San Angelo Medical S-4 Registration of securities issued in business combination transactions

Exhibit 3.248

Delaware	PAGE 1
The First State

I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF DELAWARE, DO HEREBY CERTIFY THE ATTACHED ARE TRUE AND CORRECT COPIES OF ALL DOCUMENTS ON FILE OF “QHG OF BLUFFTON COMPANY, LLC” AS RECEIVED AND FILED IN THIS OFFICE.

THE FOLLOWING DOCUMENTS HAVE BEEN CERTIFIED:

CERTIFICATE OF FORMATION, FILED THE SEVENTEENTH DAY OF DECEMBER, A.D. 2007, AT 10:53 O’CLOCK A.M.

CERTIFICATE OF MERGER, FILED THE TWENTY-EIGHTH DAY OF DECEMBER, A.D. 2007, AT 10:55 O’CLOCK A.M.

AND I DO HEREBY FURTHER CERTIFY THAT THE EFFECTIVE DATE OF THE AFORESAID CERTIFICATE OF MERGER IS THE THIRTY-FIRST DAY OF DECEMBER, A.D. 2007, AT 11:59 O’CLOCK P.M.

AND I DO HEREBY FURTHER CERTIFY THAT THE AFORESAID CERTIFICATES ARE THE ONLY CERTIFICATES ON RECORD OF THE AFORESAID LIMITED LIABILITY COMPANY, “QHG OF BLUFFTON COMPANY, LLC”.

4474767    8100H   111142039 /s/    Jeffrey W. Bullock         Jeffrey W. Bullock, Secretary of State AUTHENTICATION:    9120157   DATE:    10-27-11

State of Delaware

Secretary of State

Division of Corporations

Delivered 11:06 AM 12/17/2007

FILED 10:53 AM 12/17/2007

SRV 071328257 – 4474767 FILE

STATEof DELAWARE

LIMITED LIABILITY COMPANY

CERTIFICATEof FORMATION

• First: The name of the limited liability company isQHG of Bluffton Company, LLC.

• Second: The address of its registered office in the State of Delaware is2711 Centerville Road, Suite 400 in the City ofWilmington (New Castle County). The name of its Registered agent at such address isCorporation Service Company.

• Third:(Use this paragraph only if the company is to have a specific effective date of dissolution.) “The latest date on which the limited liability company is to dissolve is                                        .”

• Fourth:(Insert any other matters the members determine to include herein.)

In Witness Whereof, the undersigned have executed this Certificate of Formation ofQHG of Bluffton Company, LLC this17 day ofDecember     , 2007.

BY:	/s/ Robin J. Keck
	Authorized Person(s)
NAME:	Robin J. Keck, Organizer
	Type or Print

State of Delaware

Secretary of State

Division of Corporations

Delivered 11:09 AM 12/28/2007

FILED 10:55 AM 12/28/2007

SRV 071370028 - 4474767 FILE

CERTIFICATE OF MERGER

MERGING

QHG OF BLUFFTON, INC.

WITH AND INTO

QHG OF BLUFFTON COMPANY, LLC

The undersigned limited liability company, formed and existing under and by virtue of the Delaware Limited Liability Company Act, 6Del.C. §§ 18-101etseq., does hereby certify that:

FIRST: The name and jurisdiction of formation or organization of each of the constituent entities in the merger are as follows:

Name	Jurisdiction of Formation or Organization
QHG of Bluffton, Inc.	Indiana
QHG of Bluffton Company, LLC	Delaware

SECOND: An Agreement and Plan of Merger between the parties to the merger has been approved and executed by each of the constituent entities in accordance with the requirements of applicable law.

THIRD: The name of the surviving limited liability company is QHG of Bluffton Company, LLC.

FOURTH: This Certificate of Merger, and the merger referenced herein, shall be effective as of 11:59 p.m. on December 31, 2007.

FIFTH: The executed Agreement and Plan of Merger is on file at a place of business of the surviving limited liability company. The address of such place of business of the surviving limited liability company is 4000 Meridian Blvd., Franklin, TN 37067.

SIXTH: A copy of the Agreement and Plan of Merger will be furnished by the surviving limited liability company, on request and without cost, to any stockholder or member of, or any other person holding an interest in, either of the constituent entities in the merger.

[Signature Page Follows]

IN WITNESS WHEREOF, the surviving limited liability company has caused this Certificate of Merger to be duly executed in its name this 27^th day of December, 2007.

QHG OF BLUFFTON COMPANY, LLC
By:	/s/ Rachel A. Seifert
	Name:	Rachel A. Seifert
	Title:	Senior Vice President and Secretary Authorized Person