2023-08-15T09:55:11-05:00 2022-09-30 861065772 Deloitte Tax LLP 695 Town Center Drive Suite 1200 Costa Mesa CA 926261924 990 2021-10-01 273311774 St Luke's McCall Ltd STLU 2083812222 190 E Bannock Boise ID 83712 Pete DiDio SVP/CFO/Treasurer 2083812222 2023-08-15 1 Pete DiDio 999009999 John Sadoff Jr P00540589 7144367100 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z Chris Roth 190 E Bannock Boise ID 83712 52877778 0 X www.stlukesonline.org X 2010 ID Provide healthcare services to the community. 15 12 0 32 0 0 2277633 1019456 48718991 49178107 115578 87969 76009 151171 51188211 50436703 0 0 0 0 0 0 0 0 195540 41235881 45530484 41235881 45530484 9952330 4906219 67484684 70409891 8924616 7256516 58560068 63153375 To improve the health of people in the communities we serve. 0 0 36624133 42758578 Medical SurgicalIn 2010, McCall Memorial Hospital integrated with St. Luke's Health System and became St. Luke's McCall. This 15-bed critical access hospital, founded in 1956, is located in the central Idaho mountains about 100 miles north of Boise. The hospital provides 24-hour emergency services, inpatient and outpatient care, surgical care, maternal and childbirth services, hospice care and more. Its providers and staff have long been on the leading edge of prevention and wellness initiatives and integrative therapies.During Fiscal Year 2022, St. Luke's McCall provided patient care for 529 admissions covering 1,385 patient days. They also provided patient care associated with 31,279 outpatient visits. 5498538 6419529 Physician ServicesSt. Luke's McCall has two physician clinics:(1) Payette Lakes Medical Clinic has 10 family medicine physicians, and seven family medicine P.A.s and N.P.s who collectively completed 31,469 clinic visits in fiscal year 2022.(2) McCall Medical Clinic has two internal medicine physicians, one general surgeon, two orthopedic surgeons and four P.A.s and N.P.s who collectively completed 14,678 clinic visits in Fiscal Year 2022. 42122671 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X X Jared Grant System Controller 2083812222 190 E Banonck Boise ID 83712 X Chris Roth President & CEO 2.00 52.00 X X 0 1218717 51123 Bob Lokken Chair 0.50 2.50 X X 0 0 0 Alan Korn MD Director 0.50 2.50 X 0 0 0 Andy Scoggin Director 0.50 2.50 X 0 0 0 Arthur F Oppenheimer Director (End 11/2021) 0.50 4.50 X 0 0 0 Bill Whitacre Director 0.50 2.50 X 0 0 0 Brigette Bilyeu Director 0.50 2.50 X 0 0 0 Dan Krahn Director 0.50 2.50 X 0 0 0 Emily Baker Director (Start 11/2021) 0.50 2.50 X 0 0 0 Jon Miller Director 0.50 2.50 X 0 0 0 Karen Vauk Director (End 7/2022) 0.50 2.50 X 0 0 0 Lisa Grow Director 0.50 2.50 X 0 0 0 Lucie DiMaggio MD Director 0.50 2.50 X 0 427546 0 Mark Durcan Director 0.50 2.50 X 0 0 0 Rich Raimondi Director 0.50 4.50 X 0 0 0 Rosa Davila Director 0.50 2.50 X 0 0 0 Tom Corrick Director 0.50 2.50 X 0 0 0 Jeffrey S Taylor SVP/CFO/Treasurer (End 9/2022) 2.00 50.00 X 0 819813 388921 Christine Neuhoff SVP/Chief Legal Officer/Secretary 2.00 50.00 X 0 770299 41918 Sandee Moore Gehrke SVP, Chief Operating Officer 5.00 35.00 X 0 543383 42945 Kathryn Fowler SVP/CFO/Treasurer (Start 8/2022) 2.00 48.00 X 0 349149 24101 Dennis Mesaros VP, Population Health 10.00 30.00 X 0 526467 36077 Amber Green Chief Nursing/Operating Officer 40.00 0.00 X 0 175692 31655 Gregory W Irvine MD Physician 40.00 0.00 X 0 616233 43949 Timothy Neuschwander MD Physician 40.00 0.00 X 0 561576 34280 Adam Weller MD Physician 40.00 0.00 X 0 478043 44074 Patrick Kinney MD Physician 40.00 0.00 X 0 405868 34603 Maureen Ferguson MD Physician 40.00 0.00 X 0 414638 20578 Pamela Lindemoen Former COO 0.00 0.00 X 0 1569276 9054 David C Pate MD JD Former CEO & President 0.00 0.00 X 0 154684 0 0 9031384 803278 0 1 1 0 Hobson Fabricating Corp 6428 Business Way Boise ID 83716 Construction Services 1691437 Lea Electric Inc PO Box 190130 Boise ID 83719 Construction Services 1384118 Pointcore Construction LLC 601 SW Water St Peoria IL 61602 Construction Services 1197638 Hummell Architechts PLLC 2785 N Bogus Basin Rd Boise ID 83702 Construction Services 876260 Rightsourcing Inc 9 Executive Cir 290 Irvine CA 92614 Medical Staffing 687663 17 969456 50000 1019456 Net patient revenue 900099 46785585 46785585 Contract Service Reven 900099 1193931 1193931 Premium Revenue 900099 428164 428164 Taxing District Revenu 900099 360000 360000 SLHS Allocated Revenue 900099 312459 312459 97968 97968 49178107 94247 94247 80913 115 80798 80798 80798 2434682 2431828 9132 2854 -9132 -6278 -6278 Cafeteria/Catering/Ven 722514 70373 70373 70373 50436703 49178107 0 239140 1378319 1378319 16500 16500 28235 28235 2155891 2155891 11535 11535 533288 533010 278 2941210 2941210 460583 460468 115 155978 130470 25508 1280944 1060981 219963 Allocated SLHS Wages 24541119 22272110 2077704 191305 Supplies 6576926 6478241 94728 3957 Allocated SLHS expense 3234310 3234310 Contract Service 956670 755191 201479 1258976 677735 581241 45530484 42122671 3212273 195540 97233 95200 7267808 7466712 1992895 1476074 793100 778319 69739809 13427930 29415928 56311879 4573354 4281707 23344366 0 67484684 70409891 3388976 2646281 5535640 4610235 8924616 7256516 X 58560068 63153375 58560068 63153375 67484684 70409891 X 4906219 -362912 50000 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 88407 995810 1084217 11630962 6541015 5089947 7930441 6886915 1043526 49094189 49094189 56311879 AP Medicare-Medicaid Program 2121634 Operating Leases 539021 Due to Related Organization 1944817 Other Liabilities 4763 4610235 X Part X, Line 2: Footnote Disclosure - Uncertain Tax Positions Under ASC 740 (Source: Consolidated Financial Statements-St. Luke's Health System Fiscal Year 2022) Income Taxes - The Health System is a not-for-profit corporation and is recognized as tax-exempt pursuant to Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The Health System has activities that are considered unrelated business taxable income (UBTI), which are subject to excise tax. The Health System also has two taxable subsidiaries, SLHP and the Plan whose operations are included in the consolidated financial statements and as such we have provided for income taxes on this activity under the Accounting Standards Codification (ASC) 740. For the Health System's taxable subsidiary and activities considered UBTI, income taxes are accounted for under the asset and liability method, which requires the recognition of Deferred Tax Assets (DTAs) and Deferred Tax Liabilities (DTLs) for the expected future tax consequences of events that have been included in the consolidated financial statements. Under this method, the Health System determines DTAs and DTLs based on the differences between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. The effect of a change in tax rates on DTAs and DTLs is recognized in results of operations in the period that includes the enactment date of the rate change. The Health System recognizes DTAs to the extent that these assets are more likely than not to be realized. In making such a determination, the Health System considers all available positive and negative evidence, including future reversals of existing taxable temporary differences, projected future taxable income, tax-planning strategies, and results of recent operations. If the Health System determines that DTAs are realizable in the future in excess of their net recorded amount, the Health System would make an adjustment to the DTA valuation allowance, which would reduce the provision for income taxes. The Health System records uncertain tax positions in accordance with ASC 740 on the basis of a two-step process in which (1) the Health System determines whether it is more likely than not that the tax positions will be sustained on the basis of the technical merits of the position and (2) for those tax positions that meet the more-likely-than-not recognition threshold, the Health System recognizes the largest amount of tax benefit that is more than 50 percent likely to be realized upon ultimate settlement with the related tax authority. Management is not aware of any uncertain tax positions that should be recorded. 1 1 X 1 X 1 X 1 0 0 547040 547040 0.01200 5487234 4323685 1163549 0.02560 28199 0 28199 0.00060 6062473 4323685 1738788 0.03820 346530 58450 288080 0.00630 189944 189944 0.00420 8178 8178 0.00020 29955 29955 0.00070 574607 58450 516157 0.01140 6637080 4382135 2254945 0.04960 11950 11950 0.00030 6636 6636 0.00010 11324 11324 0.00020 29910 29910 0.00060 1 708855 0 8798741 12076544 -3277803 X 1 1 1 1 St Luke's McCall 1000 State Street McCall ID 83638 www.stlukesonline.org State of Idaho License #11 X X X X St Luke's McCall 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X See Section V, Part C X 1 21 1 See Section V, Part C 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X www.stlukesonline.org/resources/before-your-visit/financial-care X www.stlukesonline.org/resources/before-your-visit/financial-care X www.stlukesonline.org/resources/before-your-visit/financial-care X X X X X X X 1 X 0 X X X X 1 X 0 0 St. Luke's McCall Part V, Section B, Line 5: A series of interviews with people representing the broad interests of our community are conducted in order to assist in defining, prioritizing, and understanding our most important community health needs. Many of the representatives participating in the process have devoted decades to helping others lead healthier lives. We sincerely appreciate the time, thought, and valuable input they provide during our CHNA process. The openness of the community representatives allow us to better explore a broad range of health needs and issues. The representatives we interview have significant knowledge of our community. To ensure they come from distinct and varied backgrounds, we include multiple representatives from each of the following categories:Category I: Persons with special knowledge of public health. This includes persons from state, local, and/or regional governmental public health departments with knowledge, information, or expertise relevant to the health needs of our community. Category II: Individuals or organizations serving or representing the interests of the medically underserved, low-income, and minority populations in our community. Medically underserved populations include populations experiencing health disparities or at risk populations not receiving adequate medical care as a result of being uninsured or underinsured or due to geographic, language, financial, or other barriers. Category III: Additional people located in or serving our community including, but not limited to, health care advocates, nonprofit and community-based organizations, health care providers, community health centers, local school districts, and private businesses. Each potential need is scored by the community representatives on a scale from negative six (-6) to six (6). A high score signifies the representative believes the health need is both important and needs to be addressed with additional resources. Lower scores typically mean the representative believes the need is relatively less important or that it is already being addressed effectively with the current set of programs and services available.Representatives from the following organizations were contacted and interviewed:1) Affiliation: Blue Cross of Idaho Foundation2) Affiliation: Cascade Medical Center3) Affiliation: Central District Health4) Affiliation: Central District Health Community Partner5) Affiliation: Council Area (Trident Holdings employee)6) Affiliation: Idaho Department of Health and Welfare7) Affiliation: Idaho Department of Health and Welfare, Region IV Mental Health8) Affiliation: Idaho Division of Public Health9) Affiliation: Idaho Food Bank10) Affiliation: Idaho Office of the Governor11) Affiliation: Local Government12) Affiliation: McCall Donnelly School District13) Affiliation: McCall Fire & EMS14) Affiliation: Southwest District Health15) Affiliation: Southwest Idaho Area Agency on Aging16) Affiliation: St. Luke's Health Partners17) Affiliation: St. Luke's Health System18) Affiliation: St. Luke's Health System19) Affiliation: St. Luke's McCall20) Affiliation: The Speedy Foundation21) Affiliation: Treasure Valley YMCA22) Affiliation: United Way of Treasure Valley23) Affiliation: WICAP Head Start St. Luke's McCall Part V, Section B, Line 11: The following health needs received the highest score within each category, signifying the importance of addressing these needs to improve community health.Significant Health Needs(1) Health Behaviors - Nutrition Programs/Education/Opportunities(2) Clinical Care - Availability of Behavioral Health Services(3) Social and Economic Factors - Housing Stability(4) Physical Environment - Accessible Modes of TransportationThe following implementation plan illustrates the strategies St. Luke's and its community partners will employ in fiscal year 2023 to address the most significant health needs identified in our 2022 Community Health Needs Assessment for the McCall area.(1) Health Behaviors - Nutrition Programs/Education/OpportunitiesMost Americans today do not have a healthy diet. The role of nutrition in chronic disease prevention and management is particularly crucial as diet is a modifiable risk factor for most chronic conditions.Improve availability and access to healthy foods.- Support community health workers and cultural liaisons within local foodbanks.- SNAP and WIC promotion and outreach.Improve understanding, education and skills to utilize healthy foods.- Deliver and support healthy eating as well as nutrition education and skill building.Support sustainable systems to lessen instances and duration of food insecurity- Identify and implement advocacy opportunities to address food/nutrition insecurity.- Explore value-based-care payment models and benefits designed for nutrition supports. (2) Clinical Care - Availability of Behavioral Health ServicesAccording to the National Alliance on Mental Illness, nearly a quarter of Idahoans are living with a mental illness. Substance Abuse and Mental Health Services Administration reports that all Idaho counties have shortages of mental health professionals.Awareness, education and skill building.- Support delivery of gatekeeper trainings.- Provide and promote mental and behavioral health education.- Implement Aging in Place survey recommendations.Population identification and intervention.- Support the community-school model.Increase access to mental and behavioral health services.- Participate and appropriately contribute to Governor's Behavioral Health Council.- Support implementation of Community Health Worker, Community Health EMS and Center for Community Health models.- Build suicide prevention and postvention strategies. (3) Social and Economic Factors - Housing StabilityAccess to stable housing leads to better physical and mental health outcomes for all. According to a report published by the Idaho Asset Building Network, "In communities with enough affordable homes, primary care visits go up by 20%, emergency room visits go down by 18%, and accumulated medical expenses go down by 12%."Prevention, identification and outreach.- Support development and implementation of social determinantsof health screening tool in the electronic medical record (EPIC) to assess the housing needs of patients.- Participate in local housing discussions.Increase housing availability.- Identify and engage in advocacy opportunities to address housing stability.Increase support services to help people secure and maintain safe, stable housing.- Support quality early learning programs.(4) Physical Environment - Accessible Modes of TransportationPeople facing the biggest transportation challenges are often economically and/or socially marginalized, and include lower income families, children and older adults. Ensuring access to transportation also improves access to healthier food options, medical care and employment. Create and maintain safe walking/biking paths and programs.- Support local healthy transportation opportunities.Support infrastructure for public transportation and shared ridership models.- Promote the Connecting-U McCall to Riggins bus program.- Support local transportation discussions to expand the Mountain Valley Transit route. St. Luke's McCall Part V, Section B, Line 13b: Financial Care: Eligible applicants will receive the following assistance:1. Full Discount: The full amount for eligible services will be covered under the Financial Care Policy for any patient or guarantor whose income is at or below 200 percent of the federal poverty level.2. Partial Discount: A sliding fee schedule will be used to determine the amount eligible for financial care assistance for any uninsured or underinsured patient or guarantor. For such applicants, assistance will be provided based on a combination of household income and assets. Partial discounts will be provided if the combination of income and assets is greater than 200 percent but equal to or less than 400 percent of the FPL. Assistance is granted only after all third-party reimbursement possibilities available to the applicant have been exhausted.3. Uninsured and underinsured individuals deemed medically indigent may qualify for a highly discounted rate.4. If the patient balance exceeds 30 percent of household income, patients will qualify for a one-time reduction.5. Assets for evaluation include, but are not limited to:a. home equity;b. IRAs, 403(b) accounts, 401k accounts, stocks/bonds;c. savings/money market accounts; andd. other investments (rental properties, etc.).WWW.STLUKESONLINE.ORG/RESOURCES/BEFORE-YOUR-VISIT/FINANCIAL-CARE St. Luke's McCall Part V, Section B, Line 16j: A Financial Care application is provided to the patient which contains Patient Financial Advocate contact information. Part V, Section B, Line 7a: https://www.stlukesonline.org/about-st-lukes/supporting-the-community/community-health-needs-assessments Part V, Section B, Line 10a: https://www.stlukesonline.org/about-st-lukes/supporting-the-community/community-health-needs-assessments 7 1 - St Luke's Clinic 209 Forest St McCall ID 83638 General Surgery, Internal Medicine, Wound Center 2 - St Luke's Clinic 200 Forest St McCall ID 83638 Orthopedic Surgery and Sleep medicine 3 - St Luke's Clinic 301 Deinhard Lane McCall ID 83638 Behavioral Health and Integrative Medicine 4 - St Luke's Clinic 211 Forest St McCall ID 83638 Family Medicine, Nephrology 5 - St Luke's Clinic Salmon River 214 N Main St Riggins ID 83549 Family Medicine 6 - St Luke's Meadows Valley Family Med 320 Virginia St New Meadows ID 83654 Family Medicine 7 - St Luke's Rehabilitation 1010 State Street McCall ID 83638 Rehabilitation Part I, Line 3c: Please refer to the disclosure for Part V, Section B, Line 13b - which describes methods used to determine eligibility for financial assistance. Part I, Line 7: The cost to charge ratio was used to calculate the financial assistance provided to the community. Other Community benefits come from a data repository maintained by St. Luke's Employees that tracks community benefit costs and hours. Part 1, Line 6a: St. Luke's McCall, Ltd. is not required under Idaho law to file a community benefit report, since its total licensed beds are less than the minimum 150 bed requirement threshold. (McCall has 15 licensed beds.) Moreover, the activity of St. Luke's McCall, Ltd. is not included in the community benefit report within any of its related organizations within the St. Luke's Health System. Part 1, Line 7i, Cash and in-kind contributions for community benefit: During the fiscal year 2022, St. Luke's administrated and dispensed the majority of community grants, cash, and in-kind donations at the system level. Those grants and donations were still awarded and continued to support health initiatives through all the communities we serve and were reported on form 990 for St. Luke's Health System. Part 1, Line 5a, Discounted Care: Financial assistance is provided to any qualifying patients, regardless of budget. Part II, Community Building Activities: St. Luke's is an active participant in the community, and provides support to address public health issues, and works with coalitions to address local health needs. St. Luke's takes on initiatives as need arises to help the long term development of the community particularly to shape and improve public health and access to medical services. Part III, Line 2: The Cost to Charge ratio method was used to calculate bad debt expense at cost. Part III, Line 3: St. Luke's has a very robust financial assistance program, therefore, no estimate is made for bad debt attributable to patients eligible under the financial assistance policy. Part III, Line 4: Per the audited financial statements in footnote three, St. Luke's grants credit without collateral to its patients, most of whom are local residents and many of whom are insured under third-party agreements. The allowance for estimated uncollectible amounts is determined by analyzing both historical information (write-offs by payor classification), as well as current economic conditions. Part III, Line 8: The source of the information is the Medicare Cost Report for fiscal year 2022. The amount is calculated by comparing the total Medicare apportioned costs (allowable costs) to payments (including IME and GME) received during FY'22.St. Luke's provides medical care to all patients eligible for Medicare regardless of the shortfall and thereby relieves the Federal Government of the burden for paying the full cost of Medicare. Part III, Line 9b: All subsidiaries within the St. Luke's Health System have policies in place to provide financial assistance to those who meet established criteria and need assistance in paying for the amounts billed for their provided health care services. In addition, the collection policies and practices in place within the St. Luke's Health System provide guidance to patients on how to apply for this assistance. Collection of amounts due may be pursued in cases where the patient is unable to qualify for charity care or financial assistance and the patient has the financial resources to pay for the billed amounts. Part VI, Line 2: A Community Health Needs Assessment (CHNA) was conducted for the fiscal year ending 9/30/2022. Information related to the CHNA is shown in the responses to questions 3 and 7 of "Part V, Section B, Facility Policies and Practices".A complete copy of the CHNA assessments for all of the hospitals operating within the St. Luke's Health System can be found at the following website:https://www.stlukesonline.org/about-st-lukes/supporting-the-community/community-health-needs-assessments Part VI, Line 3: (A) St. Luke's provides notice of the availability of financial assistance via: 1. Signage 2. Patient brochure 3. Billing Statement 4. Written collection action letter 5. Online at www.stlukesonline.org/billing (B) Financial assistance policy is translated into the following language: Spanish (C) St. Luke's provides individual notice of the availability of financial assistance to a patient expected to incur charges that may not be paid in full by third party coverage, along with an estimate of the patient's liability. (D) For cases in which St. Luke's independently determines patient eligibility for financial assistance, St. Luke's provides written notice of determination that the patient is or is not eligible within 10 business days of receiving a completed application and the required supporting documentation. Part VI, Line 4: Adams and Valley counties represent the geographic area used to define the community we serve, also referred to here as our primary service area or service area. The criteria we use in selecting the service area is the identification of what counties our hospitalized patients reside in. Those counties that make up 70% or greater of the inpatient hospitalizations are identified as our service area. The residents of Adams and Valley counties comprise about 80% of our inpatients with approximately 61% of our inpatients living in Valley County and 19% in Adams County.Both Idaho and our service area territory are comprised of about a 97% white population while the nation, as a whole, is 76% white. The Hispanic population in Idaho represents 13% of the overall population and about 4% of our defined service area. Adams County is approximately 4% Hispanic, and Valley County is 5% Hispanic.Idaho experienced a 14% increase in population from 2010 to 2019, ranking it as one of fastest growing states in the country. Adams and Valley Counties have followed that trend, experiencing a 13% increase in population within that timeframe. St. Luke's McCall isworking to manage the volume and scope of services to meet the needs of a growing population.Over the past 10 years the 65 plus year old age group has been the fastest growing segment of our service area. Currently, about 27% of the people in our service area are over the age of 65. According to the U.S. Census, about 16% of the people in the U.S. are over age 65.The official United States poverty rate has been decreasing since 2012. The poverty rate in Valley County is currently well below the national average at 9% but above the national average in Adams County at 13%. The poverty rate in our service area for children under the age of 18 is again below the national average for Valley County at 12% and above the national average for Adams County at 20%.Median income in the United States has risen steadily since 2009. Median income in Idaho remains below the national average but continues to grow. Median income in Adams County is well below the national median and lower than Idaho's median income. Median income in Valley County is slightly below than the national median income. Part VI, Line 5: The people who serve on the various boards for subsidiaries within the St. Luke's Health System are local citizens who have a vested interest in the health of their communities. These committed leaders volunteer on our boards because they are dedicated to ensuring that the people of southern Idaho and the surrounding area have access to the most advanced, most comprehensive health care possible. St. Luke's believes that locally owned and governed hospitals can take the best measure of community health care needs. We are grateful to our board leadership for giving generously of their time and talents and bringing to the table their unique perspectives and intimate knowledge of their communities. St. Luke's would not be the organization it is today without our volunteer board members. The vision of dedicated community leaders has guided St. Luke's for many decades, and will continue to guide us well into the future. As a not-for-profit organization,100% of St. Luke's revenue after expenses is reinvested in the organization to serve the community in the form of staff, buildings, or new technology. Also, St. Luke's McCall, Ltd. maintains an open medical staff. Any physician can apply for practicing privileges as long as they meet the standards for St. Luke's McCall, Ltd. Part VI, Line 6: As the only Idaho-based not-for-profit health system, St. Luke's Health System is part of the communities we serve, with local physicians and boards who further our organization's mission "To improve the health of people in the communities we serve." Working together, we share resources, skills, and knowledge to provide the best possible care, no matter which of our hospitals provide that care. Each St. Luke's Health System hospital is nationally recognized for excellence in patient care, with prestigious awards and designations reflecting the exceptional care that is synonymous with the St. Luke's name. St. Luke's Health System provides facilities and services across the region, covering a 150-mile radius that encompasses southern and central Idaho, northern Nevada, and eastern Oregon-bringing care close to home and family. The following entities are part of the St. Luke's Health System: (1) St. Luke's Regional Medical Center, Ltd. with the following locations: --St. Luke's Boise Hospital --St. Luke's Meridian Hospital --St. Luke's Children's Hospital --St. Luke's Boise/Meridian/Caldwell/Fruitland Physician Clinics --St. Luke's Eagle Urgent Care --St. Luke's Elmore Hospital with physician clinic --St. Luke's Fruitland Emergency Department/Urgent Care (2) St. Luke's Wood River Medical Center, Ltd. which consists of a critical access hospital located in Ketchum, Idaho as well as various physician clinics (3) St. Luke's Magic Valley Regional Medical Center, Ltd. which consists of the following: --St. Luke's Magic Valley Hospital-Twin Falls, Idaho --Various St. Luke's Physician Clinics in Twin Falls --Canyon View-(Behavioral Health) --St. Luke's Jerome Hospital-Jerome, Idaho --Various Physician clinics in Jerome (4) St. Luke's McCall, Ltd. which consists of a critical access hospital located in McCall, Idaho as well as various physician clinics. (5) St. Luke's Nampa Medical Center, Ltd. which consists of a critical access hospital located in Nampa, Idaho as well as various physician clinics. St. Luke's physician clinics and services are provided in partnership with area physicians and other health care professionals. These include: Cardiovascular; Child Abuse and Neglect Evaluation; Endocrinology; Ear, Nose, and Throat; Family Medicine; Gastroenterology; General Surgery; Hypertensive Disease; Internal Medicine; Maternal/Fetal Medicine; Medical Imaging; Metabolic and Bariatric Surgery; Nephrology; Neurology; Neurosurgery; Obstetrics/Gynecology; Occupational Medicine; Orthopedics; Outpatient Rehabilitation; Plastic Surgery; Psychiatry and Addiction; Pulmonary Medicine; Sleep Disorders; and Urology. In addition, St. Luke's works with other regional facilities, including Weiser Memorial Hospital and Salmon River Clinic, through a combination of management and other contracts for select specified services. 1 1 0 0 0 0 0 0 0 Pamela Lindemoen Former COO 0 335909 0 0 0 1233367 0 6933 0 2121 0 1578330 0 0 Chris Roth President & CEO 0 1051056 0 1158 0 166503 0 21816 0 29307 0 1269840 0 0 Jeffrey S Taylor SVP/CFO/Treasurer (End 9/2022) 0 763131 0 1158 0 55524 0 366723 0 22198 0 1208734 0 0 Christine Neuhoff SVP/Chief Legal Officer/Secretary 0 683156 0 1158 0 85985 0 21816 0 20102 0 812217 0 0 Gregory W Irvine MD Physician 0 507995 0 55880 0 52358 0 21816 0 22133 0 660182 0 0 Timothy Neuschwander MD Physician 0 540378 0 1158 0 20040 0 10250 0 24030 0 595856 0 0 Sandee Moore Gehrke SVP, Chief Operating Officer 0 467389 0 1158 0 74836 0 17444 0 25501 0 586328 0 0 Dennis Mesaros VP, Population Health 0 469260 0 1158 0 56049 0 17444 0 18633 0 562544 0 0 Adam Weller MD Physician 0 331224 0 126779 0 20040 0 17444 0 26630 0 522117 0 0 Patrick Kinney MD Physician 0 283644 0 102238 0 19986 0 17251 0 17352 0 440471 0 0 Maureen Ferguson MD Physician 0 257499 0 128903 0 28236 0 16062 0 4516 0 435216 0 0 Lucie DiMaggio MD Director 0 427546 0 0 0 0 0 0 0 0 0 427546 0 0 Kathryn Fowler SVP/CFO/Treasurer (Start 8/2022) 0 308451 0 1158 0 39540 0 17444 0 6657 0 373250 0 0 Amber Green Chief Nursing/Operating Officer 0 168876 0 1658 0 5158 0 4663 0 26992 0 207347 0 0 David C Pate MD JD Former CEO & President 0 0 0 0 0 154684 0 0 0 0 0 154684 0 154684 Part I, Line 3 Compensation for the organization's CEO is determined by St. Luke's Health System, Ltd. (System), sole member of St. Luke's McCall, Ltd. The System board approves the compensation amount per the recommendation of its compensation committee, and the decision is then reviewed and ratified by the board of directors for St. Luke's McCall, Ltd. In determining compensation for the CEO, the System board utilizes the following criteria: Compensation Committee Independent compensation consultant Compensation survey or study Approval by the board or compensation committee Part I, Line 4b: During CY2021, the following individuals participated in a supplemental non-qualified executive retirement plan: David C. Pate received $154,684 of taxable and $372,053 of non-taxable benefits for service in a supplemental retirement plan. Part I, Line 4b: During CY2021, Jeffrey S. Taylor was a participant in the supplemental non-qualified executive retirement plan. There were no additional benefits accrued during the calendar year on behalf of the participant. Part II - Column (B)(III) The reportable individual, Pamela Lindemoen, is paid by St. Luke's Health System, a related organization recognized by the Internal Revenue Service as exempt as described in Internal Revenue Code Section 501(c)(3). Severance pay is based on length of service. Payments of severance are conditioned upon signing a separation and release agreement. During the 2021 calendar year, the reportable individual received severance payments in the amount of $874,994. Part II-Column (C) During CY2021 the following individual participated in the basic pension plan. Due to changes in actuarial assumptions, this individual experienced an increase in the vested balance of the plan. Jeffrey Taylor $340,535 Form 990 Part V, Line 1 & 2 Accounts payable and payroll process are consolidated at the supporting organization level (St. Luke's Health System, Ltd). Therefore, corresponding reporting for 1099's and W-2's occurs at that level. Form 990, Part VI, Section A, line 2 Andy Scoggin has a business relationship with Dan Krahn. Form 990, Part VI, Section A, line 6 St. Luke's Health System, Ltd. is the sole member of St. Luke's McCall, Ltd. Form 990, Part VI, Section A, line 7a St. Luke's McCall (Corporation) and St. Luke's Health System, Ltd. (Member) cooperatively select and employ the CEO of the Corporation. St. Luke's Health System, Ltd. is the sole member of the Corporation. Form 990, Part VI, Section A, line 7b St. Luke's Health System,Ltd (member) maintains approval and implementation authority over St. Luke's McCall, Ltd. (SLM). Actions requiring approval authority may be initiated by either the Corporation or its Member, but must be approved by both the Corporation (by action of its Board of Directors)and the Member. Actions requiring approval authority of the Member include: (a) Amendment to the Articles of Incorporation; (b) Amendment to the Bylaws of the Corporation; (c) Appointment of members of the Corporation's Board of Directors, other than ex officio directors; (d) Removal of an individual from the Corporation's Board of Directors if and when removal is requested by the Corporation's Board of Directors, which request may only be made if the Director is failing to meet the reasonable expectations for service on the Corporation's Board of Directors that are established by the Member and are uniform for the Corporation and for all of the other hospitals for which the Member then serves as the sole corporate member. (e) Approval of operating and capital budgets of the Corporation, and deviations to an approved budget over the amounts established from time to time by the Member; and (f) Approval of the strategic/tactical plans and goals and objectives of the Corporation. Implementation Authority means those actions which the Member may take without the approval or recommendation of the Corporation. This authority will not be utilized until there has been appropriate communication between the Member and the Corporation's Board of Directors and its Chief Executive Officer. Actions requiring implementation authority include: (a) Changes to the Statements of mission, philosophy, and values of the Corporation; (b) Removal of an individual from the Corporation's Board of Directors if and when the Member determines in good faith that the Director is failing to meet the Approved Board of Member Expectations. This authority to remove Directors shall not be used merely because there is a difference in business judgment between the Director and the Corporation or the Member, and shall never be used to remove one or more Directors from the Corporation's Board of Directors in order to change a decision made by the Corporation's Board of Directors; (c) Employment and termination of the Chief Executive Officer of the Corporation; (d) Appointment of the auditor for the Corporation and the coordination of the Corporation's annual audit; (e) Sales, lease, exchange, mortgage, pledge, creation of a security interest in or other disposition of real or personal property of the Corporation if such property has a fair market value in excess of a limit set from time to time by the Member and that is not otherwise contained in an Approved Budget; (f) Sale, merger, consolidation, change of membership, sale of all or substantially all of the assets of the corporation, or closure of any facility operated by the Corporation; (g) The dissolution of the Corporation; (h) Incurrence of debt by or for the Corporation in accordance with requirements established from time to time by the Member and that is not otherwise contained in an Approved Budget; and (i) Authority to establish policies to promote and develop an integrated, cohesive health care delivery system across all corporations for which the Member serves as the corporate member. Form 990, Part VI, Section B, line 11b The Form 990 (Form) is reviewed by an independent public accounting firm based on audited financial statements of the St. Luke's Health System and with the assistance of the organization's finance and accounting staff. A complete copy of the Form 990 is made available to the Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c The organization annually reviews the conflict of interest policy with each board member and also with new board members. Persons covered under the policy include officers, directors, senior executives, non-director members of Board committees, and others as identified by a senior executive. At all levels the board is responsible for assessing, reviewing, and resolving any conflicts of interest that have been disclosed by a covered person, or a conflict of interest disclosed by a covered person with respect to a covered person other than himself/herself. Where a conflict exists, the affected parties must recuse themselves from participating in any discussion and/or vote related to the conflict. Form 990, Part VI, Section B, line 15 Executive compensation is set by St. Luke's Boards of Directors and is reviewed annually. Compensation levels are based on an independent analysis of comparable pay packages offered at similar institutions across the country, with the goal of placing executives in the 50th percentile in aggregate of those surveyed. These surveys are usually done annually. St. Luke's Health System is committed to providing the highest quality medical care to all people regardless of their ability to pay. To keep that commitment, St. Luke's puts a great deal of time and effort into recruiting and retaining the top physicians in a variety of medical fields. Our relationships with physicians range from having privileges at the hospital to full employment. For those physicians who choose to be employed, St. Luke's must offer competitive pay and benefits. Physician compensation is based on a range of criteria and can be influenced by a number of variables including: -Community need for medical specialty -Experience -Productivity -Geography -National surveys adjusted for local conditions -Willingness to serve regardless of patients' ability to pay -Duration of relationship and contractual terms -Performance on quality metrics To ensure physician compensation and benefits remain within industry standards and legal requirements for not-for-profit institutions, St. Luke's has a Physician Arrangements policy that specifies circumstances requiring a third-party valuation and also periodically uses third-party consulting firms to review St. Luke's physician compensation arrangements. Given the growing national shortage of physicians, recruiting and retaining physicians is more critical than ever to guarantee that people seeking care at St. Luke's will continue to have access to the physicians and specialists they need regardless of their insurance status or insurance provider. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Form 990 is available for public inspection on our website, which contains financial information. Form 990 Part VII Section A Allocation of Compensation and Hours: The total hours worked and compensation reported for the following individuals represent services rendered to organizations within the St. Luke's Health System: Chris Roth: St. Luke's Health System, Ltd. St. Luke's Regional Medical Center, Ltd. St. Luke's McCall, Ltd. St. Luke's Health Foundation, Ltd. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. St. Luke's Clinic Coordinated Care, Ltd. St. Luke's Nampa Medical Center, Ltd. Christine Neuhoff: St. Luke's Health System, Ltd. St. Luke's Regional Medical Center, Ltd. St. Luke's McCall, Ltd. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's Wood River Medical Center, Ltd. St. Luke's Clinic Coordinated Care, Ltd. St. Luke's Nampa Medical Center, Ltd. Dennis Mesaros: St. Luke's Health System, Ltd. St. Luke's Regional Medical Center St. Luke's McCall, Ltd. Jeffrey S. Taylor: St. Luke's Clinic Coordinated Care, Ltd. St. Luke's Health System, Ltd. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's McCall, Ltd. St. Luke's Nampa Medical Center, Ltd. St. Luke's Regional Medical Center St. Luke's Wood River Medical Center, Ltd. Kathryn Fowler: St. Luke's Health System, Ltd. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's McCall, Ltd. St. Luke's Nampa Medical Center, Ltd. St. Luke's Regional Medical Center St. Luke's Wood River Medical Center, Ltd. Sandee Moore Gehrke: St. Luke's Health System, Ltd. St. Luke's Magic Valley Regional Medical Center, Ltd. St. Luke's McCall, Ltd. St. Luke's Nampa Medical Center, Ltd. St. Luke's Regional Medical Center St. Luke's Wood River Medical Center, Ltd. Also, it should be noted that the hours reported for the officers, key employees, and highest paid employees are based on a minimum 40 hour work week. However, due to the demands of their roles within the St. Luke's Health System, the hours worked by these individuals often exceed the minimum required 40 hours. Form 990, Part XI, line 9: Capital invested in plant 50,000. Form 990, Part I, Line 6: Volunteer counts exceed those in prior years due to the lifting of restrictions on access to the hospitals and resuming in-person events following COVID-19 concerns. St Luke's Clinic-McCall LLC 190 E Bannock Boise ID 83712 452715717 Physician Clinic Services ID 6779245 455016 St Luke's McCall Ltd St Luke's Clinic Coordinated Care Ltd 190 E Bannock Boise ID 83712 455195864 Accountable Care Organization ID 501(c)(3) 10 St Luke's Health System Ltd 0 St Luke's Health Foundation Ltd 190 E Bannock Boise ID 83712 810600973 Fundraising ID 501(c)(3) 7 St Luke's Health System Ltd 0 St Luke's Health System Ltd 190 E Bannock Boise ID 83712 562570681 Supporting Organization ID 501(c)(3) 12C, III-FI N/A 0 St Luke's Magic Valley Regional Medical Center Ltd 190 E Bannock Boise ID 83712 562570686 Healthcare Services ID 501(c)(3) 3 St Luke's Health System Ltd 0 St Luke's Regional Medical Center Ltd 190 E Bannock Boise ID 83712 820161600 Healthcare Services ID 501(c)(3) 3 St Luke's Health System Ltd 0 St Luke's Nampa Medical Center Ltd 190 E Bannock Boise ID 83712 821162805 Healthcare Services ID 501(c)(3) 3 St Luke's Health System Ltd 0 St Luke's Wood River Medical Center Ltd 190 E Bannock Boise ID 83712 841421665 Healthcare Services ID 501(c)(3) 3 St Luke's Health System Ltd 0 Sequoyah Assurance Ltd PO Box 1051 Grand Cayman CJ KY1-1102 981631863 Captive Insurance CJ N/A C 0 St Luke's Health Plan Inc 800 E Park Blvd Boise ID 83712 874765682 Health Insurance Provider ID N/A C 0 Select Medical Network of Idaho Inc PO Box 1990 Boise ID 83701 810594024 Provider Network ID N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0