BOISE -- As it has with more than 20 Christmases past, this year St. Luke's Hospitalhelped somepatientswith a secret surprise.

This is a quiet Christmas tradition that's been going on at St. Luke's for more than two decades; the tradition is so quiet in fact that some people who work at the hospital don't even know about it.

We've been doing it quietly for a lot of years, but it's nice to see that people are happy about it and nice to see we were able to help out the holiday season, St. Luke's spokesman Ken Dey said.

Building up abig bill

On Saturday afternoon, baby Kyler Rex happilyplayed with his toy nativity set. It was his first Christmas Eve after a year that wasn't so easy. Within his first month of life, he got very ill.

When he was 2 weeks old last January, he got really, really sick and was admitted to the PICU. Wehad a 10 day hospital stay with him, which in the PICU racks up quite a large bill, Kyler's mother Maria Rex said.

That hospital bill with St. Luke's got even bigger: Kyler needed tubes in his ears in June, then his sister needed surgery in October. The total was about $7,000.

It's been very tough to pay those bills. Especially around Christmas. We wanted to be able to have Christmas for our kids and not have to pay a hospital bill instead, Rex said.

'I almost didn't open it!'

As she had for months, on Friday, Maria Rex got another envelope from the hospital. She knew a $900 payment was due next and already figuring what was inside, almost didn't open the envelope.

I thought it was my bill for the next month, so I didn't really worry about opening and decided I'd open it anyway, and I was quite shocked it was a letter instead of my bill, Rex said.

That letter informed the Rex family they wouldn't be getting any more bills from St. Luke's.

The letter read: Dear Mrs. Rex, during the holiday season, we are presented with an opportunity to reflect on the purpose of which St. Luke's Health System was founded. It concluded with: It is my pleasure to inform you we will be crediting your hospital bill by $1,965.

The nearly $2,000 credit wipes out the rest of her family's balance.

St. Luke's quietly helping families for two decades

The economy's tough; they've been diligently paying their bills. It's a chance for us to give a little bit back to them and maybe help them at Christmas time, Dey explained of all the families the hospital helps.

For years, this act of kindness has been a bit of a secret; it's not something the hospital publicizes. The Saint Luke's billing department tells the hospital CEO about families who don't meet criteria for free or charity care, but who could certainly use help paying off bill balances.

We've been doing this for probably more than 20 years. This originated with one of our previous CEOs, Ed Dahlberg, who started this. We've been doing it quietly. We haven't sought any publicity for it, Dey said.

'The best Christmas card I've ever gotten'

The Rex's letter is hung in their home with prominence; it's a gesture they'll never forget.

It's the best Christmas card I've ever gotten, so I decided it needed to go on my Christmas card wall, Rex said, showing dozens of cards taped up in the living room.

Just as her usual bill was replaced by a surprise letter, Rex plans to replace her usual check with her own special letter to Saint Luke's as well.

That's the first thing on my agenda after Christmas is to send them a thank you card, Rex said.

This year St. Luke's helped 38 people with medical bills, crediting those patients with a total of $118,000. The individual bills ran from around $200 to $8,000. St. Luke's is a not-for-profit hospital and will absorb the cost of helping those 38 families.

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