SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Saint Anthony Hospital
 
Employer identification number

51-0217097
Return Reference Explanation
Form 990, Part VI, Section A, line 6 Saint Anthony Health Ministries is the sole corporate member of Saint Anthony Hospital.
Form 990, Part VI, Section A, line 7a As the sole corporate member of Saint Anthony Hospital, Saint Anthony Health Ministries has the right to appoint or remove members of the governing body.
Form 990, Part VI, Section A, line 7b As the sole corporate member of Saint Anthony Hospital, the Canonical Directors of Saint Anthony Health Ministries have the right to approve or ratify significant decisions made by the governing body. Such rights include: 1) Approving the mission and vision statements of the organization, 2) Approving changes to the governing documents, 3) Appointment or removal of members of the governing board, 4) Approving or recommending the formation of legal entities, the sale, transfer, or substantial change in use of all or substantially all of the assets, divestitures, dissolutions, closures, mergers, consolidations, or changes in corporate membership, 5) Approving the operating budget and capital plan, 6) Approving the transfer or encumbrance of the assets, and 7) Approving the incurrence of debt of the organization.
Form 990, Part VI, Section B, line 11b A thorough review of Form 990 is performed by management. A copy of the return is shared with the Board of Directors prior to filing Form 990 with the IRS.
Form 990, Part VI, Section B, line 12c Annually, the Corporate Responsibility Officer has the Board, as well as officers, vice presidents, and operational department heads, review, fill out, and sign the conflict of interest questionnaire. The Corporate Responsibility Officer reviews the completed conflict of interest questionnaires. If a conflict of interest arises, the affected board member (or officer) abstains from voting on the respective issue. The Corporate Responsibility Officer maintains all signed conflict of interest statements on file.
Form 990, Part VI, Section B, line 15 All annual salary increases for the President & CEO are reviewed and approved by the President Compensation Sub-Committee and documented in minutes prepared for each meeting. All annual salary increases for other officers are reviewed and approved by the Compensation Committee and documented in minutes prepared for each meeting. Also, an independent market survey was conducted in November 2015 to ensure that the salaries of the CEO and other officers were within standard market range.
Form 990, Part VI, Section C, line 19 Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code Section 6104. These documents are not available to the public at this time.
Form 990, Part XI, line 9: Transfer of Net Assets to Saint Anthony Health Affiliates -1,496,972. Change in Interest of Saint Anthony Hospital Foundation 2,467,450. Prior Period Adjustment 6,485,456.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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