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        <City>Crystal City</City>
        <State>MO</State>
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      <ActivityOrMissionDescription>Jefferson Regional Medical Center is a community based integrated healthcare system. The hospital consists of a 251-bed licensed facility which provides a full range of diagnostic, preventative &amp; healthcare services along with 24 hr emergency room care. Services are provided on a non-discriminatory basis. Jefferson Regional Medical Center is a community based integrated healthcare system. The hospital consists of a 251-bed licensed facility which provides a full range of diagnostic, preventative healthcare services along with 24 hr emergency room care. Services are provided on a non-discriminatory basis.</ActivityOrMissionDescription>
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        <Description>Jefferson Regional Medical Center is further complimented by the Supportive Care Service Departments which provide home care services. The Home Health agency provided 20,615 visits and the Hospice agency provided 16,274 days of service for the fiscal year.</Description>
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      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>false</ExpensesExceededBudget>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>3109713</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>3109713</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.02540</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>22709274</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>15988393</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>6720881</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.05490</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>25818987</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>15988393</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>9830594</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.08030</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <PersonsServed>7912</PersonsServed>
        <TotalCommunityBenefitExpense>13921</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>13921</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>220730</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>220730</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00180</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>152716</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>152716</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00120</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <PersonsServed>7912</PersonsServed>
        <TotalCommunityBenefitExpense>387367</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>387367</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00310</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <PersonsServed>7912</PersonsServed>
        <TotalCommunityBenefitExpense>26206354</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>15988393</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>10217961</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.08340</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <HealthImprovementAdvocacy>
        <TotalCommunityBuildingExpense>35101</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>35101</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00030</PercentOfTotalExpense>
      </HealthImprovementAdvocacy>
      <WorkforceDevelopment>
        <TotalCommunityBuildingExpense>203642</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>203642</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00150</PercentOfTotalExpense>
      </WorkforceDevelopment>
      <Total>
        <TotalCommunityBuildingExpense>238743</TotalCommunityBuildingExpense>
        <NetCommunityBuildingExpense>238743</NetCommunityBuildingExpense>
        <PercentOfTotalExpense>0.00180</PercentOfTotalExpense>
      </Total>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>3995808</BadDebtExpenseAmount>
      <AmountAttributableTo>2263420</AmountAttributableTo>
      <AmountReimbursedByMedicare>50249597</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>54059724</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-3810127</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>Jefferson Regional Medical Center</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>P O Box 350</AddressLine1>
          <City>Crystal City</City>
          <State>MO</State>
          <ZIPCode>63019</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Jefferson Memorial Hospital Psychiatric Unit</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Jefferson Multi-Specialty Group</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>2</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Jefferson Memorial Hospital Rehabilitation Unit</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>3</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Jefferson Regional Home Care</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>4</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Jefferson Regional Hospice</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>5</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Jefferson Regional Outpatient Facilities LLC</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>6</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>Jefferson Memorial Surgical Partners LLC</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>7</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>7</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Jefferson Memorial Hospital Psychiatric Unit</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>P O Box 350</AddressLine1>
            <City>Crystal City</City>
            <State>MO</State>
            <ZIPCode>63019</ZIPCode>
          </Address>
          <FacilityType>0</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Jefferson Multi-Specialty Group</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1400 Highway 61 South</AddressLine1>
            <City>Crystal City</City>
            <State>MO</State>
            <ZIPCode>63019</ZIPCode>
          </Address>
          <FacilityType>Psychiatric services</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Jefferson Memorial Hospital Rehabilitation Unit</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>P O Box 350</AddressLine1>
            <City>Crystal City</City>
            <State>MO</State>
            <ZIPCode>63019</ZIPCode>
          </Address>
          <FacilityType>Outpatient physician clinic</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Jefferson Regional Home Care</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>5 Industrial Dr</AddressLine1>
            <City>Festus</City>
            <State>MO</State>
            <ZIPCode>63028</ZIPCode>
          </Address>
          <FacilityType>Rehabilitation services</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Jefferson Regional Hospice</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>5 Industrial Dr</AddressLine1>
            <City>Festus</City>
            <State>MO</State>
            <ZIPCode>63028</ZIPCode>
          </Address>
          <FacilityType>Home care services</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Jefferson Regional Outpatient Facilities LLC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1400 Highway 61 South</AddressLine1>
            <City>Crystal City</City>
            <State>MO</State>
            <ZIPCode>63019</ZIPCode>
          </Address>
          <FacilityType>Hospice services</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Jefferson Memorial Surgical Partners LLC</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>P O Box 350</AddressLine1>
            <City>Crystal City</City>
            <State>MO</State>
            <ZIPCode>63019</ZIPCode>
          </Address>
          <FacilityType>Urgent care services</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Identifier>Part I line 7 column f</Identifier>
        <Explanation>The organization had bad debt expense in the amount of 10,796,562 reported on Part IX, line 25, however, it has been subtracted for purposes of calculating the percentage in this column.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part I line 7</Identifier>
        <Explanation>The costs reported in the table in Part I, Line 7 used a ratio of patient care costs to charges computed in Worksheet 2 of the form instructions. This methodology was used for all patient segments. Part II Jefferson Regional Medical Center coordinates and/or assists patients in their transportation needs to improve access to healthcare services. Jefferson Regional recruits new physicians to serve the residents of Jefferson and surrounding counties.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III line 4</Identifier>
        <Explanation>The organization reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The organization provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the organization bills third-party payers directly and bills the patient when the patients liability is determined. Patient accounts receivable</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III line 4</Identifier>
        <Explanation>are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III line 8</Identifier>
        <Explanation>The organizations shortfall on line 7 represents unreimbursed Medicare services provided to members of the community who might otherwise not be able to afford adequate health care services.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III line 9b</Identifier>
        <Explanation>Jefferson Regional Medical Center continues to offer and process financial assistance to patients who are identified as candidates throughout the debt collection process. All collection agency letters and bills state financial assistance is available. Collection agency representatives also communicate the availability of financial assistance to patients as they recognize a financial need. They notify the Medical Center of these patients. We then follow up on these accounts and send a</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part III line 9b</Identifier>
        <Explanation>financial assistance packet to the patient.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part V</Identifier>
        <Explanation>Line 19d The hospital facility uses the average rate of all payers for those services at the hospital facility.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 2</Identifier>
        <Explanation>Jefferson Regional Medical Center is currently conducting a 2-year comprehensive community health needs assessment of certain cities and towns in its primary service area. The overall goal of the assessment is to provide Jefferson Regional with the ability to clarify the health needs and priorities of the communities it serves. The project will consist of two phases. Phase I, consists of a thorough review of existing data from the Missouri Department of Public Health. The anticipated</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 2</Identifier>
        <Explanation>completion of Phase I is December 2012. In Phase II, a comprehensive community survey will be distributed to a random sample of 2,400 households in our primary area. In addition, a series of community interviews will be conducted to help determine leading health needs and priorities. This is to be completed by April 2013. The final report will provide a needs assessment prepared from all the data collected in both phases of the project.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 3</Identifier>
        <Explanation>Jefferson Regional Medical Center business partner, Firstsource Solutions USA, LLC, representatives visit self-pay inpatients, patients with minimal insurance benefits and other referred patients including Emergency Department and outpatients to assist with Medicaid eligibility, SSI, W/C, TPL, Crime Victims, VA Champus, COBRA, medical hardship cases, and others. If no potential eligibility for third party payment is determined, the patient is provided with a financial assistance packet and</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 3</Identifier>
        <Explanation>an explanation of the financial assistance process. Our Financial Assistance Coordinator also assists patients with any help they may need in completing required paperwork and follow up. Informational posters regarding the availability of financial assistance are displayed on every level of the facility near main entrance locations, registration areas, the Emergency Department, each individual emergency treatment room and the Patient Accounts department cashiering office. Business cards for</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 3</Identifier>
        <Explanation>the Financial Assistance Coordinator are available at all registration areas and are given to potential applicants by registration personnel and during in-house visits. All medical center patient account letters and bills, as well as collection letter informing patients of the availability of financial assistance. Patient Accounts department information along with financial assistance information and applications are available on the Jefferson Regional Medical Center website. Patient Accounts</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 3</Identifier>
        <Explanation>Representatives communicate the availability of financial assistance and explain eligibility criteria upon learning of patient financial need. Financial Assistance Program in-services are provided to Admitting and Social Services staff. Also, new employees are informed of the Financial Assistance Program during orientation. Financial assistance announcements/reminders are made periodically during Leadership meetings and via our Medical Center Employee Newsletter.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 4</Identifier>
        <Explanation>As one of the fastest growing counties in Missouri, Jefferson County benefits from its proximity to the amenities of St. Louis combined with the semi-rural atmosphere of small town living. Located in the Twin Cities of Crystal City and Festus, Jefferson Regional Medical Center reaches beyond the city limits to the neighboring communities of DeSoto, Herculaneum, Hillsboro and Pevely, along with many other smaller towns and villages. The hospital also serves nearby Ste. Genevieve and</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 4</Identifier>
        <Explanation>St. Francois counties. Positioned near the intersection of Interstate 55 and US Highways 61 and 67, Jefferson Regional is at the primary hub for southern Jefferson County and is easily accessible from the St. Louis area as well as southeastern Missouri. According to 2010 U.S. Census data, Jefferson County as a whole grew more than 10 adding 20,634 residents for a total population of 218,733. Crystal City and Festus recorded growth percentages of 14 and 20 respectively, while other nearby</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 4</Identifier>
        <Explanation>cities - with smaller base populations - grew even more dramatically including Hillsboro at 68, Pevely with 46 and Herculaneum at 24. The populations are based on Census Designated Place which does not necessarily correspond with Postal ZIP Code or municipal boundaries. Most Jefferson County residents - about 73 - live outside of the city limits in unincorporated areas of the county. Still those cities are the primary centers of commerce and community, with the majority of businesses,</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 4</Identifier>
        <Explanation>churches, and schools located within the city limits. Founded as a company town around the glass factory that was built on the banks of the Mississippi River in the mid 1800s, Crystal City celebrated its centennial in 2011, marking 100 years of incorporation. Jefferson Regional owes significant gratitude to the glass factory and the community of Crystal City for the fund-raising drive that built the community hospital in 1957. The City of DeSoto is a railroad town and the largest city in</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 4</Identifier>
        <Explanation>Jefferson County south of the hospital. With 6,400 residents, according to the 2010 census, it also played a significant role in the fund-raising drive that built the hospital. The City of Festus is the largest community in southern Jefferson County with a 2010 population of 11,602. In combination with the three adjacent communities of Crystal City, Herculaneum and Pevely the population within a five-mile radius of Jefferson Regional Medical Center is more than 25,000. Demographically, as</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 4</Identifier>
        <Explanation>a whole, Jefferson Countys population is less than 5 non-white with very small ethnic communities located primarily in the cities of Crystal City, DeSoto and Festus. About 11 of the county population is over age 65 with the highest percentages occuring in the hospitals primary service area 17.3 in Crystal City, 13.5 in DeSoto, 13.8 in Festus, 15.4 in Herculaneum, 11 in Hillsboro and 10.8 in Pevely. The median income for the five-city base excluding Hillsboro is 46,652, while the</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 4</Identifier>
        <Explanation>median income countywide is 53,939. A total of 84.6 of persons age 25 and older are high school graduates and 16.8 have a bachelors degree or higher education.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 5</Identifier>
        <Explanation>As the areas largest employer, Jefferson Regional Medical Center is committed to community building activities including collaborative efforts that focus on health education, access to care, and commercial development. The hospital hosts community residents and participates in health fair activities that bring critical healthcare information to the communities it serves. Events held on the Medical Center campus, at local businesses, and in school settings include multiple healthcare providers</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 5</Identifier>
        <Explanation>offering information and screenings in a health fair format. The annual Family Health Fair held at Jefferson Regional attracts hundreds of area residents each year and provides low-cost, full-lipid panel screenings, free health assessments, and discount-priced childrens bicycle helmets. The Medical Center offers free transportation for area residents visiting the hospital for appointments. A VIP Care service coordinates the transportation and offers a lounge area for patients to wait between</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 5</Identifier>
        <Explanation>appointments and tests. Patients health can be monitored during their stay in the VIP Care lounge, all at no charge. During the October 1, 2010 through September 30, 2011 reporting period, Jefferson Regional has recruited new physician specialists to serve the residents of Jefferson and surrounding counties. Jefferson Regional added a new bariatric weight loss program and now has two certified diabetic educators who serve patients and community residents. Jefferson Regional has earned</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>Part VI Line 5</Identifier>
        <Explanation>National accreditation for its Acute Rehab Program, Chest Pain Center and Stroke Center.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
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      <RecordsMaintained>true</RecordsMaintained>
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        <RecipientNameBusiness>
          <BusinessNameLine1>City of Crystal City</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>130 Mississippi Avenue</AddressLine1>
          <City>Crystal City</City>
          <State>MO</State>
          <ZIPCode>63019</ZIPCode>
        </AddressUS>
        <EINOfRecipient>436000936</EINOfRecipient>
        <IRCSection>unit of local govt.</IRCSection>
        <AmountOfCashGrant>10000</AmountOfCashGrant>
        <PurposeOfGrant>general support</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>De Soto School District</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>731 Amvets</AddressLine1>
          <City>De Soto</City>
          <State>MO</State>
          <ZIPCode>63020</ZIPCode>
        </AddressUS>
        <EINOfRecipient>436001005</EINOfRecipient>
        <IRCSection>school district</IRCSection>
        <AmountOfCashGrant>6350</AmountOfCashGrant>
        <PurposeOfGrant>general support</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>Jefferson Reorganized School District</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>501 Westwind Drive</AddressLine1>
          <City>Festus</City>
          <State>MO</State>
          <ZIPCode>63028</ZIPCode>
        </AddressUS>
        <EINOfRecipient>436002980</EINOfRecipient>
        <IRCSection>school district</IRCSection>
        <AmountOfCashGrant>5425</AmountOfCashGrant>
        <PurposeOfGrant>general support</PurposeOfGrant>
      </RecipientTable>
      <RecipientTable>
        <RecipientNameBusiness>
          <BusinessNameLine1>American Heart Association</BusinessNameLine1>
        </RecipientNameBusiness>
        <AddressUS>
          <AddressLine1>460 N Lindbergh Blvd</AddressLine1>
          <City>St Louis</City>
          <State>MO</State>
          <ZIPCode>63141</ZIPCode>
        </AddressUS>
        <EINOfRecipient>135613797</EINOfRecipient>
        <IRCSection>501c3</IRCSection>
        <AmountOfCashGrant>95500</AmountOfCashGrant>
        <PurposeOfGrant>general support</PurposeOfGrant>
      </RecipientTable>
      <TotalNbrOf501C3AndGovtGrants>4</TotalNbrOf501C3AndGovtGrants>
      <Form990ScheduleIPartIV>
        <Identifier>I</Identifier>
        <ReturnReference>2</ReturnReference>
        <Explanation>The organization awards assistance to preapproved local charity based organizations. The amounts of 5,000 to 20,000 are approved by the CFO and amounts over 20,000 are approved by the CEO.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
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      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>true</SeverancePayment>
      <SupplementalNonqualRetirePlan>false</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <Form990ScheduleJPartII>
        <NamePerson>James Muehlhauser</NamePerson>
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        <DeferredCompFilingOrg>12250</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>16278</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>336953</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Beverly Johnson</NamePerson>
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        <OtherCompensationFilingOrg>3433</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>9576</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>8663</NontaxableBenefitsFilingOrg>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Blake Temple</NamePerson>
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        <BonusFilingOrg>17692</BonusFilingOrg>
        <OtherCompensationFilingOrg>780</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>9959</DeferredCompFilingOrg>
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        <TotalCompensationFilingOrg>230096</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Jerome Ladous</NamePerson>
        <BaseCompensationFilingOrg>161588</BaseCompensationFilingOrg>
        <BonusFilingOrg>16201</BonusFilingOrg>
        <OtherCompensationFilingOrg>1170</OtherCompensationFilingOrg>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Timothy Pigg</NamePerson>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Clarence Temple</NamePerson>
        <BaseCompensationFilingOrg>553613</BaseCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>314</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>553927</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>William Kennen</NamePerson>
        <BaseCompensationFilingOrg>517491</BaseCompensationFilingOrg>
        <BonusFilingOrg>25000</BonusFilingOrg>
        <NontaxableBenefitsFilingOrg>10129</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>552620</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Lawrence Billy</NamePerson>
        <BaseCompensationFilingOrg>188942</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>9711</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>10320</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>208973</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Nicole Ducharme</NamePerson>
        <BaseCompensationFilingOrg>194471</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>39366</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>11739</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>9864</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>255440</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Meredith Hartle</NamePerson>
        <BaseCompensationFilingOrg>172069</BaseCompensationFilingOrg>
        <BonusFilingOrg>1650</BonusFilingOrg>
        <OtherCompensationFilingOrg>18750</OtherCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>5348</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>197817</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Lloyd Ford Jr</NamePerson>
        <BaseCompensationFilingOrg>260093</BaseCompensationFilingOrg>
        <BonusFilingOrg>62788</BonusFilingOrg>
        <OtherCompensationFilingOrg>149441</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>4900</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>23655</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>500877</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>I</Identifier>
        <ReturnReference>4A</ReturnReference>
        <Explanation>Lloyd Ford Jr. received 147,411 in severance pay from The Jefferson Memorial Hospital Association.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="990K:1" softwareId="10000149" softwareVersion="2010.2.15">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>Health and Educational Facilities Authority of the State of Missouri</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>431178966</IssuerEIN>
        <CUSIPNumber>60635RN45</CUSIPNumber>
        <DateIssued>2004-05-27</DateIssued>
        <IssuePrice>37340504</IssuePrice>
        <DescriptionOfPurpose>Various capital projects</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>Health and Educational Facilities Authority of the State of Missouri</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>431178966</IssuerEIN>
        <CUSIPNumber>60635RU47</CUSIPNumber>
        <DateIssued>2005-04-27</DateIssued>
        <IssuePrice>7410212</IssuePrice>
        <DescriptionOfPurpose>Various capital projects</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>Industrial Development Authority of Jefferson County</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>431281572</IssuerEIN>
        <DateIssued>2010-12-16</DateIssued>
        <IssuePrice>3000000</IssuePrice>
        <DescriptionOfPurpose>Equipment acquisition</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <TotalProceeds>37275000</TotalProceeds>
        <AmountInReserveFund>3571876</AmountInReserveFund>
        <RefundingEscrow>25558528</RefundingEscrow>
        <IssuanceCostsFromProceeds>852796</IssuanceCostsFromProceeds>
        <CapitalExpenditures>6280000</CapitalExpenditures>
        <YearOfSubstCompletion>2006</YearOfSubstCompletion>
        <CurrentRefunding>true</CurrentRefunding>
        <AdvanceRefunding>true</AdvanceRefunding>
        <FinalAllocationMade>true</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>false</BondCounselRoutinelyEngaged>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>false</BondCounselRoutinelyEngaged>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondCounselRoutinelyEngaged>false</BondCounselRoutinelyEngaged>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="990L" softwareId="10000149" softwareVersion="2010.2.15">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Clarence Temple MD</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Father of B Temple-VP of Business Development</Relationship>
        <AmountOfTransaction>600018</AmountOfTransaction>
        <DescriptionOfTransaction>Employed physician</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Benjamin Albano Jr MD</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Son of B Albano Sr-Board Member</Relationship>
        <AmountOfTransaction>335570</AmountOfTransaction>
        <DescriptionOfTransaction>Employed physician</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="990O" softwareId="10000149" softwareVersion="2010.2.15">
      <GeneralExplanation>
        <Identifier>Form 990 Part V</Identifier>
        <ReturnReference>7b</ReturnReference>
        <Explanation>The organization supplies the information if requested by the donor. The organization will be implementing the necessary procedures to ensure notifications are provided in the future for donations.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>2</ReturnReference>
        <Explanation>Board members Lindell Carter and Tonda Breeze have a business relationship.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>6</ReturnReference>
        <Explanation>Under the Articles of Incorporation, Article VI states that the Corporation shall have one member, Jefferson Health System.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>7a</ReturnReference>
        <Explanation>In establishing new bylaws, Jefferson Memorial Hospital Associations members of the initial board shall be reduced to nine members, as members leave the board and are not to be replaced. Once the Board of Directors are reduced to nine menbers, members shall be appointed as necessary by the sole member, Jefferson Health System, from among its 15 member Board of Directors.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>7b</ReturnReference>
        <Explanation>Jefferson Health System, as the sole member of Jefferson Memorial Hospital Association shall maintain certain reserved powers of decisions over the sale of assets, long-term debt over a certain dollar amount, all decisions dealing with the assets and debts and any other decisions reserved for the Member. Jefferson Memorial Hospital Associations Board of Directors shall report to the Board of Directors of Jefferson Health System.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>11b</ReturnReference>
        <Explanation>The completed tax forms 990 and its related schedules are reviewed by both the Chief Accounting Officer and the Chief Financial Officer. The final tax return is presented to the board of directors at their monthly board meeting, where they are reviewed and discussed as needed.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>12c</ReturnReference>
        <Explanation>Jefferson Memorial Hospital Association requires all board members and senior management to complete an annual Conflict of Interest Questionnaire, which should disclose all potential and existing conflicts of interest. An annual report summarizing the comments from the questionnaire is approved by the board. As conflicts arise, members are required to disclose or abstain from voting and excuse themselves for the discussion.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>15</ReturnReference>
        <Explanation>Executive compensation is reviewed annually by an outside contracted individual who is responsible for bringing recommendations to the financial committee and then to the full board. This procedure establishes salary limits as well as annual strategic goals and related bonuses.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VI</Identifier>
        <ReturnReference>19</ReturnReference>
        <Explanation>The organization makes its financial statements available to the public upon request.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part VII</Identifier>
        <ReturnReference>1a</ReturnReference>
        <Explanation>The following officers also have hours recorded for related organizations - James Muehlhauser has .5 average hours per week for Jefferson Land Company, Inc and 1 average hour per week for Jefferson Health System. Dan Eckenfels has .5 average hours per week for Jefferson Land Company, Inc.. Timothy Pigg has .5 average hours per week for Jefferson Land Company, Inc.. All of the board members also have .5 average hours per week for Jefferson Land Company and Jefferson Health System. Lloyd Ford, Jr. has .5 average hours per week for both Jefferson Land Company and Jefferson Health System.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part XI</Identifier>
        <ReturnReference>5</ReturnReference>
        <Explanation>The other changes in net assets include - change in unrealized gains and losses of 633,120, change in unrestricted funds of 240,588, difference in Endowment revenue for contributions of 101,043, adjustment of prior year activity of 40,900 and rounding of 7, which totals to 250,584.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Part XII</Identifier>
        <ReturnReference>1</ReturnReference>
        <Explanation>The corporation uses the modified accrual method of accounting.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Explanation>Form 990 Part V Line 7b The organization supplies the information if requested by the donor. The organization will be implementing the necessary procedures to ensure notifications are provided in the future for donations. Form 990 Part VI Section A Line 2 Board members Lindell Carter and Tonda Breeze have a business relationship. Form 990 Part VI Section A Line 6 Under the Articles of Incorporation, Article VI states that the Corporation shall have one member, Jefferson Health System. Form 990 Part VI Section A Line 7a In establishing new bylaws, Jefferson Memorial Hospital Associations members of the initial board shall be reduced to nine members, as members leave the board and are not to be replaced. Once the Board of Directors are reduced to nine menbers, members shall be appointed as necessary by the sole member, Jefferson Health System, from among its 15 member Board of Directors. Form 990 Part VI Section A Line 7b Jefferson Health System, as the sole member of Jefferson Memorial Hospital Association shall maintain certain reserved powers of decisions over the sale of assets, long-term debt over a certain dollar amount, all decisions dealing with the assets and debts and any other decisions reserved for the Member. Jefferson Memorial Hospital Associations Board of Directors shall report to the Board of Directors of Jefferson Health System. Form 990 Part VI Section B Line 11b The completed tax forms 990 and its related schedules are reviewed by both the Chief Accounting Officer and the Chief Financial Officer. The final tax return is presented to the board of directors at their monthly board meeting, where they are reviewed and discussed as needed. Form 990 Part VI Section B Line 12c Jefferson Memorial Hospital Association requires all board members and senior management to complete an annual Conflict of Interest Questionnaire, which should disclose all potential and existing conflicts of interest. An annual report summarizing the comments from the questionnaire is approved by the board. As conflicts arise, members are required to disclose or abstain from voting and excuse themselves for the discussion. Form 990 Part VI Section B Line 15 Executive compensation is reviewed annually by an outside contracted individual who is responsible for bringing recommendations to the financial committee and then to the full board. This procedure establishes salary limits as well as annual strategic goals and related bonuses. Form 990 Part VI Section C Line 19 The organization makes its financial statements available to the public upon request. Form 990 Part VII Section A Line 1a The following officers also have hours recorded for related organizations - James Muehlhauser has .5 average hours per week for Jefferson Land Company, Inc and 1 average hour per week for Jefferson Health System. Dan Eckenfels has .5 average hours per week for Jefferson Land Company, Inc.. Timothy Pigg has .5 average hours per week for Jefferson Land Company, Inc.. All of the board members also have .5 average hours per week for Jefferson Land Company and Jefferson Health System. Lloyd Ford, Jr. has .5 average hours per week for both Jefferson Land Company and Jefferson Health System. Form 990 Part XI Line 5 The other changes in net assets include - change in unrealized gains and losses of 633,120, change in unrestricted funds of 240,588, difference in Endowment revenue for contributions of 101,043, adjustment of prior year activity of 40,900 and rounding of 7, which totals to 250,584. Form 990 Part XII Line 1 The corporation uses the modified accrual method of accounting.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="990R" softwareId="10000149" softwareVersion="2010.2.15">
      <Form990ScheduleRPartI>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Jefferson Hospital Company ICH LLC</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1400 Highway 61 South</AddressLine1>
          <City>Crystal City</City>
          <State>MO</State>
          <ZIPCode>63019</ZIPCode>
        </AddressUS>
        <EIN>263754189</EIN>
        <PrimaryActivities>Management company</PrimaryActivities>
        <LegalDomicileState>MO</LegalDomicileState>
        <EOYAssets>142864</EOYAssets>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
      </Form990ScheduleRPartI>
      <Form990ScheduleRPartI>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Jefferson Physician Network</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1400 Highway 61 South</AddressLine1>
          <City>Crystal City</City>
          <State>MO</State>
          <ZIPCode>63019</ZIPCode>
        </AddressUS>
        <EIN>263753905</EIN>
        <PrimaryActivities>Physician offices</PrimaryActivities>
        <LegalDomicileState>MO</LegalDomicileState>
        <TotalIncome>3909234</TotalIncome>
        <EOYAssets>2609747</EOYAssets>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
      </Form990ScheduleRPartI>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Jefferson Land Company Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>P O Box 350</AddressLine1>
          <City>Crystal City</City>
          <State>MO</State>
          <ZIPCode>63019</ZIPCode>
        </AddressUS>
        <EIN>431330360</EIN>
        <PrimaryActivities>Title holding company</PrimaryActivities>
        <LegalDomicileState>MO</LegalDomicileState>
        <ExemptCodeSection>501c2</ExemptCodeSection>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
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          <BusinessNameLine1>Jefferson Health System</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1400 Highway 61 South</AddressLine1>
          <City>Crystal City</City>
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          <ZIPCode>63019</ZIPCode>
        </AddressUS>
        <EIN>263920271</EIN>
        <PrimaryActivities>Supporting organization</PrimaryActivities>
        <LegalDomicileState>MO</LegalDomicileState>
        <ExemptCodeSection>501c4</ExemptCodeSection>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
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      </Form990ScheduleRPartII>
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          <BusinessNameLine1>Jefferson Memorial Surgical Partners LLC</BusinessNameLine1>
        </NameOfRelatedOrg>
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          <City>Crystal City</City>
          <State>MO</State>
          <ZIPCode>63019</ZIPCode>
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        <EIN>431803975</EIN>
        <PrimaryActivity>Outpatient surgery</PrimaryActivity>
        <LegalDomicileState>MO</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <PredominantIncomeType>Related</PredominantIncomeType>
        <ShareOfTotalIncome>-72422</ShareOfTotalIncome>
        <ShareOfEOYAssets>6160</ShareOfEOYAssets>
        <DisproportionateAllocations>false</DisproportionateAllocations>
        <GeneralOrManagingPartner>false</GeneralOrManagingPartner>
        <PercentageOwnership>0.95690</PercentageOwnership>
      </Form990ScheduleRPartIII>
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        <NameOfRelatedOrg>
          <BusinessNameLine1>Apothecary Services Inc</BusinessNameLine1>
        </NameOfRelatedOrg>
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          <City>Crystal City</City>
          <State>MO</State>
          <ZIPCode>63019</ZIPCode>
        </AddressUS>
        <EIN>431627267</EIN>
        <PrimaryActivity>Retail Pharmacy</PrimaryActivity>
        <LegalDomicileState>MO</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C Corp</TypeOfEntity>
        <ShareOfTotalIncome>749988</ShareOfTotalIncome>
        <ShareOfEOYAssets>637093</ShareOfEOYAssets>
        <PercentageOwnership>1.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
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      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>true</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>true</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>false</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>true</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>true</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Apothecary Services Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>a</TransactionType>
        <AmountInvolved>29316</AmountInvolved>
        <MethodOfAmtDetermination>actual</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Apothecary Services Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>r</TransactionType>
        <AmountInvolved>923569</AmountInvolved>
        <MethodOfAmtDetermination>actual</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Apothecary Services Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>p</TransactionType>
        <AmountInvolved>1800000</AmountInvolved>
        <MethodOfAmtDetermination>actual</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Apothecary Services Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>n</TransactionType>
        <AmountInvolved>460743</AmountInvolved>
        <MethodOfAmtDetermination>actual</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Apothecary Services Inc</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>o</TransactionType>
        <AmountInvolved>2319241</AmountInvolved>
        <MethodOfAmtDetermination>actual</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Jefferson Memorial Surgical Partners LLC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>r</TransactionType>
        <AmountInvolved>579565</AmountInvolved>
        <MethodOfAmtDetermination>book value of assets</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Jefferson Health System</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>n</TransactionType>
        <AmountInvolved>885549</AmountInvolved>
        <MethodOfAmtDetermination>actual</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Jefferson Health System</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>p</TransactionType>
        <AmountInvolved>1125000</AmountInvolved>
        <MethodOfAmtDetermination>actual</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Jefferson Health System</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>a</TransactionType>
        <AmountInvolved>41500</AmountInvolved>
        <MethodOfAmtDetermination>actual</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Jefferson Health System</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>o</TransactionType>
        <AmountInvolved>172161</AmountInvolved>
        <MethodOfAmtDetermination>actual</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>