH STRATEGIES UNDER ACCESS TO HEALTHCARE INCLUDING SPECIALTY PROVIDER RECRUITMENT AND VIRTUAL HEALTH. IN ADDITION, ST. JAMES OFFERS A DIABETES AND HEART DISEASE PREVENTION PROGRAM. IN 2023, EDUCATIONAL MESSAGING FOR HEART ATTACK AWARENESS WAS PROVIDED ON SNOW SHOVELS AT LOCAL BUSINESSES. HANDS ONLY CPR EDUCATION WAS PROVIDED TO COMMUNITY ORGANIZATIONS, SCHOOLS, AND CHURCHES. SCREENING EVENTS WERE HELD TO SCREEN FOR HIGH BLOOD PRESSURE AND CARDIOVASCULAR RISK WITH REFERRALS TO PROVIDERS FOR RESIDENTS DETERMINED TO BE AT-RISK. SOCIAL DETERMINANTS OF HEALTH: HOUSING INSECURITY WAS REPORTED BY 42.5% OF LOW-INCOME RESIDENTS IN SILVER BOW COUNTY. 16.3% OF THE BUTTE-SILVER BOW POPULATION IS LIVING BELOW THE FEDERAL POVERTY LEVEL, HIGHER THAN THE MONTANA AND U.S. PERCENTAGES. LOW-INCOME RESIDENTS HAVE POORER HEALTH OUTCOMES ON A NUMBER OF MEASURES INCLUDING MULTIPLE CHRONIC HEALTH CONDITIONS, SYMPTOMS OF CHRONIC DEPRESSION, SUICIDAL IDEATION, USE OF THE EMERGENCY ROOM, UNSAFE HOUSING, TOBACCO USE, FOOD INSECURITY, AND SELF-REPORTED FAIR/POOR OVERALL HEALTH. ST. JAMES COLLABORATED WITH COMMUNITY PARTNERS TO PROVIDE SUPPORTIVE HOUSING TO 6 HIGH NEED RESIDENTS THROUGH THE FUSE INITIATIVE. SUPPORT FOR HOMELESS RESIDENTS WAS ALSO PROVIDED THROUGH 65,794 DONATED MEALS FOR THE BUTTE RESCUE MISSION. HOMELESSNESS WAS ALSO ADDRESSED WITH IN-KIND SUPPORT OF THE LOCAL CONTINUUM OF CARE COALITION. IN ADDITION, ST. JAMES SUPPORTED COMMUNITY EFFORTS TO IMPROVE ECONOMIC DEVELOPMENT FOR BUTTE-SILVER BOW, INCLUDING IN-KIND SUPPORT TO LOCAL ECONOMIC DEVELOPMENT ORGANIZATIONS. OTHER SIGNIFICANT NEEDS NOT PRIORITIZED: ST. JAMES RECOGNIZES OTHER HEALTH NEEDS AND INDICATORS IDENTIFIED IN THE CHNA PROCESS ARE IMPORTANT FOR THE HOSPITAL AND COMMUNITIES IT SERVES. NUMEROUS OTHER ORGANIZATIONS ARE CONCURRENTLY ADDRESSING THE OTHER NEEDS THAT WERE NOT PRIORITIZED BY ST. JAMES. DUE TO LIMITED EXPERTISE AND RESOURCES, ST. JAMES NARROWED ITS PRIORITY HEALTH NEEDS TO THE FOUR HEALTH NEEDS DISCUSSED. ST. JAMES CONTINUES TO COLLABORATE WITH COMMUNITY ORGANIZATIONS TO ENSURE THESE HEALTH NEEDS ARE ADDRESSED.
PART V, SECTION, B, LINE 16A, 16B, 16C:	HTTPS://INTERMOUNTAINHEALTHCARE.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?1
Name and address		Type of Facility (describe)
1	1 - SUMMIT SURGERY CENTER LLC 434 S CLARK STREET BUTTE,MT59701	OUTPATIENT SURGERY CENTER
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2023

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 3C:	MAXIMUM FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS AT OR BELOW 250% OF THE FEDERAL POVERTY GUIDELINES ("FPG"). APPLICANTS EQUAL TO OR BELOW THIS THRESHOLD RECEIVE A 100% WAIVER OF PATIENT FINANCIAL OBLIGATION.A SLIDING SCALE IS USED FOR PATIENTS BETWEEN 250% AND 500% OF FPG.TO DETERMINE ELIGIBILITY FOR PROVIDING FREE OR DISCOUNTED CARE, A VARIETY OF FACTORS IS USED, INCLUDING INCOME, MEDICAL INDIGENCE, INSURANCE STATUS, SOCIAL-ECONOMIC, GEOGRPAHICAL LOCATION, AND MEDICAID ELIGIBILITY.TOTAL CHARGES ARE LIMITED IN RELATION TO THE GROSS HOUSEHOLD INCOME. CHARGES ARE DISCOUNTED TO NOT EXCEED 25% OF GROSS ANNUAL HOUSEHOLD INCOME.SINCE EACH PATIENT'S CIRCUMSTANCES VARY, ALLOWANCE IS MADE FOR EXTENUATING CIRCUMSTANCES NOT DIRECTLY ADDRESSED IN THE FINANCIAL ASSISTANCE POLICIES TO BE CONSIDERED WHEN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE.
PART I, LINE 6A:	THIS ORGANIZATION IS PART OF THE INTERMOUNTAIN HEALTH CARE, INC. SYSTEM WHICH PREPARES AN ANNUAL REPORT TO THE COMMUNITY ON A CONSOLIDATED BASIS. THE REPORT IS PREPARED BY THE PARENT COMPANY, INTERMOUNTAIN HEALTH CARE, INC.
PART I, LINE 7:	THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A, 7B AND 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E, 7F, 7G, 7H AND 7I ARE REPORTED AT COST AS REPORTED IN THE ORGANIZATION'S FINANCIAL STATEMENTS.PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990,PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCHEDULE H, PART I, LINE 7 COLUMN (F) IS $1,577,119.
PART II, COMMUNITY BUILDING ACTIVITIES:	ST. JAMES RECOGNIZES THE NEED TO ADDRESS UNDERLYING FACTORS WHICH INFLUENCE HEALTH IN OUR COMMUNITY SUCH AS EDUCATION, HOUSING, EARLY CHILDHOOD DEVELOPMENT AND ECONOMIC SECURITY. WE COLLABORATE WITH COMMUNITY BASED ORGANIZATIONS TO ADDRESS THESE ISSUES. IN 2023, ST. JAMES DONATED 65,794 MEALS TO THE BUTTE RESCUE MISSION TO FEED INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS.PART III, LINE 1: THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT NO. 15 TO THE EXTENT THAT HFMA STATEMENT NO. 15 FOLLOWS GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) FOR REPORTING BAD DEBT.
PART III, LINE 2:	THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 IS AT CHARGES AS RECORDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.
PART III, LINE 4:	THE ALLOWANCE FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING THE BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.THE BAD DEBT ALLOWANCE IS CALCULATED AS A PERCENTAGE OF PATIENT RECEIVABLES AFTER DEDUCTIONS FOR ESTIMATED PROVISIONS FOR CONTRACTUAL ADJUSTMENTS (DISCOUNTS) ON SERVICES PROVIDED TO ENROLLEES OF MEDICARE, MEDICAID, THIRD-PARTY PAYOR PROGRAMS, CHARITY CARE, UNINSURED DISCOUNTS, AND OTHER ADMINISTRATIVE ADJUSTMENTS.THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN AND PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.CERTAIN PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT BECAUSE THE ORGANIZATION DOES NOT HAVE SUFFICIENT INFORMATION TO DETERMINE IF THE PATIENT WOULD QUALIFY FOR FREE CARE OR FINANCIAL AID. THEREFORE, IT IS POSSIBLE THAT SOME BAD DEBT IS ACTUALLY CHARITY CARE. HOWEVER, IF A PATIENT ACCOUNT IS WRITTEN OFF TO BAD DEBT AND THE COLLECTION AGENCY LATER DETERMINES THAT THE PATIENT WOULD HAVE QUALIFIED FOR FREE CARE OR FINANCIAL AID, THEN THE BAD DEBT EXPENSE IS RECLASSIFIED TO CHARITY CARE. THE PATIENT SERVICE REVENUE FOOTNOTE WHICH DESCRIBES BAD DEBT EXPENSE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ON PAGES 12 AND 13 OF THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS.
PART III, LINE 8:	THE ORGANIZATION BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. PROVIDING THESE SERVICES CLEARLY LESSENS THE BURDENS OF THE GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINES 5, 6 AND 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. BY ABSORBING THE MEDICARE SHORTFALL COSTS, WE ARE PROVIDING A COMMUNITY BENEFIT AS WELL AS EASING THE BURDEN OF THE FEDERAL GOVERNMENT HAVING TO COVER THESE COSTS. ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, BURDENS BORNE BY GOVERNMENTS ARE RELIEVED. TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 6 AMOUNT, WE USED ACTUAL MEDICARE CHARGES FROM INTERNAL RECORDS AND APPLIED AN ESTIMATED COST TO CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS. THE ESTIMATED MEDICARE COST TO CHARGE RATIO IS THE PRIOR PERIOD MEDICARE COST REPORT COST TO CHARGE RATIO.
PART III, LINE 9B:	AN INTEGRAL COMPONENT OF OUR MISSION IS TO BE GOOD FINANCIAL STEWARDS. THIS REQUIRES US TO DETERMINE WHICH PATIENTS ARE IN NEED OF CHARITY CARE AND WHICH ARE ABLE TO CONTRIBUTE SOME PAYMENT FOR CARE RECEIVED. WE MAINTAIN A BALANCE THAT ENABLES US TO CONTINUE TO PROVIDE CHARITY CARE TO THOSE WHO NEED IT MOST AND ENSURE THAT WE MANAGE OUR RESOURCES SOWE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. THE ORGANIZATION NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND DISCHARGE. IN ADDITION, THE PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS. PATIENTS ARE CONTACTED MULTIPLE TIMES ABOUT UNPAID BALANCES PRIOR TO INITIATING ANY COLLECTION ACTION. IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION PROCESS, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED.
PART V, SECTION A, WEBSITE	WEBSITE: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/LOCATIONS/INTERMOUNTAIN-HEALTH-ST-JAMES-HOSPITAL
PART VI, LINE 2:	ST. JAMES CONTINUOUSLY ASSESSES THE NEEDS OF THE COMMUNITY THROUGH CLOSE WORKING RELATIONSHIPS AND PARTNERSHIPS WITH SERVICE AGENCIES IN THE COMMUNITY. ST. JAMES'S LEADERSHIP SERVES ON VARIOUS COMMUNITY BOARDS TO UNDERSTAND THE SPECIFIC NEEDS OF THEIR COMMUNITY.IN ADDITION TO THE CHNA DATA FOCUSED ON BUTTE-SILVER BOW COUNTY, ST. JAMES UTILIZES DATA FROM COMMUNITY BASED ORGANIZATIONS THAT CONDUCT PERIODIC SURVEYS RELATED TO HEALTH. SECONDARY DATA SUCH AS COUNTY HEALTH RANKINGS AND THE BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) IS REVIEWED TO DETERMINE HEALTH NEEDS FOR NEIGHBORING COUNTIES. ADDITIONAL OUTREACH AND RELATIONSHIPS WITH OTHER CRITICAL ACCESS HOSPITALS, HEALTH CENTERS, AND CLINICS IN SURROUNDING RURAL COMMUNITIES ENABLE ST. JAMES TO BETTER ASSESS THE HEALTH NEEDS OF THESE COMMUNITIES.
PART VI, LINE 3:	THE ORGANIZATION NOTIFIES PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND PRIOR TO DISCHARGE. NOTICES ABOUT THE FINANCIAL ASSISTANCE POLICY ARE DISPLAYED THROUGHOUT THE HOSPITAL. IN ADDITION, PATIENTS RECEIVE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY WITH THEIR PATIENT BILLS AND THROUGH THE PATIENT PORTAL, MYCHART. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE POSTED ON THE HOSPITAL'S WEBSITE. THE POLICY AND APPLICATION ARE ALSO AVAILABLE UPON REQUEST. THE ORGANIZATION HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES PATIENTS OPPORTUNITIES TO APPLY FOR FREE OR DISCOUNTED CARE AND/OR TO BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM. THE PROCESS INCLUDES IDENTIFYING PATIENTS WITH A FINANCIAL CONCERN, PROVIDING FINANCIAL COUNSELING AND ASSISTANCE IN APPLYING FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS.
PART VI, LINE 4:	GEOGRAPHY AND POPULATION: SILVER BOW COUNTY, THE 2023 CHNA-DEFINED COMMUNITY, IS LOCATED IN SOUTHWEST MONTANA AND SPANS 716 SQUARE MILES. BUTTE-SILVER BOW IS PREDOMINANTLY URBAN, WITH 88.6% OF THE POPULATION LIVING IN AREAS DESIGNATED AS URBAN. THE ESTIMATED POPULATION OF SILVER BOW COUNTY IS 34,895 REPRESENTING A 2.7% INCREASE FROM 2010.HOSPITALS IN THE SERVICE AREA: THERE ARE NO OTHER ACUTE HOSPITALS SERVING BUTTE AND SILVER BOW COUNTY.AGE: IN BUTTE-SILVER BOW 20.4% OF THE POPULATION ARE CHILDREN AGED 0-17; 60.7% ARE AGES 18 TO 64; AND 18.9% ARE 65 AND OVER. THE MEDIAN AGE IS 40.1. RACIAL AND ETHNICITY: THE MAJORITY OF BUTTE-SILVER BOW RESIDENTS ARE WHITE (93.5%), 2.3% ARE NATIVE AMERICAN, AND 2.9% OF RESIDENTS ARE MULTIPLE RACES. TOTAL OF 4.7% OF BUTTE-SILVER BOW RESIDENTS ARE HISPANIC OR LATINO, HIGHER THAN THE MONTANA PERCENTAGE.ECONOMICS: THE PERCENTAGE OF INDIVIDUALS LIVING IN POVERTY IN SILVER BOW COUNTY IS 16.3%, INCLUDING AN ESTIMATED 1,279 CHILDREN IN POVERTY. A HIGHER PERCENTAGE OF BUTTE-SILVER BOW RESIDENTS LIVE BELOW THE POVERTY LINE THAN STATE OR NATIONAL PERCENTAGES. AMONG THE BUTTE-SILVER BOW POPULATION AGE 25 AND OLDER, AN ESTIMATED 6.5% DO NOT HAVE A HIGH SCHOOL DIPLOMA. HEALTH STATUS: MOST BUTTE-SILVER BOW RESIDENTS RATE THEIR OVERALL HEALTH FAVORABLY WITH 81.9% REPORTING EXCELLENT, VERY GOOD, OR GOOD OVERALL HEALTH. 18.1% OF BUTTE-SILVER BOW ADULTS BELIEVE THEIR HEALTH IS FAIR OR POOR. DISPARITIES IN HEALTH STATUS ARE NOTABLE AMONG LOW-INCOME ADULTS WITH 28.5% OF LOW-INCOME ADULTS REPORTING FAIR OR POOR HEALTH.UNINSURED RATE: 9.2% OF PEOPLE IN SILVER BOW COUNTY ARE UNINSURED, WHICH IS SLIGHTLY LOWER THAN THE U.S. AVERAGE OF 9.3%.
PART VI, LINE 5:	ST. JAMES ADHERES TO COMMUNITY BENEFIT GUIDELINES OUTLINED IN THE CATHOLIC HEALTH ASSOCIATION'S PUBLICATION, "A GUIDE TO PLANNING AND REPORTING COMMUNITY BENEFIT". ST. JAMES'S COMMUNITY BENEFIT WORK IS DRIVEN BY IDENTIFIED COMMUNITY HEALTH NEEDS AND DIRECTED IN COLLABORATION WITH OTHER HEALTHCARE ORGANIZATIONS AND THE BROADER COMMUNITY. A COMMUNITY BENEFIT REPORT TO THE COMMUNITY IS PUBLISHED ANNUALLY AND CAN BE FOUND AT: HTTPS://INTERMOUNTAINHEALTHCARE.ORG/-/MEDIA/FILES/INTERMOUNTAIN-HEALTH/CHNA-REPORTS---PEAKS/ST-JAMES-CHNA-2023.ASHXCOMMUNITY BENEFIT STRATEGIES ARE INTEGRATED IN THE ORGANIZATIONAL STRATEGIC PLAN. PROGRAMS ARE LOCATED THROUGHOUT THE ORGANIZATION AND STAFF AND BOARD EDUCATION IS CONDUCTED. ST. JAMES HAS DEDICATED STAFF COMMITTED TO COMMUNITY BENEFIT EFFORTS. HOSPITAL LEADERS, MANAGERS, AND SUPERVISORS ARE ENCOURAGED TO PARTICIPATE ANNUALLY IN COMMUNITY BENEFIT SERVICE EVENTS WITH NON-PROFIT ORGANIZATIONS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. MONTANA MARKET'S BOARD OF DIRECTORS IS A VOLUNTEER GOVERNING BODY WHICH INCLUDE INDEPENDENT PERSONS THAT REPRESENT THE COMMUNITY. WITHIN THE BOARD OF DIRECTORS, THERE IS A SPECIFIC COMMUNITY BENEFIT BOARD LEVEL COMMITTEE. THIS COMMITTEE IS DEEPLY INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND PROVIDES DIRECTION TOWARDS THE DEVELOPMENT OF THE ORGANIZATION'S IMPROVEMENT PLAN IN RESPONSE TO RESULTS OF COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL'S COMMUNITY BENEFIT BOARD COMMITTEE MONITORS IMPLEMENTATION OF COMMUNITY BENEFIT PROGRAMS AND PROVIDES REPORTS BACK TO THE FULL MARKET BOARD. AS THE ONLY ACUTE CARE FACILITY IN SOUTHWEST MONTANA, ST. JAMES SERVES ITS COMMUNITY BY PROVIDING COMPREHENSIVE MEDICAL SERVICES INCLUDING CARDIOLOGY, ONCOLOGY, ORTHOPEDIC, OB/GYN FOR WOMEN, UROLOGY, EMERGENCY AND TRAUMA, NEONATAL INTENSIVE CARE, NEUROLOGY, GENERAL SURGICAL, PRIMARY CARE, PEDIATRIC CARE, FAMILY AND INTERNAL MEDICINE. ST. JAMES OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. ST. JAMES ENGAGES IN THE TRAINING AND EDUCATION OF HEALTHCARE PROFESSIONALS AND PARTICIPATES IN MEDICAID, MEDICARE, AND OTHER GOVERNMENT-SPONSORED HEALTH PROGRAMS. ST. JAMES EMPLOYS THE STAFF OF THE ST. JAMES HOSPITAL FOUNDATION, A NON-PROFIT ORGANIZATION THAT PROVIDES FUNDRAISING FOR ST. JAMES FACILITIES AND PROGRAMS THAT REACH BOTH THE POOR AND THE BROADER COMMUNITY. OPERATIONS OF THE FOUNDATION ARE GOVERNED BY A SEPARATE FOUNDATION BOARD WITH VOLUNTARY MEMBERSHIPS FROM THE LOCAL COMMUNITY. WHEN ST. JAMES HAS EXCESS REVENUE OVER OPERATING EXPENSES, THOSE FUNDS ARE USED TO OBTAIN CURRENT HEALTH CARE TECHNOLOGIES AND EQUIPMENT, IMPROVE PATIENT CARE, PROVIDE MEDICAL TRAINING EDUCATION, AND WORK TO EXPAND ACCESS TO CARE. THESE INVESTMENTS ENSURE ST. JAMES WILL CONTINUE TO PROVIDE CARE FOR FUTURE GENERATIONS.
PART VI, LINE 6:	THE FILING ORGANIZATION IS AN AFFILIATE OF INTERMOUNTAIN HEALTH CARE, INC. (INTERMOUNTAIN), AN INTEGRATED HEALTH SYSTEM WHOSE VISION IS TO "BE A MODEL HEALTH SYSTEM BY PROVIDING EXTRAORDINARY CARE AND SUPERIOR SERVICES AT AN AFFORDABLE COST". INTERMOUNTAIN STRIVES TO FULFILL THAT MISSION THROUGH ACCOMPLISHING ITS STATED MISSION OF "HELPING PEOPLE LIVE THE HEALTHIEST LIVES POSSIBLE". INTERMOUNTAIN, IS A NONPROFIT CORPORATION EXEMPT UNDER INTERNAL REVENUE CODE 501(C)(3). AFFILIATES WITHIN THE HEALTH SYSTEM NETWORK INCLUDE NONPROFIT CORPORATIONS EXEMPT UNDER IRS 501(C)(3) AND 501(C)(4), TAXABLE CORPORATIONS, PARTNERSHIPS WITH PHYSICIANS, STRATEGIC INVESTMENTS, AND JOINT VENTURES.HEADQUARTERED IN UTAH WITH LOCATIONS IN SEVEN STATES AND ADDITIONAL OPERATIONS ACROSS THE WESTERN U.S., INTERMOUNTAIN HEALTH IS A NONPROFIT SYSTEM OF MORE THAN 66,000 CAREGIVERS, 33 HOSPITALS, 385 CLINICS, MEDICAL GROUP, A HEALTH PLAN DIVISION CALLED SELECT HEALTH WITH MORE THAN ONE MILLION MEMBERS, AND OTHER HEALTH SERVICES. HELPING PEOPLE LIVE THE HEALTHIEST LIVES POSSIBLE, INTERMOUNTAIN IS COMMITTED TO IMPROVING COMMUNITY HEALTH AND IS WIDELY RECOGNIZED AS A LEADER IN TRANSFORMING HEALTHCARE BY USING EVIDENCE-BASED BEST PRACTICES TO CONSISTENTLY DELIVER HIGH-QUALITY OUTCOMES AT SUSTAINABLE COSTS. INTERMOUNTAIN IS WORKING TO IMPROVE THE HEALTH AND WELL-BEING BY IMPROVING MENTAL WELL-BEING, PREVENTING AVOIDABLE DISEASE, IMPROVING AIR QUALITY, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, AND OTHER COMMUNITY HEALTH INITIATIVES.THROUGH MULTIPLE CHARITABLE FOUNDATIONS, INTERMOUNTAIN ALSO DEVELOPS FINANCIAL AND CHARITABLE SUPPORT FOR ITS PATIENTS WHILE ALSO SUPPORTING OTHER NONPROFIT ORGANIZATIONS THAT PROVIDE DIRECT MEDICAL, DENTAL, AND MENTAL SERVICES FOR LOW-INCOME, UNINSURED, OR MEDICALLY UNDERSERVED POPULATIONS.

Schedule H (Form 990) 2023

Additional Data

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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

2023

Open to Public
Inspection

Name of the organization
ST JAMES HEALTHCARE

Employer identification number
81-0231785

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021	23-7379161	501(C)(3)	4,349,664	0			SUPPORT MONTANA CLINCIS
(2) ST JAMES HEALTHCARE FOUNDATION 400 SOUTH CLARK ST BUTTE,MT59701	65-1202190	501(C)(3)	388,667	0			SUPPORT FOR MISSION

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) 2023

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
PART I, LINE 2:	PROCESS FOR MONITORING GRANTS AND AWARDS THE ORGANIZATION KEEPS RECORDS TO SUPPORT THE AMOUNTS PROVIDED OR REASON FOR SUCH SUPPORT. ELIGIBILITY FOR FUNDING IS DETERMINED ON AN INDIVIDUAL BASIS, CONSIDERING THE USE OF THE FUNDS AND HOW THE USE RELATES TO THE ORGANIZATION'S MISSION.

Schedule I (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ST JAMES HEALTHCARE

Employer identification number

81-0231785

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

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

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2023

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)
1BRYAN JOHNSON INTERIM PRESIDENT, MONTANA REGION (P	(i) (ii)	0 ------------- 502,548	0 ------------- 109,425	0 ------------- 72,639	0 ------------- 255,252	0 ------------- 27,360	0 ------------- 967,224	0 ------------- 162,823
2JENNIFER ALDERFER PRESIDENT, MONTANA REGION - PART YEA	(i) (ii)	0 ------------- 549,575	0 ------------- 130,931	0 ------------- 76,177	0 ------------- 14,518	0 ------------- 27,603	0 ------------- 798,804	0 ------------- 203,684
3JAMES DOYLE PRESIDENT SJB	(i) (ii)	329,299 ------------- 0	80,718 ------------- 0	43,247 ------------- 0	155,408 ------------- 0	20,806 ------------- 0	629,478 ------------- 0	75,553 ------------- 0
4JAMES RITCHEY FORMER KEY EMPLOYEE	(i) (ii)	0 ------------- 327,797	0 ------------- 62,403	0 ------------- 44,221	0 ------------- 150,869	0 ------------- 30,210	0 ------------- 615,500	0 ------------- 73,082
5MARWAN MASSOUH MD FORMER HIGHEST COMPENSATED	(i) (ii)	0 ------------- 534,089	0 ------------- 12,000	0 ------------- 8,157	0 ------------- 14,436	0 ------------- 22,381	0 ------------- 591,063	0 ------------- 0
6JENNIFER DAVENPORT MD VP CMO SJB/ASSOCIATE CMO MT (PARTIAL	(i) (ii)	347,301 ------------- 0	50,533 ------------- 0	1,847 ------------- 0	160,737 ------------- 0	21,441 ------------- 0	581,859 ------------- 0	50,004 ------------- 0
7MOHAN NANDALUR MD FORMER HIGHEST COMPENSATED	(i) (ii)	0 ------------- 521,725	0 ------------- 0	0 ------------- 0	0 ------------- 14,380	0 ------------- 9,143	0 ------------- 545,248	0 ------------- 0
8PAMELA PALAGI VP FINANCE REGION MT	(i) (ii)	0 ------------- 309,390	0 ------------- 47,018	0 ------------- 29,612	0 ------------- 137,628	0 ------------- 10,735	0 ------------- 534,383	0 ------------- 74,294
9KATIE ROEDOCKER VP COO/CNO SJB	(i) (ii)	201,779 ------------- 0	31,345 ------------- 0	129,656 ------------- 0	100,320 ------------- 0	27,640 ------------- 0	490,740 ------------- 0	31,345 ------------- 0
10ADAM SCHAFER VP NETWORK DEVELOPMENT REGION MT	(i) (ii)	0 ------------- 261,298	0 ------------- 10,565	0 ------------- 1,889	0 ------------- 112,625	0 ------------- 10,084	0 ------------- 396,461	0 ------------- 10,565
11SUSAN PETERSEN MD DIRECTOR	(i) (ii)	0 ------------- 222,183	0 ------------- 106,353	0 ------------- 1,870	0 ------------- 12,912	0 ------------- 2,492	0 ------------- 345,810	0 ------------- 0
12TRACY NEARY VP MISSION INTEGRATION REGION MT	(i) (ii)	0 ------------- 183,426	0 ------------- 28,674	0 ------------- 15,888	0 ------------- 85,749	0 ------------- 25,814	0 ------------- 339,551	0 ------------- 42,913
13JOEL DYE MD FORMER HIGHEST COMPENSATED	(i) (ii)	0 ------------- 286,882	0 ------------- 0	0 ------------- 6,761	0 ------------- 13,167	0 ------------- 31,082	0 ------------- 337,892	0 ------------- 0
14LUC HIBBS MD FORMER HIGHEST COMPENSATED	(i) (ii)	0 ------------- 294,985	0 ------------- 0	0 ------------- 1,318	0 ------------- 13,432	0 ------------- 25,163	0 ------------- 334,898	0 ------------- 0
15DAVID SILK MD FORMER HIGHEST COMPENSATED	(i) (ii)	0 ------------- 285,907	0 ------------- 0	0 ------------- 4,457	0 ------------- 12,929	0 ------------- 31,082	0 ------------- 334,375	0 ------------- 0
16ALAN MAYER MD FORMER HIGHEST COMPENSATED	(i) (ii)	0 ------------- 289,887	0 ------------- 0	0 ------------- 6,802	0 ------------- 13,220	0 ------------- 24,398	0 ------------- 334,307	0 ------------- 0
17JAMES BARRY OSER MD FORMER HIGHEST COMPENSATED	(i) (ii)	0 ------------- 309,053	0 ------------- 0	0 ------------- 6,502	0 ------------- 13,860	0 ------------- 3,730	0 ------------- 333,145	0 ------------- 0
18TRISHA PALMER DIRECTOR OF HUMAN RESOURCES	(i) (ii)	184,389 ------------- 0	18,063 ------------- 0	5,712 ------------- 0	54,343 ------------- 0	13,864 ------------- 0	276,371 ------------- 0	14,340 ------------- 0
19DANAE APLAS ANESTHESIOLOGIST	(i) (ii)	193,740 ------------- 0	0 ------------- 0	40,757 ------------- 0	11,354 ------------- 0	13,939 ------------- 0	259,790 ------------- 0	0 ------------- 0
20RISIK RASK DIRECTOR PHARMACY	(i) (ii)	168,552 ------------- 0	12,936 ------------- 0	528 ------------- 0	27,884 ------------- 0	18,210 ------------- 0	228,110 ------------- 0	12,936 ------------- 0
21TONYA GRIM DIRECTOR HEALTH INFORMATICS NURSING_	(i) (ii)	152,292 ------------- 0	12,308 ------------- 0	3,462 ------------- 0	26,333 ------------- 0	30,774 ------------- 0	225,169 ------------- 0	12,308 ------------- 0
22JEFFREY NEIL PHARMACIST	(i) (ii)	179,111 ------------- 0	450 ------------- 0	998 ------------- 0	8,327 ------------- 0	31,000 ------------- 0	219,886 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

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	THE FILING ORGANIZATION AND RELATED ORGANIZATIONS ALLOW FOR CERTAIN TAX INDEMNIFICATION AND GROSS-UP PAYMENTS IN THE INSTANCES OF RELOCATION. THESE AMOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE INDIVIDUALS THAT RECEIVED TAX GROSS-UP PAYMENTS IN 2023 WERE: KATIE ROEDOCKER - $33,193
PART I, LINE 1B	THE FILING ORGANIZATION DOES NOT HAVE A FORMAL WRITTEN POLICY FOR TAX INDEMNIFICATION AND GROSS-UP PAYMENTS. HOWEVER, BEFORE ANY TAX INDEMNIFICATION AND GROSS-UP PAYMENTS ARE MADE; PROPER APPROVAL FROM THE EMPLOYEE'S MANAGER IS REQUIRED. IN ADDITION, APPROVAL IS ALSO REQUIRED FROM HUMAN RESOURCES.
PART I, LINE 3	COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE INTERMOUNTAIN HEALTH CARE, INC. BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCLHS AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO INTERMOUNTAIN HEALTH CARE, INC.'S BOARD FOR APPROVAL OF ANY CHANGES. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY INTERMOUNTAIN HEALTH CARE, INC. AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. THE BOARD PLACES A HIGH PRIORITY ON THE NEED TO RECURIT AND RETAIN A STRONG LEADERSHIP TEAM AND TO CREATE A HIGHLY MOTIVATED AND ENGAGED WORKFORCE. COMPENSATION LEVELS FOLLOW IRS GUIDELINES AND ARE SUBJECT TO IRS OVERSIGHT. AS PART OF THE REVIEW PROCESS, INTERMOUNTAIN HEALTH CARE, INC. USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) COMPENSATION SURVEYS AND STUDIES 5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD.
PART I, LINE 4B	PART I, LINE 4B PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN A RELATED ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) KNOWN AS SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) FOR EXECUTIVES (SENIOR MANAGEMENT) TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT-FOR-PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. IN 2014, IN AN EFFORT TO REDUCE LONG-TERM COSTS AND HAVE GREATER CONTROL OVER FINANCIAL RISK, THE SERP WAS CONVERTED FROM A DEFINED BENEFIT (DB) TO A DEFINED CONTRIBUTION (DC) DESIGN. CERTAIN MEMBERS OF SENIOR MANAGEMENT WHOSE BENEFITS WERE CONVERTED FROM DB TO DC WOULD HAVE BEEN DISPROPORTIONATELY AND NEGATIVELY AFFECTED BY THE CHANGE, SO THE COMMITTEE DETERMINED IT WOULD BE APPROPRIATE TO GRANT "TRANSITION CREDITS" IN ORDER TO MITIGATE THE NEGATIVE IMPACT OF THE CHANGE ON THEIR RETIREMENT BENEFITS. THIS IS A COMMON APPROACH EMPLOYED BY OTHER ORGANIZATIONS UNDERGOING A SIMILAR TRANSITION. THE TRANSITION CREDITS VEST IN ACCORDANCE WITH THE TERMS OF THE DC SERP (I.E., AFTER THREE YEARS) AND ARE PAID TO THE EXECUTIVE UPON VESTING. NQDC SERP PLANS STARTING IN 2014 STARTING IN 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS ROLLING 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2023. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2023 WERE: JENNIFER ALDERFER - $72,753; BRYAN JOHNSON - $53,398; JAMES DOYLE - $32,949; PAMELA PALAGI - $27,276; TRACY NEARY - $14,239; JAMES RITCHEY - $25,482.
ADDITIONAL OFFICER AND BOARD DISCLOSURES	INTERMOUNTAIN HEALTH CARE, INC. AND RELATED TAX-EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING ACCOUNTABILITY. IN KEEPING WITH INTERMOUNTAIN HEALTH CARE, INC.'S CORE VALUE OF STEWARDSHIP, INTERMOUNTAIN HEALTH CARE, INC.'S BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH CARE SYSTEM. HOWEVER, A PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES.

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- 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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

ST JAMES HEALTHCARE

Employer identification number

81-0231785

Return Reference	Explanation
FORM 990, LINE J WEBSITE:	HTTPS://INTERMOUNTAINHEALTHCARE.ORG/LOCATIONS/INTERMOUNTAIN-HEALTH-ST-JA MES-HOSPITAL
FORM 990, PART V, LINE 1A	EXPLANATION FOR NUMBER REPORTED IN BOX 3 OF FORM 1096: THE ORGANIZATION'S EXPENSES ARE PAID BY A RELATED 501(C)(3) TAX-EXEMPT ORGANIZATION. THE RELATED ORGANIZATION FILES THE REQUIRED FORM 1096 AND RELATED 1099 TAX FORMS FOR ANY EXPENDITURE THAT REQUIRES A FORM 1099 TO BE FILED.
FORM 990, PART VI, SECTION A, LINE 2	PAM PALAGI / TRACY NEARY - BUSINESS RELATIONSHIP (EMPLOYER/EMPLOYEE RELATIONSHIP IN SCL HEALTH - MONTANA, A RELATED TAX-EXEMPT ORGANIZATION). JEN ALDERFER / ADAM SCHAFER / SUSAN PETERSEN - BUSINESS RELATIONSHIP (EMPLOYER/EMPLOYEE RELATIONSHIP IN SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC., A RELATED TAX-EXEMPT ORGANIZATION).
FORM 990, PART VI, SECTION A, LINE 6	MEMBERS OR STOCKHOLDERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMBER OF ST. JAMES HEALTHCARE.
FORM 990, PART VI, SECTION A, LINE 7A	POWER TO ELECT OR APPOINT MEMBERS SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC., THE SOLE MEMBER OF ST. JAMES HEALTHCARE, HAS THE POWER TO APPOINT MEMBERS OF THE ST. JAMES HEALTHCARE BOARD OF DIRECTORS, SUBJECT TO THE RATIFICATION BY THE BOARD OF INTERMOUNTAIN HEALTH CARE, INC.
FORM 990, PART VI, SECTION A, LINE 7B	DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS WHILE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) IS THE SOLE MEMBER OF ST. JAMES HEALTHCARE, RESERVED POWERS ARE PRIMARILY HELD BY INTERMOUNTAIN HEALTH CARE, INC. (INTERMOUNTAIN), WHO AS A RESULT OF AFFILIATION, IS A MEMBER OF SCLHS. SCLHS, HAS THE POWER TO APPOINT TRUSTEES TO THE BOARD OF DIRECTORS, WHICH ARE SUBJECT TO RATIFICATION BY INTERMOUNTAIN. RESERVED POWERS HELD BY INTERMOUNTAIN INCLUDE: - ESTABLISH THE MISSION, VISION, AND VALUES FOR THE CORPORATION; - DEVELOP, ADOPT, AND OVERSEE STRATEGY, GOALS, OBJECTIVES, POLICIES, STANDARDS, AND GUIDELINES FOR THE CORPORATION; - ADOPT, AMEND, OR REPEAL THE GOVERNING DOCUMENTS OF THE CORPORATION; - FIX THE NUMBER OF TRUSTEES OF THE BOARD AND APPOINT AND REMOVE TRUSTEES TO AND FROM THE BOARD; - APPOINT AND REMOVE THE TRUSTEES, DIRECTORS, MANAGERS, OR BOARD OFFICERS OF THE CORPORATION; - PROVIDE FOR THE OVERALL MANAGEMENT OF THE CORPORATION, INCLUDING APPOINTING, OVERSEEING, AND REMOVING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION; - OVERSEE AUDIT AND COMPLIANCE, CLINICAL EXCELLENCE, COMPENSATION, FINANCE, INVESTMENT, NOMINATING AND GOVERNANCE, AND ANY OTHER NEEDED FUNCTIONS FOR THE PROPER OPERATION OF THE CORPORATION; - OVERSEE THE MEDICAL GROUPS OF THE SYSTEM IN A MANNER TO ENCOURAGE THE DELIVERY OF COST-EFFECTIVE PROFESSIONAL SERVICES TO PATIENTS SERVED AND, IN ACCORDANCE WITH APPLICABLE STATE LAW, OVERSEE CLINICAL PRACTICE AND EVIDENCED-BASED MEDICINE; - APPROVE THE ACQUISITION OF ASSETS, INCURRENCE OF INDEBTEDNESS, SALE, LEASE, TRANSFER, ASSIGNMENT, OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; - APPROVE ANY MERGER, CHANGE OF CONTROL, DISSOLUTION, OR CORPORATE RESTRUCTURING OF THE CORPORATION; - OVERSEE THE ACQUISITION OR FORMATION OF ANY NEW SUBSIDIARY OF THE CORPORATION; AND - DIRECT FINANCES AND INVESTMENTS OF THE CORPORATION, INCLUDING CONTROLS, OPERATING AND CAPITAL BUDGETS, INTERCOMPANY TRANSFERS OR LOANS, AND SELECTION AND REMOVAL OF EXTERNAL AUDITORS. THE OTHER MEMBER OF SCLHS IS LEAVEN MINISTRIES, WHO WAS GRANTED THE FOLLOWING RESERVED POWERS: - TO APPROVE THE ADOPTION, AMENDMENT OR REPEAL OF THE CIVIL ARTICLES OF INCORPORATION OR BYLAWS OF SCLHS, OF ANY CIVIL CORPORATION OF WHICH SCLHS IS THE CONTROLLING MEMBER, AND OF ANY SUBSIDIARY CORPORATION OF SCLHS; - TO FIX THE NUMBER AND APPOINT THE MEMBERS OF THE BOARD OF TRUSTEES OF SCLHS; - TO REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF TRUSTEES OF SCLHS; - TO APPROVE FOR SCLHS, ANY CORPORATION OF WHICH SCLHS IS THE CONTROLLING MEMBER, OR ANY SUBSIDIARY CORPORATION OF SCLHS, THE INCURRENCE OF INDEBTEDNESS OR THE SALE, TRANSFER, ASSIGNMENT, OR ENCUMBERING OF THE ASSETS, PURSUANT TO POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBERS OF LEAVEN MINISTRIES; - TO APPROVE ANY OTHER ACTION WHICH, IN ACCORDANCE WITH THE CIVIL CORPORATE DOCUMENTS GOVERNING SCLHS IS RESERVED TO THE MEMBERS OF LEAVEN MINISTRIES; - TO APPROVE ANY ALIENATION, SALE, GIFT OR OTHER TRANSFER OF THE REAL PROPERTY HELD BY ANY SCLHS CATHOLIC ENTITY THAT CONSTITUTES ECCLESIASTICAL GOODS; - TO APPROVE ANY DISSOLUTION, FILING OF A BANKRUPTCY PETITION, MERGER, CONSOLIDATION OR CHANGE OF MAJORITY CONTROL OF ANY SCLHS CATHOLIC ENTITY; - TO APPROVE ANY MORTGAGE OR OTHER SECURITY INSTRUMENT THAT DIRECTLY ENCUMBERS THE REAL PROPERTY OF ANY SCLHS CATHOLIC ENTITY THAT CONSTITUTES ECCLESIASTICAL GOODS; - TO MONITOR, OVERSEE AND ENFORCE THE CATHOLIC PROTECTIONS INCLUDING THOSE ON-GOING OBLIGATIONS OF THE CONSOLIDATED SYSTEM PARENT SET FORTH IN THE MERGER AGREEMENT THAT ARE FOR THE BENEFIT OF LEAVEN MINISTRIES; AND - TO APPROVE ANY ALTERATION, REVOCATION, SUSPENSION, OR OTHER TERMINATION OR MODIFICATION OF THE RESERVED POWERS SET FORTH HEREIN. IN THE EVENT ANY CONFLICTS ARISE BETWEEN THE RESERVED POWERS GRANTED TO LEAVEN MINISTRIES AND THOSE OF INTERMOUNTAIN, THE LEAVEN RESERVED POWERS WILL CONTROL.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY THE TAX DEPARTMENT OF INTERMOUNTAIN HEALTH CARE, INC. AND SUBSIDIARIES. THE DRAFT FORM 990 IS REVIEWED BY CERTAIN MEMBERS OF SENIOR MANAGEMENT. A COPY OF THE FINAL FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	EACH OFFICER, DIRECTOR, TRUSTEE AND KEY EMPLOYEE IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AT LEAST ANNUALLY. THESE INDIVIDUALS HAVE BEEN INSTRUCTED TO UPDATE THEIR QUESTIONNAIRE INFORMATION IF THEY BECOME AWARE OF A NEW POTENTIAL CONFLICT, OR IF ANY OF THE PREVIOUSLY REPORTED INFORMATION CHANGES. ADDITIONALLY, BOARD MEMBERS ARE ASKED AT THE BEGINNING OF EACH BOARD OR COMMITTEE MEETING IF THEY ARE AWARE OF ANY CONFLICTS. ACCORDING TO POLICY, THE QUESTIONNAIRES ARE COLLECTED AND REVIEWED BY INTERMOUNTAIN'S CHIEF COMPLIANCE OFFICER. POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED WITH APPROPRIATE PERSONNEL, WHICH MAY INCLUDE (BUT IS NOT LIMITED TO) THE AUDIT AND COMPLIANCE COMMITTEE CHAIR, SENIOR MANAGEMENT AND THE LEGAL DEPARTMENT. IF AN INDIVIDUAL DISCLOSES A SITUATION THAT POSES A CONFLICT OF INTEREST, A DETERMINATION IS MADE WHETHER THE SITUATION CAN BE MANAGED (SUCH AS BY RECUSAL IN DECISION-MAKING SETTINGS) OR MUST BE ELIMINATED (SUCH AS THROUGH DIVESTITURE OF THE OUTSIDE INTEREST). FINDINGS ARE REPORTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF INTERMOUNTAIN HEALTH CARE, INC.
FORM 990, PART VI, SECTION B, LINE 15	THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE INTERMOUNTAIN HEALTH CARE, INC. BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SCLHS AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO INTERMOUNTAIN HEALTH CARE, INC.'S BOARD FOR APPROVAL OF ANY CHANGES TO COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY INTERMOUNTAIN HEALTH CARE, INC. AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. CONSISTENT WITH THE PAY PHILOSOPHY SET BY INTERMOUNTAIN HEALTH CARE, INC.'S BOARD, THE COMMITTEE EMPHASIZES THE IMPORTANCE OF ENSURING TOTAL REMUNERATION IS REASONABLE AND APPROPRIATE WHEN REVIEWING AND MAKING RECOMMENDATIONS WITH RESPECT TO COMPENSATION PACKAGES FOR THE OFFICERS AND SENIOR MANAGEMENT. AS PART OF THE REVIEW PROCESS, INTERMOUNTAIN HEALTH CARE, INC. USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) COMPENSATION SURVEYS AND STUDIES 5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19	AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11G	PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 13,023,295. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,023,295. MEDICAL STAFFING: PROGRAM SERVICE EXPENSES 4,650,782. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,650,782. CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 185,519. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 185,519. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 9,110,798. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,110,798. LAB SERVICES: PROGRAM SERVICE EXPENSES 806,828. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 806,828.
FORM 990, PART XI, LINE 9:	BOOK VS TAX ADJUSTMENT FOR JOINT VENTURE INCOME -92,670. ENVIRONMENTAL REMEDITION LIABILITY ADJUSTMENT -800,000. THIRD PARTY MEDICARE ADJUSTMENT -426,113. FAIR VALUE ACQUISITION ADJUSTMENT -712,090.

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

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ST JAMES HEALTHCARE

Employer identification number

81-0231785

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 23-7379161	MANAGEMENT OF RELATED TAX EXEMPT HOSPITALS AND HEALTHCARE SERVICES	KS	501(C)(3)	LINE 12C, III-FI	INTERMOUNTAIN HEALTH CARE INC	Yes
(2)SCL HEALTH FOUNDATION 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 82-3290526	SUPPORT RELATED TAX EXEMPT ORGANIZATIONS	CO	501(C)(3)	LINE 7	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(3)SCL HEALTH RESEARCH INSTITUTE INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 85-2014794	MEDICAL RESEARCH	CO	501(C)(3)	LINE 4	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(4)INTEGRITY HEALTH 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 47-4520350	SUPPORTING ORGANIZATION	CO	501(C)(3)	LINE 12C, III-FI	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(5)BRIGHTON COMMUNITY HOSPITAL ASSOCIATION 1600 PRAIRIE CENTER PARKWAY BRIGHTON,CO80601 84-0482695	HOSPITAL SERVICES	CO	501(C)(3)	LINE 3	INTEGRITY HEALTH	Yes
(6)PLATTE VALLEY MEDICAL CENTER FOUNDATION 1600 PRAIRIE CENTER PARKWAY BRIGHTON,CO80601 74-2255936	SUPPORTING ORGANIZATION	CO	501(C)(3)	LINE 12A, I	BRIGHTON COMMUNITY HOSPITAL ASSOCIATION	Yes
(7)MOUNT ST VINCENT HOME INC 4159 LOWELL BOULEVARD DENVER,CO80211 84-0405260	RESIDENT CARE	CO	501(C)(3)	LINE 10	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(8)NJH-SJH INC 500 ELDORADO BLVD SUITE 4300 DENVER,CO80211 47-1194849	MANAGEMENT OF RELATED TAX EXEMPT HOSPITALS AND HEALTHCARE SERVICES	CO	501(C)(3)	LINE 12A, I	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(9)SAINT JOSEPH HOSPITAL INC 1375 EAST 19TH AVENUE DENVER,CO80218 84-0417134	HOSPITAL SERVICES	CO	501(C)(3)	LINE 3	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(10)SAINT JOSEPH HOSPITAL FOUNDATION 1375 EAST 19TH AVENUE DENVER,CO80218 84-0735096	SUPPORT RELATED TAX EXEMPT ORGANIZATIONS	CO	501(C)(3)	LINE 7	SAINT JOSEPH HOSPITAL INC	Yes
(11)SCL HEALTH - FRONT RANGE INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 84-1103606	HOSPITAL SERVICES	CO	501(C)(3)	LINE 3	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(12)GOOD SAMARITAN MEDICAL CENTER FOUNDATION 200 EXEMPLA CIRCLE LAFAYETTE,CO80026 84-1649162	SUPPORT RELATED TAX EXEMPT ORGANIZATIONS	CO	501(C)(3)	LINE 7	SCL HEALTH-FRONT RANGE INC	Yes
(13)LUTHERAN MEDICAL CENTER FOUNDATION 8300 WEST 38TH AVENUE WHEAT RIDGE,CO80033 20-8846152	SUPPORT RELATED TAX EXEMPT ORGANIZATIONS	CO	501(C)(3)	LINE 7	SCL HEALTH-FRONT RANGE INC	Yes
(14)ST MARY'S HOSPITAL & MEDICAL CENTER INC 2635 NORTH 7TH STREET GRAND JUNCTION,CO81501 84-0425720	HOSPITAL SERVICES	CO	501(C)(3)	LINE 3	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(15)ST MARY'S HOSPITAL FOUNDATION 2635 NORTH 7TH STREET GRAND JUNCTION,CO81501 23-7001007	SUPPORTING ORGANIZATION	CO	501(C)(3)	LINE 12A, I	ST MARYS HOSPITAL & MEDICAL CENTER INC	Yes
(16)CARITAS CLINICS INC 818 NORTH 7TH STREET LEAVENWORTH,KS66048 48-1009910	CLINIC SERVICES	KS	501(C)(3)	LINE 3	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(17)HOLY ROSARY HEALTHCARE 2600 WILSON STREET MILES CITY,MT59301 81-0231792	HOSPITAL SERVICES	MT	501(C)(3)	LINE 3	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(18)HOLY ROSARY HEALTHCARE FOUNDATION INC 2600 WILSON STREET MILES CITY,MT59301 20-2270238	SUPPORTING ORGANIZATION	MT	501(C)(3)	LINE 12A, I	HOLY ROSARY HEALTHCARE	Yes
(19)ST JAMES HEALTHCARE FOUNDATION INC 400 SOUTH CLARK STREET BUTTE,MT59701 65-1202190	SUPPORTING ORGANIZATION	MT	501(C)(3)	LINE 12A, I	ST JAMES HEALTHCARE	Yes
(20)SCL HEALTH - MONTANA 1233 NORTH 30TH STREET BILLINGS,MT59101 81-0232124	HOSPITAL SERVICES	MT	501(C)(3)	LINE 3	SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	Yes
(21)ST VINCENT HEALTHCARE FOUNDATION INC 1106 NORTH 30TH STREET BILLINGS,MT59101 81-0468034	SUPPORT RELATED TAX EXEMPT ORGANIZATIONS	MT	501(C)(3)	LINE 7	SCL HEALTH - MONTANA	Yes
(22)INTERMOUNTAIN HEALTH CARE INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY,UT84111 87-0269232	HOLDING COMPANY	UT	501(C)(3)	LINE 12B, II	N/A		No
(23)INTERMOUNTAIN COMMUNITY CARE FOUNDATION INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY,UT84111 94-2853320	COMMUNITY HEALTH	UT	501(C)(3)	LINE 12B, II	INTERMOUNTAIN HEALTH CARE INC	Yes
(24)SELECTHEALTH INC 5381 GREEN STREET MURRAY,UT84123 87-0409820	DELIVERY OF HEALTH BENEFITS	UT	501(C)(4)		INTERMOUNTAIN HEALTH CARE INC	Yes
(25)INTERMOUNTAIN HEALTH CARE RETIREE VEBA 36 SOUTH STATE SUITE 2200 SALT LAKE CITY,UT84111 74-2675605	RETIREE BENEFIT	UT	501(C)(9)		INTERMOUNTAIN HEALTH CARE INC	Yes
(26)INTERMOUNTAIN HEALTHCARE FOUNDATION INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY,UT84111 80-0225150	COMMUNITY HEALTH	UT	501(C)(3)	LINE 7	INTERMOUNTAIN HEALTH SERVICES INC	Yes
(27)INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC 6355 SOUTH BUFFALO LAS VEGAS,NV89113 20-0160881	HOLDING COMPANY	DE	501(C)(3)	LINE 3	INTERMOUNTAIN HEALTH SERVICES INC	Yes
(28)IHC HEALTH SERVICES INC 36 S STATE STREET SUITE 2200 SALT LAKE CITY,UT84111 94-2854057	HEALTHCARE	UT	501(C)(3)	LINE 3	INTERMOUNTAIN HEALTH CARE INC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

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) SCLH-GI ENDOSCOPY HOLDINGS LLC 382 S ARTHUR AVENUE LOUISVILLE,CO80027 81-2979243	OP ENDOSCOPY	CO	N/A					No			No
(2) SCLTDI JV LLC 4200 SIX FORKS ROAD SUITE 1000 RALEIGH,NC27609 47-2294770	RADIOLOGY	DE	N/A					No			No
(3) ATHLETIC MEDICINE & PERFORMANCE LLC (SVB IS PARTNER) 1144 NORTH 28TH STREET BILLINGS,MT59101 27-2270640	PHYSICAL THERAPY	MT	N/A					No			No
(4) SUMMIT SURGERY CENTER LLC 434 SOUTH CLARK STREET BUTTE,MT59701 81-0536068	OP SURGERY	MT	ST JAMES HEALTHCARE	RELATED	831,933	6,618,888		No			No	89.860 %
(5) GRAND VALLEY SURGICAL CENTER LLC 710 WELLINGTON AVENUE SUITE 21 GRAND JUNCTION,CO81501 84-1505075	OP SURGERY	CO	N/A					No			No
(6) HEALTHCARE MANAGEMENT LLC PO BOX 1929 GRAND JUNCTION,CO81502 84-1238904	MANAGEMENT SERVICES	CO	N/A					No			No
(7) MONUMENT HEALTH LLC 744 HORIZON CT STE 260 GRAND JUNCTION,CO81506 47-4424617	HEALTH CARE NETWORK	CO	N/A					No			No
(8) PAVILION IMAGING LLC 750 WELLINGTON AVENUE GRAND JUNCTION,CO81501 03-0516198	RADIOLOGY	CO	N/A					No			No
(9) SAN JUAN CANCER CENTER LLC 600 SOUTH 5TH STREET MONTROSE,CO81401 20-2856331	OP CANCER	CO	N/A					No			No
(10) CAREFLIGHT OF THE ROCKIES LLC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 47-3525381	MEDICAL AIR TRANSPORT	CO	N/A					No			No
(11) MED-MAP LLC PO BOX 1295 BILLINGS,MT59103 81-0491356	RENTAL REAL ESTATE	MT	N/A					No			No
(12) YELLOWSTONE SURGERY CENTER LLC 1144 NORTH 28TH STREET BILLINGS,MT59101 72-1519467	OP SURGERY	MT	N/A					No			No
(13) GALLATIN VALLEY SURGERY CENTER LLC 2825 WEST MAIN STREET SUITE C BOZEMAN,MT59718 88-2505265	OP SURGERY	MT	N/A					No			No
(14) FIRST FLIGHT OF WYOMING LLC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 92-1785143	MEDICAL AIR TRANSPORT	CO	N/A					No			No
(15) MCKAY DEE SURGICAL CENTER LLC 3895 HARRISON BLVD STE 200 OGDEN,UT84403 26-0286308	OP SURGERY	UT	N/A					No			No
(16) GRANDEUR PEAK INTERNATIONAL STALWARTS LP 136 S MAIN STREET STE 720 SALT LAKE CITY,UT84101 47-5468723	INVESTMENTS	DE	N/A					No			No
(17) INNOVATION FUND HOLDINGS COMPANY LLC 1000 WEST FULTON STREET STE 213 CHICAGO,IL60607 47-1525723	INNOVATION	DE	N/A					No			No
(18) HEALTHBOX SALT LAKE CITY I LLC 33 WEST MONROE STREET STE 1700 CHICAGO,IL60603 46-5338772	INNOVATION	DE	N/A					No			No
(19) INTERMOUNTAIN VENTURES FUND LLC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY,UT84111 84-4037085	INVESTMENTS	DE	N/A					No			No
(20) PELION OPPORTUNITY FUND III LLC 2750 E COTTONWOOD PARKWAY STE 600 SALT LAKE CITY,UT84121 84-2757193	INVESTMENTS	DE	N/A					No			No
(21) AACP KOREA BUYOUT INVESTORS II LP ONE EMBARCADERO 16TH FLOOR SAN FRANCISCO,CA94111 82-4971663	INVESTMENTS	CJ	N/A					No			No
(22) AACP SPECIAL SITUATIONS II LP ONE EMBARCADERO 16TH FLOOR SAN FRANCISCO,CA94111 83-2883726	INVESTMENTS	CJ	N/A					No			No
(23) AACP KOREA BUYOUT INVESTORS IV LP ONE EMBARCADERO 16TH FLOOR SAN FRANCISCO,CA94111 98-1549044	INVESTMENTS	CJ	N/A					No			No
(24) LOGAN SURGERY CENTER LLC 1300 NORTH 500 EAST LOGAN,UT84341 86-1965725	OP SURGERY	UT	N/A					No			No
(25) ST GEORGE SURGERY CENTER LLC 652 SOUTH MEDICAL CENTER DRIVE ST GEORGE,UT84790 85-3880188	OP SURGERY	UT	N/A					No			No
(26) SALTZER ASC TEN MILE LLC 875 S VANGUARD WAY SUITE 120 MERIDIAN,ID83642 84-5119941	OP SURGERY	ID	N/A					No			No
(27) NORTHPOINTE SURGICAL CENTER LLC 2326 NORTH 400 EAST STE 100 TOOELE,UT84074 46-1487986	OP SURGERY	UT	N/A					No			No
(28) HW AE CO-INVESTMENT PARTNERS LP 2500 N MILITARY TRAIL 470 BOCA RATON,FL33431 87-3405511	INVESTMENTS	DE	N/A					No			No
(29) PERFORMANCE EQUITY GROWTH OPPORTUNITIES FUND LP 5 GREENWICH OFFICE PARK THIRD FLOOR GREENWICH,CT06831 85-3942801	INVESTMENTS	DE	N/A					No			No
(30) MURRAY SURGERY CENTER LLC 5848 SOUTH FASHION BOULEVARD MURRAY,UT84107 87-3940183	OP SURGERY	UT	N/A					No			No
(31) PROVO SURGERY CENTER LLC 1157 NORTH 300 WEST PROVO,UT84604 87-3623664	OP SURGERY	UT	N/A					No			No
(32) SARATOGA SPRINGS SURGERY CENTER LLC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY,UT84111 87-3875864	OP SURGERY	UT	N/A					No			No
(33) PARK CITY SURGERY CENTER LLC 900 ROUND VALLEY DRIVE PARK CITY,UT84060 84-4898736	OP SURGERY	UT	N/A					No			No
(34) PARK CITY SURGICAL CENTER REAL ESTATE LLC 900 ROUND VALLEY DRIVE PARK CITY,UT84060 86-2568233	OP SURGERY	UT	N/A					No			No
(35) CDHC 3 LLC 265 N COUNTRY MANOR LANE ALPINE,UT84004 87-3215157	INVESTMENTS	UT	N/A					No			No
(36) ARK GLOBAL EMERGING COMPANIES LP 22 EAST 100 SOUTH 3RD FLOOR SALT LAKE CITY,UT84111 82-3044843	INVESTMENTS	UT	N/A					No			No
(37) PELION OPPORTUNITY FUND IV LLC 14761 S FUTURE WAY SUITE 500 SALT LAKE CITY,UT84020 85-3909188	INVESTMENTS	UT	N/A					No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(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) CARENT LABORATORY SOLUTIONS LLC 22240 COUNTRY ROAD 39 LASALLE,CO80645 32-0557616	MEDICAL LABORATORY	CO	N/A	C				Yes
(2) CARITAS INC AND SUBSIDIARIES 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 48-0941069	HEALTHCARE	KS	N/A	C				Yes
(3) WEST END ASSOCIATION INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 85-4261243	REAL ESTATE MANAGEMENT	MT	N/A	C				Yes
(4) LEAVEN INSURANCE COMPANY LTD 23 LIME TREE BAY AVENUE WEST BAY R GRAND CAYMAN KY CJ 98-0370522	INSURANCE	CJ	N/A	C				Yes
(5) ROCKY MOUNTAIN ACCOUNTABLE HEALTH NETWORK INC 500 ELDORADO BLVD SUITE 4300 BROOMFIELD,CO80021 46-3632053	HEALTHCARE	MT	N/A	C				Yes
(6) SELECTHEALTH BENEFIT ASSURANCE COMPANY 5381 GREEN STREET MURRAY,UT84123 87-0497549	DELIVERY OF HEALTH BENEFITS	UT	N/A	C				Yes
(7) HEALTHCARE CAPTIVE INSURANCE COMPANY 36 SOUTH STATE SUITE 2200 SALT LAKE CITY,UT84111 20-1937561	INSURANCE	AZ	N/A	C				Yes
(8) ALLUCEO INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY,UT84111 82-4614934	MENTAL HEALTH INTEGRATION SERVICES	DE	N/A	C				Yes
(9) SALTZER MEDICAL GROUP INC 215 EAST HAWAII AVENUE NAMPA,ID83686 82-0299231	MEDICAL SERVICES	ID	N/A	C				Yes
(10) CLASSIC MEDICAL INC 1021 SOUTH DOUGLAS STREET SALT LAKE CITY,UT84105 46-1141912	AIRCRAFT HOLDING COMPANY	UT	N/A	C				Yes
(11) CLASSIC HELICOPTERS INC 1021 SOUTH DOUGLAS STREET SALT LAKE CITY,UT84105 46-1153642	AIRCRAFT HOLDING COMPANY	UT	N/A	C				Yes
(12) CULMINATION BIO INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY,UT84111 36-5016511	BIOREPOSITORY	DE	N/A	C				Yes
(13) CAN YOU PLAY INC 1541 SOUTH 120 EAST FARMINGTON,UT84025 88-0846977	SOFTWARE DEVELOPMENT	UT	N/A	C				Yes

Schedule R (Form 990) 2023

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Yes

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

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

Yes

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ST JAMES HEALTHCARE FOUNDATION	B	388,667	CASH
(2) SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	B	4,349,664	CASH
(3) ST JAMES HEALTHCARE FOUNDATION	C	688,827	CASH
(4) SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	M	19,744,495	FMV
(5) SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	P	632,220	CASH
(6) SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC	R	2,794,349	CASH

Schedule R (Form 990) 2023

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) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	649
6	Total number of volunteers (estimate if necessary) .............	6	6
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,429,631
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	630,951

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,284,754	1,601,677
9	Program service revenue (Part VIII, line 2g) .........	149,865,562	137,870,334
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,335,299	1,203,515
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,311,010	1,509,349
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	153,796,625	142,184,875
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	3,992,423	4,749,916
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	44,208,136	47,799,296
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	104,676,289	99,041,771
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	152,876,848	151,590,983
19	Revenue less expenses. Subtract line 18 from line 12.......	919,777	-9,406,108
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	156,566,506	143,832,551
21	Total liabilities (Part X, line 26).............	12,824,303	11,557,408
22	Net assets or fund balances. Subtract line 21 from line 20.....	143,742,203	132,275,143

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 131,053,379 including grants of $ 4,749,916 ) (Revenue $ 138,488,781 )
	ST. JAMES HEALTHCARE HAS PLAYED AN IMPORTANT ROLE IN THE HISTORY OF BUTTE, MONTANA. FOUNDED IN 1881 BY THE SISTERS OF CHARITY OF LEAVENWORTH, ST. JAMES HAS BEEN KNOWN FOR GENERATIONS FOR ITS MISSION OF COMPASSIONATE CARE AND SERVICE TO THE POOR. TODAY, THAT COMMITMENT IS ACCOMPANIED BY ST. JAMES' REPUTATION AS A TECHNOLOGICAL LEADER IN MONTANA'S HEALTHCARE INDUSTRY AND THE LARGEST ACUTE-CARE HOSPITAL IN SOUTHWEST MONTANA.ST. JAMES HEALTHCARE IS RELATED TO SCL HEALTH MEDICAL GROUP-BUTTE, LLC, A SINGLE MEMBER LIMITED LIABILITY COMPANY OWNED BY A RELATED ORGANIZATION, SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. SCL HEALTH MEDICAL GROUP-BUTTE, LLC IS A GROUP OF PHYSICIAN CLINICS THAT PROVIDE PROFESSIONAL SERVICES TO THE ST. JAMES HEALTHCARE COMMUNITY AND SUPPORTS THE MISSION OF ST. JAMES HEALTHCARE. ALTHOUGH SCL HEALTH MEDICAL GROUP-BUTTE, LLC IS NOT OWNED DIRECTLY BY ST. JAMES HEALTHCARE, ST. JAMES HEALTHCARE IS REQUIRED TO FUND ALL OPERATING LOSSES OF SCL HEALTH MEDICAL GROUP-BUTTE, LLC. IN 2023, THE HOSPITAL PROVIDED $7,144,013 IN SUPPORT OF THE LOSSES OF THE PHYSICIAN CLINICS.ON APRIL 1, 2022, INTERMOUNTAIN HEALTH CARE, INC. AND SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AFFILIATED, CREATING A MODEL HEALTH SYSTEM THAT PROVIDES HIGH-QUALITY, ACCESSIBLE, AND AFFORDABLE HEALTHCARE TO COMMUNITIES IN UTAH, IDAHO, NEVADA, COLORADO, MONTANA, WYOMING, AND KANSAS. THE ORGANIZATION EMPLOYS MORE THAN 66,000 CAREGIVERS, OPERATES 33 HOSPITALS (INCLUDING ONE VIRTUAL HOSPITAL), AND RUNS HUNDREDS OF CLINICS, WHILE PROVIDING HEALTH INSURANCE TO OVER ONE MILLION PEOPLE IN UTAH, IDAHO AND NEVADA.AS PART OF INTERMOUNTAIN HEALTH (INTEGRATED HEALTH SYSTEM), ST. JAMES HEALTHCARE HAS DIRECT ACCESS TO BEST PRACTICES, RESOURCES, TECHNOLOGY, TALENT AND STRATEGIC CAPITAL. ST. JAMES HEALTHCARE CONTINUES TO BE A PROUD RECIPIENT OF THE PRESS GANEY GUARDIAN OF EXCELLENCE AWARD.ST. JAMES HEALTHCARE HAS A VARIETY OF PROGRAMS AND SERVICES TO SERVE THE COMMUNITY INCLUDING BUT NOT LIMITED TO:- CANCER CARE- CARDIAC SERVICES- EMERGENCY AND TRAUMA SERVICES (LEVEL III TRAUMA CENTER)- HOSPICE AND PALLIATIVE CARE- IMAGING- JOINT SURGERY AND REPLACEMENT CENTER- LABOR AND DELIVERY- ORTHOPEDICS- SPORTS MEDICINE- SURGERY CENTER- THERAPY AND REHAB SERVICES- WOMEN'S HEALTH SERVICESDURING 2023, ST. JAMES HEALTHCARE HAD THE FOLLOWING RESULTS:ADMISSIONS - 2,687OUTPATIENT VISITS - 82,820EMERGENCY DEPARTMENT VISITS - 16,721BIRTHS - 255SURGERIES - 1,902LABORATORY TESTS - 309,445MISSION:WE REVEAL AND FOSTER GOD'S HEALING LOVE BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.VISION:INSPIRED BY OUR FAITH, WE WILL PARTNER WITH OUR PATIENTS AND COMMUNITIES TO EXCEED THEIR EXPECTATIONS FOR HEALTH.VALUES:CARING SPIRIT - WE HONOR THE SACRED DIGNITY OF EACH PERSON.EXCELLENCE - WE SET AND SURPASS HIGH STANDARDS.GOOD HUMOR - WE CREATE JOYFUL AND WELCOMING ENVIRONMENTS.INTEGRITY - WE DO THE RIGHT THING WITH OPENNESS AND PRIDE.SAFETY - WE DELIVER CARE THAT SEEKS TO ELIMINATE ALL HARM FOR PATIENTS AND ASSOCIATES.STEWARDSHIP - WE ARE ACCOUNTABLE FOR THE RESOURCES ENTRUSTED TO US.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses131,053,379

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	2,189,023	5,662,407	1,868,634

(A) Name and business address	(B) Description of services	(C) Compensation





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 0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	701,677
e	Government grants (contributions)		1e	900,000

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

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

h Total. Add lines 1a-1f.......		1,601,677

		Business Code
2a	PATIENT CARE	620000	137,870,334	137,369,100	501,234
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		137,870,334

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,198,626			1,198,626
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	65,361
b	Less: rental expenses	6b	388
c	Rental income or (loss)	6c	64,973
d	Net rental income or (loss).......			64,973			64,973
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		34,993
b	Less: cost or other basis and sales expenses	7b		30,104
c	Gain or (loss)	7c		4,889
d	Net gain or (loss).........			4,889			4,889
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..
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..
10a	Gross sales of inventory, less returns and allowances ..
			10a	20,761
b	Less: cost of goods sold ..		10b	123,229
c	Net income or (loss) from sales of inventory..			-102,468			-102,468

Business Code
11a	SUMMIT SURGERY CTR		620000	874,474		874,474
b	CAFETERIA REVENUE		720000	657,689	618,447	39,242
c	LAUNDRY SERVICES		810000	14,681		14,681
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,546,844
12	Total revenue. See instructions.....			142,184,875	137,987,547	1,429,631	1,166,020

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	4,749,916	4,749,916
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,294,427	2,252,321	42,106
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	36,151,439	35,488,003	663,436
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,957,744	1,921,725	36,019
9	Other employee benefits .......	4,548,622	4,495,854	52,768
10	Payroll taxes ...........	2,847,064	2,799,200	47,864
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	13,749		13,749
c	Accounting ...........
d	Lobbying ...........	13,428		13,428
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	27,777,222	27,591,703	185,519
12	Advertising and promotion ....	105,584	105,003	581
13	Office expenses .......	227,784	225,787	1,997
14	Information technology ......	7,360,112	28,973	7,331,139
15	Royalties ..
16	Occupancy ...........	2,125,135	1,851,203	273,932
17	Travel ............	234,978	217,433	17,545
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	44,775	38,545	6,230
20	Interest ...........	880,041	880,041
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	6,839,671	6,839,671
23	Insurance ...	1,147,775	1,147,775
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	27,627,360	27,627,360
b	SHARED SERVICES-OTHER	5,221,828		5,221,828
c	MAINTENANCE & OTHER SER	5,061,536	5,060,037	1,499
d	BILLING & COLLECTION	4,373,735		4,373,735
e	All other expenses	9,987,058	7,732,829	2,254,229
25	Total functional expenses. Add lines 1 through 24e	151,590,983	131,053,379	20,537,604	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,776	1	1,125
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			16,445,432	4	13,088,022
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
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
7	Notes and loans receivable, net ...........			71,898	7	0
8	Inventories for sale or use ............			2,972,017	8	2,741,233
9	Prepaid expenses and deferred charges ......			473,239	9	618,847
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	98,632,089
b	Less: accumulated depreciation	10b	11,379,736	86,849,612	10c	87,252,353
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			6,048,665	12	6,250,918
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			43,703,867	15	33,880,053
16	Total assets. Add lines 1 through 15 (must equal line 33)...			156,566,506	16	143,832,551

17	Accounts payable and accrued expenses .....	11,519,400	17	10,197,905
18	Grants payable ...		18
19	Deferred revenue .........	1,229,414	19	312,892
20	Tax-exempt bond liabilities .........		20
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 ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	75,489	25	1,046,611
26	Total liabilities. Add lines 17 through 25..	12,824,303	26	11,557,408

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	143,742,203	27	132,275,143
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 ...........	143,742,203	32	132,275,143
33	Total liabilities and net assets/fund balances ........	156,566,506	33	143,832,551