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        <NamePerson>Bryan Morrison III</NamePerson>
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      <GrantsToDomesticIndividuals>
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      <FeesForServicesLegal>
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        <Fundraising>548</Fundraising>
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      <TravelEntrtnmntPublicOfficials>
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        <Description>OTHER LIABILITIES</Description>
        <Amount>1624840</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>1624840</TotalOfAmounts>
      <Form990ScheduleDPartXIII>
        <Identifier>PART V, LINE 4</Identifier>
        <ReturnReference>ENDOWMENT FUND PURPOSE</ReturnReference>
        <Explanation>THE TWO LARGEST ENDOWMENTS ARE DESIGNATED FOR INSURANCE COVERAGE FOR THE WORKING POOR AND NURSE EDUCATION. THE REMAINDER SUPPORT VARIOUS DEPARTMENTS IN THE HOSPITAL AND FOR GREATEST NEED FOR THE HOSPITAL AND FOR PATIENTS. THE ENDOWMENTS ARE HELD BY ST. VINCENT HEALTHCARE FOUNDATION.</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent400>X</Pcent400>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>true</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>15510749</TotalCommunityBenefitExpense>
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        <PercentOfTotalExpense>0.04780</PercentOfTotalExpense>
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      <UnreimbursedMedicaid>
        <PersonsServed>16647</PersonsServed>
        <TotalCommunityBenefitExpense>32002655</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>15200885</DirectOffsettingRevenue>
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      <TotalCharityCare>
        <PersonsServed>16647</PersonsServed>
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        <PersonsServed>806</PersonsServed>
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        <PersonsServed>553</PersonsServed>
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        <NumberOfActivitiesOrPrograms>88</NumberOfActivitiesOrPrograms>
        <PersonsServed>37753</PersonsServed>
        <TotalCommunityBenefitExpense>9076599</TotalCommunityBenefitExpense>
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      <TotalCommunityBenefits>
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      <CommunitySupport>
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        <PersonsServed>2420</PersonsServed>
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        <NetCommunityBuildingExpense>322197</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00100</PercentOfTotalExpense>
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      <CoalitionBuilding>
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        <PersonsServed>8</PersonsServed>
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        <NetCommunityBuildingExpense>1839</NetCommunityBuildingExpense>
      </CoalitionBuilding>
      <HealthImprovementAdvocacy>
        <NumberOfActivitiesOrPrograms>1</NumberOfActivitiesOrPrograms>
        <PersonsServed>2</PersonsServed>
        <TotalCommunityBuildingExpense>50848</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>50848</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00020</PercentOfTotalExpense>
      </HealthImprovementAdvocacy>
      <Total>
        <NumberOfActivitiesOrPrograms>8</NumberOfActivitiesOrPrograms>
        <PersonsServed>2430</PersonsServed>
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        <NetCommunityBuildingExpense>374884</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00120</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseReported>false</BadDebtExpenseReported>
      <BadDebtExpenseAmount>8767256</BadDebtExpenseAmount>
      <AmountReimbursedByMedicare>65581323</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>65933331</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-352008</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostAccountingSystem>X</CostAccountingSystem>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
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        <PhysicansProfitOrOwnership>0.50000</PhysicansProfitOrOwnership>
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      <Form990ScheduleHPartIV>
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          <BusinessNameLine1>COMMUNITY CRISIS CTR</BusinessNameLine1>
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      </Form990ScheduleHPartIV>
      <Form990ScheduleHPartIV>
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      <Form990ScheduleHPartIV>
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      <Form990ScheduleHPartIV>
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      <Form990ScheduleHPartIV>
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      <Form990ScheduleHPartIV>
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      <Form990ScheduleHPartIV>
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        <TeachingHospital>X</TeachingHospital>
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        <Other>Durable Medical Eqp Outpatient Phy Clin</Other>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
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        <HospitalFacilityNumber>1</HospitalFacilityNumber>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
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        <FPGFreePercent>200.</FPGFreePercent>
        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>400.</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <AssetLevel>X</AssetLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <InsuranceStatus>X</InsuranceStatus>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>true</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NotifyUponAdmission>X</NotifyUponAdmission>
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        <NotifiedAllPatients>X</NotifiedAllPatients>
        <DocumentedDetermination>X</DocumentedDetermination>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <LowestNegotiatedRates>X</LowestNegotiatedRates>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
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          <Name>
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          </Name>
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            <State>MT</State>
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        <OtherFacilities>
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            <City>BILLINGS</City>
            <State>MT</State>
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        <OtherFacilities>
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            <City>BILLINGS</City>
            <State>MT</State>
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        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>YELLOWSTONE IMAGING AND BREAST CENTER</BusinessNameLine1>
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          <Address>
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            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>59101</ZIPCode>
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        <OtherFacilities>
          <Name>
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          </Name>
          <Address>
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            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591024152</ZIPCode>
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        <OtherFacilities>
          <Name>
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          <Address>
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            <City>BILLINGS</City>
            <State>MT</State>
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        <OtherFacilities>
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            <City>LAUREL</City>
            <State>MT</State>
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          <FacilityType>AMBULATORY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>OUTPATIENT REHABILITATION</BusinessNameLine1>
          </Name>
          <Address>
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            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>59101</ZIPCode>
          </Address>
          <FacilityType>OUTPATIENT THERAPIES</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>HEIGHTS FAMILY PRACTICE</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>32 WICKS LANE</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>59105</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>HARDIN MEDICAL CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>16 NORTH MILES AVENUE</AddressLine1>
            <City>HARDIN</City>
            <State>MT</State>
            <ZIPCode>590342356</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>VASCULAR CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2900 12TH AVENUE NORTHSUITE 502E</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591017504</ZIPCode>
          </Address>
          <FacilityType>VASCULAR CLINIC</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>YELLOWSTONE HEART CENTER</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2900 12TH AVENUE NORTH SUITE 307W</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>59101</ZIPCode>
          </Address>
          <FacilityType>CARDIOLOGY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>NORTHERN ROCKIES REGIONAL PAIN CENTER</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2900 12TH AVENUE NORTH SUITE 401 E</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591017506</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY PAIN MGMT AND CARE SERVICES</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>NEUROSCIENCE CENTER</BusinessNameLine1>
          </Name>
          <Address>
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            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591010136</ZIPCode>
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          <FacilityType>AMBULATORY CARE AND INFUSION SERVICES</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
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            <BusinessNameLine1>SVH NEUROSURGERY</BusinessNameLine1>
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          <Address>
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            <State>MT</State>
            <ZIPCode>59101</ZIPCode>
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        <OtherFacilities>
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            <BusinessNameLine1>CENTER FOR HEALTHY LIVING</BusinessNameLine1>
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            <State>MT</State>
            <ZIPCode>591020160</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY CARE</FacilityType>
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        <OtherFacilities>
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            <BusinessNameLine1>OCCUPATIONAL HEALTH</BusinessNameLine1>
          </Name>
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            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591010701</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY OCCUPATIONAL HEALTH</FacilityType>
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        <OtherFacilities>
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          <Address>
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            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591024810</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>PHYSICAL MEDICINE CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2900 12TH AVENUE NORTH SUITE 400 E</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591010136</ZIPCode>
          </Address>
          <FacilityType>PHYSICAL MEDICINE REHAB</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>CANCER THERAPY CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1041 NORTH 29TH STREET</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591010700</ZIPCode>
          </Address>
          <FacilityType>CANCER THERAPY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>ELIZABETH SETON PRENATAL CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1230 NORTH 30TH ST SUITE 100</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591010128</ZIPCode>
          </Address>
          <FacilityType>PRENATAL CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>SVH GASTROINTESTINAL CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1144 NORTH 28TH STREET SUITE C</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>59101</ZIPCode>
          </Address>
          <FacilityType>GASTROINTESTINAL CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>PEDIATRIC CARDIOLOGY CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1232 NORTH 30TH STREET SUITE 300</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>59101</ZIPCode>
          </Address>
          <FacilityType>PEDIATRIC CARDIOLOGY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>MOUNTAIN VIEW CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>10 ROBINSON LANE</AddressLine1>
            <City>RED LODGE</City>
            <State>MT</State>
            <ZIPCode>590680070</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>HOME HEALTH SPECIALITIES</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2600 WILSON STREET</AddressLine1>
            <City>MILES CITY</City>
            <State>MT</State>
            <ZIPCode>59301</ZIPCode>
          </Address>
          <FacilityType>DURABLE MEDICAL EQUIPMENT</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>BEHAVIORAL HEALTH ASSOCIATES</BusinessNameLine1>
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          <Address>
            <AddressLine1>1101 NORTH 27TH STREET SUITE 201</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591010100</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY PYSCH AND COUNSELING SERVICES</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>WEIGHT MANAGEMENT CLINIC</BusinessNameLine1>
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          <Address>
            <AddressLine1>1101 NORTH 27TH STREET SUITE 101</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591010100</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY CARE SERVICES RELATED TO WEIGHT LOSS</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>SISTER JOANNA BRUNER CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>720 LINDSAY LANE SUITE A</AddressLine1>
            <City>CODY</City>
            <State>WY</State>
            <ZIPCode>824144103</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>BILLINGS CARDIOLOGY</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2019 BROADWATER AVENUE</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591027588</ZIPCode>
          </Address>
          <FacilityType>CARDIOLOGY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>ABSAROKEE MEDICAL CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>55 NORTH MONTANA AVENUE</AddressLine1>
            <City>ABSAROKEE</City>
            <State>MT</State>
            <ZIPCode>590010425</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>PHYSICAL THERAPY WEST</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>14 AVANTA WAY</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>59102</ZIPCode>
          </Address>
          <FacilityType>PHYSICAL THERAPY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>SVH TRAUMATIC BRAIN INJURY</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2900 12TH AVE NORTH SUITE 10W</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>291010127</ZIPCode>
          </Address>
          <FacilityType>TRAUMATIC BRAIN INJURY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>SVH NEUROLOGY</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1233 NORTH 30 ST</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591010127</ZIPCode>
          </Address>
          <FacilityType>NEUROLOGY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>RONALD MCDONALD CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1233 NORTH 30TH STREET</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591075200</ZIPCode>
          </Address>
          <FacilityType>DENTAL AND MEDICAL CARE FOR LOW-INCOME PATIENTS</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>SVH PEDIATRIC SPECIALITY CLINICS</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1230 NORTH 30TH STREET SUITE 100</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>591020128</ZIPCode>
          </Address>
          <FacilityType>AMBULATORY CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>MATERNAL FETAL CLINIC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>2900 12TH AVENUE NORTH SUITE 130W</AddressLine1>
            <City>BILLINGS</City>
            <State>MT</State>
            <ZIPCode>59101</ZIPCode>
          </Address>
          <FacilityType>PERINATOLOGIST CARE</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>BIG HORN BASIN RADIATION ONCOLOGY CENTER</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1025 9TH STREET</AddressLine1>
            <City>CODY</City>
            <State>WY</State>
            <ZIPCode>824143441</ZIPCode>
          </Address>
          <FacilityType>RADIATION ONCOLOGY CARE</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Identifier>SCHEDULE H, PART VI</Identifier>
        <ReturnReference>SUPPLEMENTAL INFORMATION</ReturnReference>
        <Explanation>PART I, LINE 3C: ELIGIBILITY IS BASED ON FEDERAL POVERTY GUIDELINES. PART I, LINE 6A: NA PART I, LINE 7G: SEVERAL PHYSICIAN CLINICS ARE INCLUDED IN SUBSIDIZED SERVICES. THESE INCLUDE PRIMARY CARE CLINICS IN RURAL AREAS AS WELL AS CLINICS PROVIDING UNDER-REPRESENTED SPECIALTY CARE. TOTAL COSTS INCLUDED ON SCHEDULE H RELATED TO THESE CLINICS AS SUBSIDIZED SERVICES WERE $5,389,499. SUBSIDIDIZED SERVICES ARE EVALUATED FOR INCLUSION USING CHA/VHA GUIDELINES. PART I, LINE 7, COLUMN F: THE AMOUNT OF BAD DEBT EXCLUDED FROM THESE CALCULATONS WAS $19,163,107. PART I, LINE 7: COST ACCOUNTING IS USED TO DETERMINE COMMUNITY BENEFIT EXPENSES FOR SUBSIDIZED HEALTH SERVICES. THE COST ACCOUNTING SYSTEM INCLUDES THE COSTS FROM ALL BUSINESS COMPONENTS TO INCLUDE INPATIENT, OUTPATIENT, EMERGENCY ROOM AND CLINICS, AS WELL AS, ALL PAYOR SEGMENTS. A COST TO CHARGE RATIO WAS USED IN ALL THE OTHER CALCULATIONS AND WAS DERIVED USING THE WORKSHEET 2 METHODOLOGY. PART II: ST. VINCENT HEALTHCARE'S COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITY BY ADDRESSING SOCIAL DETERMINANTS OF HEALTH INCLUDING POVERTY, EDUCATION, ENVIRONMENTAL HEALTH &amp; ECONOMIC DEVELOPMENT. OUR EFFORTS ALSO INCLUDED ADVOCACY RELATED TO PUBLIC HEALTH AND ACCESS TO CARE. THIS COMMUNITY BUILDING WORK INCLUDES COSTS ASSOCIATED WITH OUR PREMIER COMMUNITY HEALTH PARTNERSHIP, THE ALLIANCE, AS WELL AS ITS COMMUNITY COALITION, HEALTHY BY DESIGN. HEALTHY BY DESIGN PARTNERS INCLUDE: BETTER BILLINGS FOUNDATION, BIG BETTER BILLINGS FOUNDATION, BIG SKY ECONOMIC DEVELOPMENT,BIG SKY STATE GAMES, BIKENET, BILLINGS CHAMBER OF COMMERCE, BILLINGS CLINIC, BILLINGS FAMILY YMCA, CITY OF BILLINGS, CITY-COUNTY PLANNING DEPARTMENT, COMMUNITY GARDENS - HOUSING AUTHORITY OF BILLINGS, COMMUNITY HEALTH ADVOCATES, CROWLEY FLECK, KEENE INSIGHT, LEAGUE OF WOMEN VOTERS OF BILLINGS, MCCALL DEVELOPMENT, MET TRANSIT, MONTANA NAPA, MSU-BILLINGS, NUTRITION FOR THE FUTURE, INC., Q360 HEALTH, RIVERSTONE HEALTH, SAFE ROUTES TO SCHOOL, SALVATION ARMY, SCHOOL HEALTH ADVISORY COUNCIL, ST. VINCENT DE PAUL SOCITY, UNITED WAY OF YELLOWSTONE COUNTY, &amp; YELLOWSTONE COUNTY EXTENSION SERVICE. THESE PARTNERS WORK TOGETHER TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT, SUBSEQUENT COMMUNITY HEALTH IMPROVEMENT PLAN, AND YEARLY TASK GROUP WORK PLANS TO SUPPORT THE FIVE WORKING COMMITTEES: HEALTH EQUITY, WORKSITE WELLNESS, BUILT ENVIRONMENT, HEALTHY WEIGHT &amp; RECOGNITION PROGRAM. DETAILED WORK PLANS ARE AVAILABLE AT WWW.HEALTHBYDESIGNYELLOWSTONE.ORG PART III, LINE 4: DISCOUNTS AND PAYMENTS APPLIED TO ACCOUNTS REDUCE BAD DEBT EXPENSE. NO METHOD IS USED TO DETERMINE THE AMOUNT THAT COULD BE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE, HOWEVER, THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ALLOWS FINANCIAL ASSISTANCE AWARDS TO BE MADE PRESUMPTIVELY TO INDIVIDUALS WHO HAVE NOT ADEQUATELY COMPLETED THE APPLICATION PROCESS IF THE INDIVIDUAL IS HOMELESS OR IF THE INDIVIDUAL IS NON-RESPONSIVE AND HAS A CREDIT SCORE LESS THAN 600. BAD DEBT EXPENSES INCLUDE ACTUAL WRITE OFFS AND ANY ASSOCIATED ACCRUAL BASED ON ACCOUNTS RECEIVABLE. THE COSTING METHODOLOGY USED TO CALCULATE THE COST OF BAD DEBT INCLUDED ON PART III LINE 2 WAS THE COST TO CHARGE RATIO DERIVED USING THE METHODOLOGY FROM WORKSHEET 2. PART III, LINE 8: THE ORGANIZATION DOES NOT BELIEVE THAT MEDICARE SHORTFALLS SHOULD BE INCUDED AS COMMUNITY BENEFIT. MEDICARE ALLOWABLE COSTS WERE DERIVED FROM THE MEDICARE COST REPORT'S SCHEDULE D PART V, PART VI AND SCHEDULE D-1. 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 TO ENSURE THAT WE MANAGE OUR RESOURCES SO THAT WE CAN CONTINUE TO BE HERE WHEN PEOPLE NEED US MOST. ST. VINCENT HEALTHCARE NOTIFIES PATIENTS OF FINANCIAL ASSISTANCE POLICY UPON ADMISSION, DISCHARGE AND IN COMMUNICATION REGARDING 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, INCLUDING REFERRAL TO A COLLECTION AGENCY, THE ACCOUNT IS RECLASSIFIED AS FINANCIAL ASSISTANCE AND DEBT COLLECTION EFFORTS ARE CEASED. NEEDS ASSESSMENT: ST. VINCENT HEALTHCARE'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN 2010 AND RELEASED TO THE PUBLIC IN 2011. THE ASSESSMENT WAS SPONSORED BY THE ALLIANCE, AN AFFILIATED PARTNERSHIP CONSISTING OF THE CHIEF EXECUTIVE OFFICERS AND THEIR DESIGNEES FROM BILLINGS CLINIC, YELLOWSTONE CITY COUNTY HEALTH DEPARTMENT DBA RIVERSTONE HEALTH, AND ST. VINCENT HEALTHCARE. THE ALLIANCE WORKS COLLABORATIVELY ON COMMUNITY AND REGIONAL HEALTH INITIATIVES WITH THE MISSION OF IDENTIFYING COMMUNITY HEALTH NEEDS AND THEN DEFINING AND IMPLEMENTING EFFICIENT AND EFFECTIVE COMMUNITY SOLUTIONS THROUGH INTEGRATED ACTIONS. THEIR VISION STATES, "TOGETHER WE IMPROVE THE HEALTH OF OUR COMMUNITY, ESPECIALLY THOSE WHO ARE UNDERSERVED AND MOST VULNERABLE, IN WAYS THAT SURPASS OUR INDIVIDUAL CAPACITY." THE 2011 CHNA WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS, INC., AND INCLUDED FOCUS GROUPS WITH COMMUNITY LEADERS AND SURVEYS OF 400 COMMUNITY MEMBERS IN YELLOWNSTONE COUNTY USING THE RANDOM-DIGIT-DIALING METHOD. THE RESULTS OF THE SURVEY AND SUBSEQUENT COMMUNITY HEALTH IMPROVEMENT PLAN CAN BE ACCESSED AT WWW.HEALTHYBYDESIGNYELLOWSTONE.ORG. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: ST. VINCENT HEALTHCARE TREATS PATIENTS WITH RESPECT AND DIGNITY REGARDLESS OF THEIR ABILITY TO PAY. ST. VINCENT HEALTHCARE HAS A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINS ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE AT VARIOUS LEVELS, INCLUDING A 100% DISCOUNT, AND IS BASED ON FEDERAL POVERTY GUIDELINES. WE WORK WITH PATIENTS TO HELP THEM UNDERSTAND THEIR FINANCIAL RESPONSIBILITY FOR CARE RECEIVED, FINANCIAL ASSISTANCE AVAILABLE TO THEM, AND TO ESTABLISH PAYMENT PROGRAMS IN DEMONSTRATION OF OUR CORE VALUE OF RESPECT. AS PART OF OUR RESPONSIBILITY TO EDUCATE, WE INFORM OUR PATIENTS AND THEIR FAMILIES OF THE AVAILABILITY OF ASSISTANCE, INCLUDING GOVERNMENT PROGRAMS. WE COMMUNICATE THIS IN A VARIETY OF WAYS TO ENSURE THAT MESSAGES REACH MULTIPLE AUDIENCES. BEFORE, DURING AND/OR AFTER ADMISSION, WE ENCOURAGE OUR SELF PAY PATIENTS TO VISIT WITH A FINANCIAL COUNSELOR TO DISCUSS QUALIFICATIONS FOR FINANCIAL ASSISTANCE. THE FINANCIAL COUNSELOR WORKS WITH THE PATIENT TO COMPLETE A FINANCIAL ASSISTANCE FORM TO DETERMINE THE LEVEL OF DISCOUNT FOR WHICH THE PATIENT MAY BE ELIGIBLE. WE POST FINANCIAL ASSISTANCE INFORMATION IN EMERGENCY AND ADMISSIONS AREAS, ON BILLINGS INVOICES, IN VARIOUS AREAS AROUND THE ST. VINCENT HEALTHCARE AND CLINIC SITES AND ON THE ST. VINCENT HEALTHCARE WEBSITE. WE PROVIDE WRITTEN MATERIALS TO PATIENTS THAT OUTLINE OUR FINANCIAL ASSISTANCE POLICY AND HOW IT IS ADMINISTERED. THIS COVERS ELIGIBILITY, STEPS TO FOLLOW TO DETERMINE IF A PATIENT QUALIFIES FOR ASSISTANCE, TYPICAL CHARGES A PATIENT MAY EXPECT FOR ROUTINE PROCEDURES, AND ASSISTANCE AVAILABLE BASED ON A PATIENT'S INCOME LEVEL. WE ENSURE THAT OUR FINANCIAL COUNSELORS, ADMISSION EMPLOYEES, SOCIAL WORKERS AND OTHER EMPLOYEES UNDERSTAND OUR POLICIES TO BE ABLE TO ASSIST PATIENTS IN THE MOST APPROPRIATE WAY. WE HAVE A PARTNERSHIP WITH WESTERN SECURITY BANK TO PROVIDE MEDICAL CREDIT LINES. THIS HELPS PATIENTS MEET THEIR FINANCIAL OBLIGATIONS IN A REASONABLE AND DIGNIFIED MANNER BASED ON THEIR ABILITY TO PAY, AND ALLOWS THEM TO CONTINUE TO ENSURE THE ONGOING WELFARE OF THEIR FAMILIES. THIS IS DONE IN ACCORDANCE WITH OUR CORE VALUE OF RESPECT. COMMUNITY INFORMATION: ST. VINCENT HEALTHCARE'S PRIMARY SERVICE AREA IS YELLOWSTONE COUNTY. YELLOWSTONE COUNTY IS LOCATED IN SOUTH-CENTRAL MONTANA. IT IS THE LARGEST COUNTY IN MONTANA AND HOME TO 15% OF ALL MONTANANS-APPROXIMATELY 150,069 PEOPLE (US CENSUS, 2011 ESTIMATE). THE POPULATION IS 27% OVER THE AGE OF 55, COMPARED TO ONLY 24% NATIONALLY. BY 2014, THE 55+ SEGMENT OF THE POPULATION IS EXPECTED TO GROW 18%, ULTIMATELY EQUATING TO 30% OF THE TOTAL POPULATION. WHITE NON-HISPANICS CONTINUE TO BE THE MAJORITY AT 88% OF THE TOTAL POPULATION (COMPARED TO 65% NATIONALLY). THE CATEGORY "ALL OTHERS" COMPRISES THE SECOND LARGEST RACE AT 7.5%. THIS IS LARGELY REPRESENTED BY THE AMERICAN INDIAN POPULATION, AS THE CROW INDIAN RESERVATION RESIDES WITHIN ST. VINCENT'S SERVICE AREA. AMERICAN INDIAN POPULATIONS TEND TO HAVE SIGNIFICANT HEALTH DISPARITIES INCLUDING HIGHER TEENAGE BIRTHRATES, INCIDENCE OF DIABETES, AND ACCIDENTAL DEATH. THE MAJORITY OF PRIMARY SERVICE AREA RESIDENTS EARN LESS THAN $50,000 ANNUALLY WITH ONLY 24% EARNING MORE THAN $75,000, COMPARED TO 30% NATIONALLY. ST. VINCENT HEALTHCARE'S TOTAL SERVICE AREA IS COMPRISED OF APPROXIMATELY 700,000 RESIDENTS AND COMPRISES MOS</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>AFFILIATED HEALTH CARE SYSTEM:</Identifier>
        <Explanation>SAINT VINCENT'S HEALTHCARE IS A CONTROLLED ENTITY OF THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS). SCLHS AND ITS AFFILIATED ENTITIES HAVE A COMMON CALLING AND MISSION "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." SAINT VINCENT'S HEALTHCARE PROMOTES THE HEALTH OF THE COMMUNITY BY DELIVERING DIRECT HIGH QUALITY HEALTHCARE SERVICES THAT ARE RESPONSIVE TO THE NEEDS OF ITS PATIENTS AND THEIR FAMILIES. SCLHS SUPPORTS THE EFFORTS OF THE HOSPITAL THROUGH STRATEGIC DIRECTION AND OPERATING OVERSIGHT. SCLHS SUPPLIES OVERHEAD SUPPORT SERVICES TO SAINT VINCENTS HEALTHCARE, INCLUDING INFORMATION TECHNOLOGY SERVICES, CENTRAL CASH MANAGEMENT AND INVESTMENT, INTERNAL AUDIT, SUPPLY CHAIN MANAGEMENT, BENEFITS ADMINISTRATION, RISK MANAGEMENT AND INSURANCE AND QUALITY IMPROVEMENT LEADERSHIP. INTERNAL AUDIT, SUPPLY CHAIN MANAGEMENT, BENEFITS ADMINISTRATION, RISK MANAGEMENT AND INSURANCE AND QUALITY IMPROVEMENT LEADERSHIP.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>STATE FILING OF COMMUNITY BENEFIT REPORT</Identifier>
        <ReturnReference>990 SCHEDULE H, PART VI</ReturnReference>
        <Explanation>CA,MT,</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="IRS990ScheduleI">
      <RecordsMaintained>true</RecordsMaintained>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>COMMUNITY CRISIS CENTER LLC</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>704 NORTH 30TH ST</AddressLine1>
          <City>BILLINGS</City>
          <State>MT</State>
          <ZIPCode>59101</ZIPCode>
        </AddressUS>
        <EINOfRecipient>203231164</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>82000</AmountOfCashGrant>
        <PurposeOfGrant>Mental health</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>ST VINCENT HEALTHCARE FOUNDATION</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO BOX 35200</AddressLine1>
          <City>BILLINGS</City>
          <State>MT</State>
          <ZIPCode>591075200</ZIPCode>
        </AddressUS>
        <EINOfRecipient>810468034</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>1082643</AmountOfCashGrant>
        <PurposeOfGrant>Operations</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>ST VINCENT DE PAUL</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>2610 MONTANA AVE</AddressLine1>
          <City>BILLINGS</City>
          <State>MT</State>
          <ZIPCode>59101</ZIPCode>
        </AddressUS>
        <EINOfRecipient>910879988</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>50000</AmountOfCashGrant>
        <PurposeOfGrant>RENT/UTILITY ASST</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>BILLINGS AREA CATHOLIC EDUCATION TRUST</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>120 South 34th Street</AddressLine1>
          <City>BILLINGS</City>
          <State>MT</State>
          <ZIPCode>59101</ZIPCode>
        </AddressUS>
        <EINOfRecipient>816081234</EINOfRecipient>
        <IRCSection>501(c)(3)</IRCSection>
        <AmountOfCashGrant>10000</AmountOfCashGrant>
        <PurposeOfGrant>STUDENT SCHOLARSHIPS</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>YWCA</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>909 Wyoming Avenue</AddressLine1>
          <City>Billings</City>
          <State>MT</State>
          <ZIPCode>59101</ZIPCode>
        </AddressUS>
        <EINOfRecipient>810534954</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>20000</AmountOfCashGrant>
        <PurposeOfGrant>DOMESTIC VIOLENCE</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>BROADWATER ELEMENTARY</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>415 Braodwater Avenue</AddressLine1>
          <City>Billings</City>
          <State>MT</State>
          <ZIPCode>59101</ZIPCode>
        </AddressUS>
        <EINOfRecipient>810433128</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>25000</AmountOfCashGrant>
        <PurposeOfGrant>FITNESS EQUIPMENT</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>YMCA</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>402 NORTH 32ND STREET</AddressLine1>
          <City>BILLINGS</City>
          <State>MT</State>
          <ZIPCode>59101</ZIPCode>
        </AddressUS>
        <EINOfRecipient>810229386</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>18000</AmountOfCashGrant>
        <PurposeOfGrant>HEALTHY FAMILIES</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>THE CENTER FOR CHILDREN AND FAMILIES</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>3021 3RD AVENUE NORTH</AddressLine1>
          <City>BILLINGS</City>
          <State>MT</State>
          <ZIPCode>59103</ZIPCode>
        </AddressUS>
        <EINOfRecipient>262318221</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>12000</AmountOfCashGrant>
        <PurposeOfGrant>Mental Health</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>COMMUNITY LEADERSHIP DEVELOPMENT INC</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>PO BOX 3381</AddressLine1>
          <City>BILLINGS</City>
          <State>MT</State>
          <ZIPCode>59103</ZIPCode>
        </AddressUS>
        <EINOfRecipient>810397424</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>16841</AmountOfCashGrant>
        <PurposeOfGrant>After school programming</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>SPECIAL OLYMPICS MONTANA</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>1233 NORTH 30TH STREET</AddressLine1>
          <City>BILLINGS</City>
          <State>MT</State>
          <ZIPCode>59101</ZIPCode>
        </AddressUS>
        <EINOfRecipient>810367064</EINOfRecipient>
        <IRCSection>501(C)(3)</IRCSection>
        <AmountOfCashGrant>30000</AmountOfCashGrant>
        <PurposeOfGrant>2012 GAMES</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>10</TotalNbrOf501C3AndGovtGrants>
      <Form990ScheduleIPartIV>
        <Identifier>MISSION FUND POLICIES</Identifier>
        <ReturnReference>PART I LINE 2</ReturnReference>
        <Explanation>ST VINCENT HEALTHCARE PROVIDES A LIMITED NUMBER OF GRANTS TO IMPROVE THE HEALTHYAND WELL-BEING OF THE PEOPLE IN OUR COMMUNITY. GUIDED BY HOSPITAL POLICY, MISSION FUND AWARD PROJECTS MUST: (1) DEMONSTRATE A COMMITTMENT TO THE ST VINCENT HEALTHCARE MISSION, VISION, AND VALUES; (2) MEET CRITERIA FOR INCLUSION IN THE COMMUNITY BENEFIT REPORT; AND (3) DOCUMENT MEASURABLE OUTCOMES THAT DEMONSTRATE THE SUCCESS OF THE PROJECT. PREFERENCE WILL BE GIVEN WHEN THE PROJECT: (1) ADDRESSES CREATIVELY THE UNMET NEEDS OF THE ECONOMICALLY DISADVANTAGED; (2) FORMS COLLABORATIVE PARTNERSHIPS THAT IMPROVE THE HEALTH OF THE COMMUNITY; (3) AIDS A SIGNIFICANT POPULATION OF THE POOR, UNDERSERVED AND/OR UNINSURED; (4) REFLECTS ST VINCENT HEALTHCARE'S ANNUAL AND STRATEGIC GOALS; AND (5) DEMONSTRATE THE POSSIBILITY FOR SUSTAINABILITY BEYOND THE GRANT PERIOD. APPLICATIONS ARE REVIEWED ON AN ANNUAL BASIS BY COMMITTEE. GRANTEES ARE REQUIRED TO PROVIDE A 6-MONTH AND 1-YEAR REPORT TO ST VINCENT HEALTHCARE AND PROVIDE FOR AN ON-SITE VISIT OF THE PROGRAM. AS NOTED IN THE MISSION FUND APPLICATION, IF FUNDS ARE USED OUTSIDE OF PROJECT GUIDELINES THE GRANTEE MAY BE ASKED TO REIMBURSE ST VINCENT HEALTHCARE FOR FUNDS ALREADY DISTRIBUTED FOR THE PROJECT.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>true</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>Jason Barker</NamePerson>
        <Title>President/ CEO</Title>
        <BaseCompensationFilingOrg>0</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>428530</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>0</BonusFilingOrg>
        <BonusRelatedOrgs>147000</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
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        <NamePerson>Mike Bush</NamePerson>
        <Title>CMO, St. Vincent Hospital</Title>
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        <NamePerson>Jill Willen-Kennelly</NamePerson>
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        <NamePerson>Ron Oldfield</NamePerson>
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        <NamePerson>Steve Loveless</NamePerson>
        <Title>COO</Title>
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        <NamePerson>Joan Thullbery</NamePerson>
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        <NamePerson>Scott Sears</NamePerson>
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        <NamePerson>Darren Walker</NamePerson>
        <Title>VP, HUman Resources</Title>
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        <NamePerson>Mike Dowdy</NamePerson>
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        <NamePerson>Dave Irion</NamePerson>
        <Title>President, Foundation</Title>
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        <NamePerson>John Kinna</NamePerson>
        <Title>Executive Director, Med Pract</Title>
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        <NamePerson>Kathleen Stevens</NamePerson>
        <Title>Med Dir, Neonatal Services</Title>
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        <NamePerson>Paul Cook</NamePerson>
        <Title>President/CEO RMHN</Title>
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        <NamePerson>Bonnie Dean</NamePerson>
        <Title>Physiatrist</Title>
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        <NamePerson>Patricia Lahaie</NamePerson>
        <Title>Physiatrist</Title>
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        <NamePerson>Bryan Morrison III</NamePerson>
        <Title>Physiatrist</Title>
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      <Form990ScheduleJPartIII>
        <Identifier>FORM 990, SCHEDULE J, PART I, LINE 3</Identifier>
        <Explanation>SEE FORM 990, SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, LINES 15A &amp; B REGARDING THE PROCESS USED BY SCLHS TO DETERMINE EXECUTIVE COMPENSATION WHICH IS RELIED UPON BY THIS ORGANIZATION. FORM 990, SCHEDULE J, PART I, LINE 4b Certain employees participate in the supplemental nonqualified retirement plan provided to executives to compensate for IRS imposed limitations in qualified plans. This benefit is consistent with other not for profit healthcare organizations, and are taxable and are taxed to the participants an amount equal to their expected income tax liability, withdrawn from the participants account and remitted to the IRS as withholding.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII />
      <Form990ScheduleJPartIII>
        <Identifier>SCHEDULE J, PART I, LINE 7 (NON-FIXED PAYMENTS)</Identifier>
        <Explanation>SCLHS HAS MANAGEMENT INCENTIVE PLANS WHICH ARE BASED ON A COMBINATION OF MEASURES. MANAGEMENT AND SENIOR LEADERSHIP ARE ELIGIBLE FOR THE INCENTIVE COMPENSATION. PERFORMANCE CATEGORIES ARE MADE UP OF A COMBINATION OF CLINICAL QUALITY MEASURES AND OPERATING INCOME. THE OPERATING INCOME CATEGORY IS GENERALLY RELATED TO THE NET EARNINGS OF THE CARE SITE IN WHICH THE INDIVIDUAL WORKS, OR IN THE CASE OF SCLHS SENIOR MANAGEMENT, THE NET EARNINGS OF SCLHS.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>FORM 990 PART VII AND SCHEDULE J, PART II</Identifier>
        <Explanation>THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. (SCLHS) CONSISTS OF ELEVEN HOSPITALS AND FOUR CLINICS (AFFILIATES) IN FOUR STATES INCLUDING ST. VINCENT HEALTHCARE (ST. VINCENT) IN BILLINGS, MONTANA. SCLHS AND ITS AFFILIATES ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING TRANSPARENCY AND ACCOUNTABILITY. IN KEEPING WITH SCLHS' CORE VALUE OF STEWARDSHIP, NO BOARD MEMBER SERVING ON SCLHS OR AFFILIATE BOARDS IS COMPENSATED FOR THAT SERVICE.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>DISCLOSURES</Identifier>
        <Explanation>FORM 990, PART VI, SECTION A, LINE 3, DELEGATE CONTROL OVER MANAGEMENT DUTIES ALTHOUGH THESE SERVICES MAY NOT ALL RISE TO THE LEVEL OF MANAGEMENT CONTROL AS DEFINED IN THE 990 INSTRUCTION, WE HAVE IN THE SPIRIT OF FULL TRANSPARENCY PROVIDED THE FOLLOWING DISCLOSURE. AS A MEMBER OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, THIS PROVIDER MAY HAVE INDIVIDUAL AND/OR SYSTEM CONTRACT(S) THAT HAS DELEGATED CONTROL OVER MANAGEMENT DUTIES IN SOME OR ALL OF THE FOLLOWING AREAS: DIETARY AND FOOD SERVICE HOUSEKEEPING SUPPLY CHAIN REVENUE CYCLE SECURITY FORM 990 PART VI, SEC A, LINES 6, 7A &amp; 7B CLASS OF MEMBER, NATURE OF RIGHTS, ELECTION OF BOARD MEMBERS, DECISIONS SUBJECT TO APPROVAL THE SOLE MEMBER AND CONTROLLING MEMBER OF THE ST VINCENT HEALTHCARE (SVH) CORPORATION IS THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC (SCLHS), A KANSAS NON-FOR-PROFIT CORPORATION. SOME OF THE EXCLUSIVE POWERS OF SCLHS INCLUDE: (1) TO APPOINT, AFTER CONSULTATION WITH THE SVH CORPORATE BOARD, THE BOARD OF DIRECTORS OF SVH AND APPOINT MEMBERS OF SCLHS TO THE SVH BOARD OF DIRECTORS; (2) TO REMOVE, WITH OR WITHOUT CAUSE, AFTER CONSULTATION WITH THE SVH CORPORATE BOARD, ANY MEMBER OF THE SVH BOARD OF DIRECTORS; (3) TO APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, THE CHIEF EXECUTIVE OFFICER AND THE CHIEF ADMINISTRATIVE OFFICER OF SVH; (4) TO IMPLEMENT CORPORATE GOALS, POLICIES, AND PROCEDURES OF SVH; (5) TO APPROVE FOR SVH THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS, OR THE LEASE, SALE, TRANSFER, ASSUMPTION, OR ENCUMBERING OF SVH ASSETS; (6) TO APPROVE THE MERGER, DISSOLUTION, OR CORPORATE RESTRUCTURING OF SVH; AND (7) TO APPROVE SVH ANNUAL STRATEGIC PLANS AND OPERATING AND CAPITAL BUDGETS. THE SVH BOARD OF DIRECTORS HAVE THE POWERS TO EXERCISE GENERAL MANAGEMENT AND CONTROL OF THE BUSINESS AFFAIRS OF SVH WITH DUE REGARD FOR THE POWERS RESERVED BY SCLHS. THE POWERS OF THE SVH BOARD OF DIRECTORS INCLUDE NOMINATION OF BOARD MEMBERS FOR APPOINTMENT BY SCLHS. FORM 990 PART VI, SEC B, LINE 11B PROCESS FOR REVIEWING FORM 990 DURING THE PREPARATION OF THE RETURN, IT IS REVIEWED BY THE SYSTEM OFFICE AND BY AN INDEPENDENT ACCOUNTING FIRM. THEN THE FORM 990 IS REVIEWED BY THE ST VINCENT BOARD BEFORE THE RETURN IS SUBMITTED TO THE IRS. DUE TO THE TIMING OF BOARD MEETINGS THERE MAY BE CHANGES TO THE FORM 990 THAT ARE COMMUNICATED TO THE BOARD AFTER THEIR REVIEW. FORM 990 PART VI, SEC B, LINE 12C WRITTEN CONFLICT OF INTEREST POLICIES ALL ST VINCENT HEALTHCARE EXECUTIVES, DIRECTORS, AND MANAGERS, BOARD MEMBERS AND BOARD COMMITTEE MEMBERS, MEDICAL EXECUTIVE COMMITTEE (MEC) MEMBERS AND OTHER PHYSICIANS IN DECISION MAKING ROLES OR SERVING ON SVH EXECUTIVE COMMITTEES, COMPLETE A NEW CONFLICT OF INTEREST (COI) DISCLOSURE FORM ANNUALLY. A COPY OF THE POLICY IS DISTRIBUTED ALONG WITH THE COI FORMS. IN THE EVENT OF A CHANGE OF CIRCUMSTANCE, EACH INDIVIDUAL WHO HAS ALREADY SIGNED A COI IS EXPECTED TO NOTIFY THE ORGANIZATION OF THE CHANGE AND UPDATE THE CONFLICT OF INTEREST INFORMATION. THE STATEMENTS ARE REVIEWED AND COI ISSUES ARE ADDRESSED BY THE ORGANIZATION RESPONSIBILITY OFFICER (ORO) AND LEADERSHIP AT THE APPROPRIATE LEVEL: - BOARD BY BOARD CHAIR - PHYSICIANS BY THE MEC PRESIDENT - SVH DIRECTORS AND MANAGERS BY THE SVH ADMINISTRATION - SVH EXECUTIVES BY THE SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM THE SIGNED COI FORMS ARE MAINTAINED IN SVH ADMINISTRATION. THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS FOR SVH EXECUTIVES ARE MAINTAINED AT SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AT THE BEGINNING OF BOARD AND BOARD COMMITTEE MEETINGS, THE QUESTION OF COI IS ASKED OF THOSE IN ATTENDANCE. WHEN AN ACTUAL CONFLICT IS IDENTIFIED, THE INDIVIDUAL ASKS TO BE EXCUSED FROM PARTICIPATING IN THE DISCUSSION AND DECISION-MAKING. FORM 990, PART VI, LINES 15A &amp; B SCLHS EMPLOYS THE EXECUTIVE TEAM AT EACH OF ITS HOSPITAL AFFILIATES. AS PART OF ITS ANNUAL REVIEW PROCESS, SCLHS USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF THOSE IN THESE POSITIONS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACTS -COMPENSATION SURVEYS AND STUDIES -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS EXECUTIVES (OFFICERS, KEY EMPLOYEES, ETC.) IS CONSISTENT WITH MARKET VALUE AND THE PAY PHILOSOPHY SET BY THE BOARD. THE PAY PHILOSOPHY SET BY THE BOARD IS TO PAY AT THE MIDDLE OF THE MARKET FOR EXECUTIVES OF SIMILAR SIZED ORGANIZATIONS OVERALL. SCLHS' EXECUTIVE COMPENSATION IS COMPARABLE TO THAT PROVIDED IN SIMILAR, NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS. FORM 990 PART VI, SEC B, LINE 16B JOINT VENTURE WRITTEN POLICIES AND PROCEDURES ST VINCENT HEALTHCARE MAINTAINS DETAILED RECORDS OF THE JOINT VENTURES IN ADMINISTRATION. ALL FILES ARE SCANNED AND REVIEWED. E&amp;Y PERFORMED A COMPREHENSIVE ANALYSIS OF THE JOINT VENTURES IN 2008. FORM 990 PART VI, SEC C, LINE 19 WRITTEN CONFLICT OF INTEREST POLICY A WRITTEN COPY OF THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY IS AVAILABLE FROM HOSPITAL ADMINISTRATION.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>SISTERS OF CHARITY LEAVENWORTH HLTH SYST</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2420 WEST 26TH AVE STE 100-D</AddressLine1>
          <City>DENVER</City>
          <State>CO</State>
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        </DirectControllingEntityName>
        <PredominantIncomeType>N/A</PredominantIncomeType>
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      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>SAN JUAN CANCER CENTER LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
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          <AddressLine1>600 SOUTH 5TH STREET</AddressLine1>
          <City>MONTROSE</City>
          <State>CO</State>
          <ZIPCode>81401</ZIPCode>
        </AddressUS>
        <EIN>202856331</EIN>
        <PrimaryActivity>OP CANCER</PrimaryActivity>
        <LegalDomicileState>CO</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>N/A</PredominantIncomeType>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>BILLINGS MRI CENTER LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
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          <AddressLine1>1041 NORTH 29TH STREET</AddressLine1>
          <City>BILLINGS</City>
          <State>MT</State>
          <ZIPCode>59101</ZIPCode>
        </AddressUS>
        <EIN>810450943</EIN>
        <PrimaryActivity>MRI-PET SCAN</PrimaryActivity>
        <LegalDomicileState>MT</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>N/A</PredominantIncomeType>
        <CodeVAmount>0</CodeVAmount>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>LUTHERAN CAMPUS ASC LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>3455 LUTHRN PKW SUITE 150</AddressLine1>
          <City>WHEATRIDGE</City>
          <State>CO</State>
          <ZIPCode>800336028</ZIPCode>
        </AddressUS>
        <EIN>020749532</EIN>
        <PrimaryActivity>OP SURGERY</PrimaryActivity>
        <LegalDomicileState>CO</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>N/A</PredominantIncomeType>
      </Form990ScheduleRPartIII>
      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>COLORADO SURGICAL VENTURES LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>30 S WACKER DR SUITE 2302</AddressLine1>
          <City>CHICAGO</City>
          <State>IL</State>
          <ZIPCode>60605</ZIPCode>
        </AddressUS>
        <EIN>208038915</EIN>
        <PrimaryActivity>OP SURGERY</PrimaryActivity>
        <LegalDomicileState>CO</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>N/A</PredominantIncomeType>
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      <Form990ScheduleRPartIII>
        <NameOfRelatedOrg>
          <BusinessNameLine1>COLORADO SURGICAL HOSPITAL LLC</BusinessNameLine1>
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          <AddressLine1>30 S WACKER DR SUITE 2302</AddressLine1>
          <City>CHICAGO</City>
          <State>IL</State>
          <ZIPCode>60605</ZIPCode>
        </AddressUS>
        <EIN>208038977</EIN>
        <PrimaryActivity>OP SURGERY</PrimaryActivity>
        <LegalDomicileState>CO</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <PredominantIncomeType>N/A</PredominantIncomeType>
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      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>CARITAS INC AND SUBSIDIARIES</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>2420 W 26th Avenue STE 100-D</AddressLine1>
          <City>Denver</City>
          <State>CO</State>
          <ZIPCode>80211</ZIPCode>
        </AddressUS>
        <EIN>480941069</EIN>
        <PrimaryActivity>OTHER MEDICAL</PrimaryActivity>
        <LegalDomicileState>KS</LegalDomicileState>
        <TypeOfEntity>C CORP</TypeOfEntity>
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      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>LEAVEN INSURANCE COMPANY LTD</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressForeign>
          <AddressLine1>23 LIME TREE BAY AVE PO BOX 1051</AddressLine1>
          <City>GEORGETOWN</City>
          <ProvinceOrState>GRAND CAYMAN</ProvinceOrState>
          <Country>CJ</Country>
          <PostalCode>KY1-1102</PostalCode>
        </AddressForeign>
        <EIN>980370522</EIN>
        <PrimaryActivity>INSURANCE</PrimaryActivity>
        <LegalDomicileForeignCountry>CJ</LegalDomicileForeignCountry>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>true</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>true</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>ST VINCENT HEALTHCARE FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>C</TransactionType>
        <AmountInvolved>526920</AmountInvolved>
        <MethodOfAmtDetermination>CASH</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>ST VINCENT HEATHCARE FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>B</TransactionType>
        <AmountInvolved>1082642</AmountInvolved>
        <MethodOfAmtDetermination>CASH</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>ST VINCENT HEATHCARE FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>Q</TransactionType>
        <AmountInvolved>2757421</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>