2022-05-16T08:49:12-05:00 2021-06-30 135565207 KPMG LLP 1225 17TH STREET SUITE 800 DENVER CO 80202 990 2020-07-01 741161938 CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER CHIS 8323551000 6624 FANNIN ST 1100 HOUSTON TX 77030 LINDA KULHANEK CFO 8323551000 2022-05-16 1 LINDA KULHANEK 999009999 MARK SHELTON P01203482 3033827856 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z BAYLOR ST LUKE'S MEDICAL CENTER T DOUGLAS LAWSON 6624 FANNIN ST 1100 HOUSTON TX 77030 1041673248 0 X HTTPS://WWW.STLUKESHEALTH.ORG/LOCATIONS/BAYLOR-ST X 1945 TX TO NURTURE THE HEALING MINISTRY OF THE ROMAN CATHOLIC CHURCH BY BRINGING IT NEW LIFE, ENERGY, AND VIABILITY IN THE TWENTY-FIRST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT MOVES TOWARD THE CREATION OF HEALTHIER COMMUNITIES. 13 12 5032 50 3982888 1103303 23433789 11554385 912126317 1020671960 27701957 1888322 9508567 7268245 972770630 1041382912 79835 458587 0 0 378360203 367907586 0 0 0 624294832 690263270 1002734870 1058629443 -29964240 -17246531 984854764 1099094656 280984251 412227410 703870513 686867246 AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. 0 0 948590429 458587 1020671960 SEE SCHEDULE H 948590429 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 1 1 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 0 0 5032 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 X JESUS GOMEZ 8323552885 6720 BERTNER AVE HOUSTON TX 77030 T DOUGLAS LAWSON PHD EX-OFFICIO/CEO SLHS 40.00 0.00 X X 2116319 0 203814 ELIZABETH YOUNGBLOOD PRESIDENT BSLMC/SVP & COO SLHS 50.00 0.00 X 822950 0 95852 BRADLEY LEMBCKE CMO BSLMC/ SVP & CMO SLHS 50.00 0.00 X 737180 0 55355 MARK TERESI INTERIM CFO OF SLHS 40.00 0.00 X 625246 0 0 JOHN BYRNE FORMER MKT SVP-MEDICAL OPERATIONS 1.00 0.00 X 610315 0 9702 VERONICA MARTIN DIV SVP CNO 50.00 0.00 X 373153 0 22123 GAY NORD FORMER PRESIDENT 0.00 0.00 X 352194 0 0 CAROLYN DOUGLAS-CURRY RN II 40.00 0.00 X 292488 0 47616 TANIA MATAR SYS VP INTERNAL HEALTH SVCS 40.00 0.00 X 311598 0 21009 JASON PELTON MD CARDIOLOGIST 40.00 0.00 X 306486 0 5156 PRISCILLA NEEDHAM TREASURER/VP-FINANCE (PARTIAL YEAR) 9.00 0.00 X 255929 0 32630 ALENE JACKSON DIRECTOR-PATIENT CARE (PARTIAL YEAR) 50.00 0.00 X 172705 0 24987 JESUS GOMEZ TREASURER/VP-FINANCE 50.00 0.00 X 175740 0 12566 PAMELA WALKO SECRETARY 9.00 0.00 X 72262 0 7216 JOHN ANDERSON MD BOARD MEMBER (PARTIAL YEAR) 1.00 0.00 X 0 0 0 JOHN SCOTT ARNOLDY BOARD MEMBER 1.00 0.00 X 0 0 0 ROBERT BLAKELY VICE CHAIR 1.00 0.00 X X 0 0 0 SARAH FOSHEE MD BOARD MEMBER 1.00 0.00 X 0 0 0 PAUL KLOTMAN MD EX-OFFICIO/BOARD MEMBER 1.00 0.00 X 0 0 0 JEFF ROSE BOARD MEMBER (PARTIAL YEAR) 1.00 0.00 X 0 0 0 TODD ROSENGART MD BOARD MEMBER 1.00 0.00 X 0 0 0 MARC SHAPIRO CHAIR 1.00 0.00 X X 0 0 0 CLAYTON TRIER BM/SECRETARY (PARTIAL YEAR) 1.00 0.00 X X 0 0 0 MARVIN OQUINN BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN GLICK BOARD MEMBER 1.00 0.00 X 0 0 0 MARK MCCOLLUM BOARD MEMBER 1.00 0.00 X 0 0 0 JONATHAN NELSON MD BOARD MEMBER 1.00 0.00 X 0 0 0 ALAN SEMPLE BOARD MEMBER 1.00 0.00 X 0 0 0 KENNETH WELLS MD BOARD MEMBER 1.00 0.00 X 0 0 0 LINDA KULHANEK CFO - CHI ST. LUKE'S HEALTH SYSTEM 40.00 0.00 X 0 0 0 7224565 0 538026 836 1 1 1 DAVID E HARVEY BUILDERS INC 3630 WEST CHASE DR HOUSTON TX 77042 CONSTRUCTION SERVICES 14610458 AMN HEALTHCARE 12400 HIGH BLUFF DR SUITE 100 SAN DIEGO CA 92130 HEALTHCARE CONSULTING SERVICES 11695303 HKS INC 350 N SAINT PAUL ST 100 DALLAS TX 75201 ARCHITECTURE SERVICES 9189773 ADAMS MANAGEMENT SERVICES CORP 336 BROAD ST ROME GA 30161 CONSULTING SERVICES 3028939 HEALTHCARE CUSTODIAL ASSOC LLC 166 HARGRAVES DR AUSTIN TX 78737 HOUSEKEEPING SERVICES 2920238 72 2792051 8746263 16071 11554385 NET PATIENT SERVICES 900099 1020671960 1020671960 0 0 1020671960 1086739 13550 1073189 989875 0 989875 989875 989875 601919 490000 0 290336 601919 199664 801583 801583 LABORATORY SERVICES 621500 3969338 3969338 INSURANCE INCENTIVE PA 524298 976280 0 0 976280 SERVICES SOLD 900099 621114 621114 711638 711638 6278370 1041382912 1020671960 3982888 5173679 X 458587 458587 2092313 732309 1360004 286548223 273378842 13169381 13796120 13134793 661327 43732882 41580102 2152780 21738048 20651146 1086902 65151 65151 234673897 222190914 12482983 203512 203512 8543167 5382195 3160972 30743334 12297333 18446001 24239945 4605590 19634355 49086 46631 2455 89880 85386 4494 30886411 30886411 38329740 36413253 1916487 5431481 5159907 271574 MEDICAL SUPPLIES 263961687 263961687 0 0 STATE PROVIDER TAX 26068111 24764705 1303406 0 INTRACOMPANY ALLOCATION 13486041 12808482 677559 0 UNRELATED BUSINESS TAXE 76360 0 76360 0 13415467 10669904 2745563 1058629443 948590429 110039014 0 15826 4499 7946492 6313360 29959122 32447891 137298315 198625416 0 0 0 25600867 34421137 9934563 4554246 883576616 255362527 560900746 628214089 0 7564595 9551237 0 50335023 46895576 155299215 138067205 984854764 1099094656 154150944 159212980 0 49239 0 0 0 0 0 126833307 252965191 280984251 412227410 X 672409621 652917586 31460892 33949660 703870513 686867246 984854764 1099094656 X -17246531 1267675 2030986 -3055397 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 65151 65151 65151 65151 948525278 948525278 948590429 948590429 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 95673 141047 284736 65151 586607 250000 250000 250000 250000 1000000 1500000 72898440 4702698 14695673 4182684 88114127 81153668 3532151 1651014 13438393 72898440 77616280 2966951 3427100 2856663 81153668 77329841 2128264 4797238 6639063 77616280 75360004 4200089 6091894 8322146 77329841 0.28000 0.28000 0.44000 1 0 127400000 127400000 365238468 75448912 289789556 16032082 10939731 5092351 240037667 168864935 71172732 134868399 108949 134759450 628214089 INTERCOMPANY RECEIVABLES 104068801 INVESTMENTS IN UNCONSOLIDATED ORGS - CONTROLLING INTEREST 1697903 RIGHT-OF-USE OPERATING LEASE 18995315 CHECK CLEARING 138375 UNCLAIMED PROPERTY 68641 FEDERAL INCOME TAXES 953395 OTHER ASSETS 12144775 138067205 0 MISC LIABILITY 5919 OTHER CURRENT LIABILITIES 5694 RETAINAGE FOR CIP 6205339 INTERCOMPANY PAYABLES 215421394 CURRENT PORTION OF OPERATING LEASE LIABILITY 5919210 LT PORTION OF OPERATING LEASE LIABILITY 12992555 SELF-INSURANCE RESERVES AND CLAIMS 12415080 252965191 X PART V, LINE 4: THE ENDOWMENT FUNDS AND THE PURPOSES FOR WHICH THEY ARE INTENDED, INCLUDE BUT ARE NOT LIMITED TO, APPLIED RESEARCH AND EDUCATION IN BIOMEDICAL ENGINEERING, CARDIOLOGY EDUCATION AND RESEARCH,DEVELOPMENTAL PROGRAMS RELATED TO INTERNAL MEDICINE, NUCLEAR MEDICINE, RADIOLOGY, ORTHOPEDIC RESEARCH AND NURSING EDUCATION. PART X, LINE 2: CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MEDICAL CENTER QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(A) AND IS DESCRIBED IN SECTION 501(C)(3) OF THE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS. SOUTH AMERICA 2 PROGRAM SERVICES MARKETING FEES 180050 MIDDLE EAST & NORTH AFRICA 0 PROGRAM SERVICES MARKETING FEES 45755 CENTRAL AMERICA & THE CARIBBEAN 0 PROGRAM SERVICES MARKETING FEES 24770 0 2 0 0 0 2 250575 0 250575 1 0 1 0 0 1 PART I, LINE 3: SOUTH AMERICA: ACCRUAL MIDDLE EAST & NORTH AFRICA: ACCRUAL CENTRAL AMERICA & THE CARIBBEAN: ACCRUAL PART III ACCOUNTING METHOD: 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 0 9617 39762497 39762497 0.03760 15211 102407395 62554725 39852670 0.03760 24828 142169892 62554725 79615167 0.07520 37299892 5021588 32278304 0.03050 1059334 1059334 0.00100 199464 199464 0.00020 38558690 5021588 33537102 0.03170 24828 180728582 67576313 113152269 0.10690 1 40965893 0 188874053 236180835 -47306782 X 1 1 1 1 CHI ST LUKE'S HEALTH BAYLOR ST LUKE'S MED CNTR 6720 BERTNER HOUSTON TX 77030 HTTPS://WWW.STLUKESHEALTH.ORG 118 X X X X X CHI ST LUKE'S HEALTH BAYLOR ST LUKE'S 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X SEE STATEMENT X 1 18 1 SEE STATEMENT 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X SEE STATEMENT X SEE STATEMENT X SEE STATEMENT X X X X X X 1 X 0 X X X X 1 X 0 0 CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MED CNTR PART V, SECTION B, LINE 5: FOR THE LATEST CHNA, THE HOSPITAL WORKED WITH THE EPISCOPAL HEALTH FOUNDATION WHICH HIRED HEALTH RESOURCES IN ACTION, A NONPROFIT PUBLIC HEALTH INSTITUTE, TO CONDUCT KEY INFORMANT INTERVIEWS WITH INFORMANTS IDENTIFIED BY THE HOSPITALS AND TO ANALYZE THOSE INTERVIEWS FOR KEY THEMES. A TOTAL OF 53 KEY INFORMANT INTERVIEWS WERE CONDUCTED. COMMUNITY INPUT ALSO INCLUDED EMAIL AND TELEPHONE SURVEYS OF RESIDENTS, AND FOCUS GROUPS INCLUDING HEALTH CARE STAFF, COMMUNITY ORGANIZATIONS AND OTHER STAKEHOLDERS. PARTICIPANTS REPRESENTED A WIDE RANGE OF COMMUNITY SECTORS, INCLUDING LOCAL PUBLIC HEALTH AND POOR AND MEDICALLY INDIGENT POPULATIONS IN THE COMMUNITY. ORGANIZATIONS REPRESENTED INCLUDE: CATHOLIC CHARITIES-FORT BEND, CHILD ADVOCATES OF FORT BEND, FORT BEND COUNTY HEALTH AND HUMAN SERVICES, FORT BEND REGIONAL COUNCIL ON SUBSTANCE ABUSE, FORT BEND SENIORS, FORT BEND WOMEN'S CENTER, THE ARC OF FORT BEND COUNTY, AIDS FOUNDATION OF HOUSTON, ASSOCIATION FOR THE ADVANCEMENT OF MEXICAN AMERICANS, AVENUE CDC, CHRIST CLINIC, COASTAL AREA HEALTH EDUCATION CENTERS, COMMUNITY HEALTH CHOICE, GREATER HOUSTON PARTNERSHIP, HEALTH CARE FOR THE HOMELESS-HOUSTON, HOPE CLINIC, HOUSTON AREA FOOD BANK, KINDER INSTITUTE, LEGACY COMMUNITY HEALTH, NEIGHBORHOOD CENTERS HEAD START/EARLY HEAD START PROGRAM SERVICES/BAKER RIPLEY, THE ROSE, LIBERTY COUNTY SHERIFF'S OFFICE, TRI COUNTY SERVICES BEHAVIORAL HEALTH CARE, PRAIRIE VIEW A&M, AND EL CENTRO DE CORAZON. CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MED CNTR PART V, SECTION B, LINE 6A: FOR THE LATEST CHNA, THE HOSPITAL COLLABORATED WITH SEVERAL OTHER HOSPITALS AND HOSPITAL SYSTEMS. CHI ST. LUKE'S FACILITIES INCLUDED: CHI ST. LUKE'S HEALTH BAYLOR MEDICAL CENTER , PATIENTS MEDICAL CENTER, SPRINGWOODS VILLAGE HOSPITAL, SUGAR LAND HOSPITAL, THE VINTAGE HOSPITAL, THE WOODLANDS HOSPITAL, AND LAKESIDE HOSPITAL. OTHER PARTICIPATING HOSPITALS WERE HOUSTON METHODIST HOSPITAL, MEMORIAL HERMANN HEALTH SYSTEM, AND TEXAS CHILDREN'S HOSPITAL. CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MED CNTR PART V, SECTION B, LINE 6B: EPISCOPAL HEALTH FOUNDATION CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MED CNTR PART V, SECTION B, LINE 11: THE SIGNIFICANT COMMUNITY HEALTH NEEDS THE HOSPITAL IS HELPING TO ADDRESS WERE IDENTIFIED IN THE HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. NEEDS BEING ADDRESSED BY STRATEGIES AND PROGRAMS ARE: ACCESS TO CARE, HUMAN TRAFFICKING, OBESITY, AND BEHAVIORAL HEALTH. THE HOSPITAL WILL TAKE ACTIONS TO HELP ADDRESS EACH OF THE SIGNIFICANT NEEDS. ACCESS TO CARE: DEFINE A PROCEDURE FOR TREATING AND/OR IDENTIFYING TRAFFICKED VICTIMS IN OUR FACILITIES AND COLLABORATING WITH COMMUNITY PARTNERS (THIS HAS REMAINED AN ONGOING EFFORT THAT HAS PROVEN MOST EFFECTIVE THROUGH OUR WORK WITH LOCAL LAW ENFORCEMENT AND HEALTHCARE PARTNERS); PROVIDE EDUCATION FOR STAFF AND COMMUNITY REGARDING SERVICES, CULTURAL DIFFERENCE THAT AFFECT TREATMENT; COLLABORATE WITH COMMUNITY ORGANIZATIONS, CHURCHES, CIVIC GROUPS AND SUPPORT GROUPS TO PRESENT EDUCATIONAL SEMINARS; FOSTER NEW RELATIONSHIPS WITH PRIMARY CARE PROVIDERS AND HEALTHCARE SERVICE PROVIDERS TO ASSIST LINKING HOSPITAL PATIENTS TO MEDICAL HOMES (THESE EFFORTS HAVE CONTINUED BUT ADDITIONAL WORK INCLUDES COMMUNICATION REFERENCING DIVERSITY AND INCLUSION WITH REGARD TO CULTURE STRESSORS THAT IMPACT BIAS AND POTENTIAL ACCESS TO CARE). HUMAN TRAFFICKING: INCREASE PREVENTION AND TREATMENT RESOURCES IN AREAS OF PHYSICAL/SEXUAL ABUSE, HUMAN TRAFFICKING AND VIOLENCE IN SCHOOLS; PARTNER WITH HOUSTON WOMEN'S CENTER TO EDUCATE STAFF ON SIGNS TO RECOGNIZE ABUSED PATIENTS; PARTNER WITH LAW ENFORCEMENT AND SOCIAL SERVICE ORGANIZATIONS TO INCREASE TRAUMA INFORMED CARE TO HUMAN TRAFFICKING VICTIMS (THESE EFFORTS HAVE CONTINUED STRONGLY. WE HAVE SHIFTED TO LARGELY VIRTUAL EDUCATION WITH OUR PARTNERS). OBESITY: PARTNER WITH SCHOOLS TO PROVIDE RESOURCES AND EDUCATIONAL SUPPORT FOR NUTRITION, OBESITY, AND HEALTHY LIFESTYLES AMONG YOUTH (LARGELY DUE TO SCHOOL CLOSURES, ACCESS TO CONSISTENT STUDENT POPULATIONS, AND STAFFING ISSUES, THE WORK TO EDUCATE HAS BEEN HINDERED. BEHAVIORAL HEALTH: DEVELOP RESOURCES IN THE EMERGENCY DEPARTMENT TO MANAGE NEEDS OF BEHAVIORAL HEALTH PATIENTS; STRENGTHEN COMMUNITY PARTNERSHIPS TO ADVOCATE FOR ADDITIONAL SUPPORT FOR BEHAVIORAL HEALTH SPECIALISTS TO WORK ALONGSIDE CAREGIVERS (WE CONTINUE TO PURSUE EDUCATION WITH FRONT LINE RESPONDERS REGARDING BEHAVIORAL HEALTH). CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MED CNTR PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD-PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A CHI HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. SCHEDULE H, PART V, SECTION B, LINE 7A - CHNA REPORT URL HTTPS://WWW.STLUKESHEALTH.ORG/ABOUT-ST-LUKES-HEALTH/HEALTHY-COMMUNITIES SCHEDULE H, PART V, SECTION B, LINE 10A - IMPLEMENTATION STRATEGY URL HTTPS://WWW.STLUKESHEALTH.ORG/ABOUT-ST-LUKES-HEALTH/HEALTHY-COMMUNITIES SCHEDULE H, PART V, SECTION B, LINE 16A - FAP AVAILABLE WEBSITE HTTPS://WWW.STLUKESHEALTH.ORG/PATIENTS-VISITORS/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16B - FAP APPLICATION FORM WEBSITE HTTPS://WWW.STLUKESHEALTH.ORG/PATIENTS-VISITORS/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16C - PLAIN LANGUAGE FAP SUMMARY WEBSITE HTTPS://WWW.STLUKESHEALTH.ORG/PATIENTS-VISITORS/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE 2 1 - BAYLOR ST LUKE'S MEDICAL CENTER - AMBUL 1977 BUTLER BLVD HOUSTON TX 77030 AMBULATORY SURGERY 2 - BAYLOR ST LUKE'S MEDICAL CENTER - ENDOS 7200 CAMBRIDGE 4TH FLOOR HOUSTON TX 77030 ENDOSCOPY PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: - THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. - THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 300% OF THE FPG. - THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP]. - THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: - RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS; - HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS CLINIC; - PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); - FOOD STAMP ELIGIBILITY; - SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; - ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID SPEND-DOWN); - LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR - PATIENT IS DECEASED WITH NO KNOWN ESTATE. PART I, LINE 7: THE COST TO CHARGE RATIO METHOD WAS UTILIZED TO DETERMINE FINANCIAL ASSISTANCE AT COST AS WELL AS TO DETERMINE UNREIMBURSED MEDICAID COSTS. TOTAL EXPENSES PER FORM 990, PART IX, LINE 25(A) WERE USED TO DETERMINE THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7(F). PART III, LINE 2: COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: CHI ST. LUKE'S HEALTH BAYLOR ST. LUKE'S MEDICAL CENTER ("MEDICAL CENTER") DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. PART III, LINE 4: PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION OF THE MEDICAL CENTER EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. PERFORMANCE OBLIGATIONS ARE GENERALLY SATISFIED OVER A PERIOD LESS THAN ONE YEAR. AS SUCH, THE MEDICAL CENTER HAS ELECTED TO APPLY THE OPTIONAL EXEMPTION PROVIDED IN FASB ACCOUNTING STANDARDS UPDATED (ASU) NO. 2015-14, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) AND IS NOT REQUIRED TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY UNSATISFIED AT THE END OF THE REPORTING PERIOD.THE MEDICAL CENTER ACCEPTS PATIENTS IN IMMEDIATE NEED OF CARE, REGARDLESS OF THEIR ABILITY TO PAY. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF ESTIMATED ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS, PRICE CONCESSIONS, AND OTHER DISCOUNTS. THE MEDICAL CENTER DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED TO UNINSURED AND UNDERINSURED PATIENTS IN ACCORDANCE WITH THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED AND UNDERINSURED PATIENTS. THE MEDICAL CENTER DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICY, AND HISTORICAL EXPERIENCE. THE MEDICAL CENTER DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THESE CLASSES OF PATIENTS USING A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO ACCOUNT FOR PATIENT CONTRACTS AS COLLECTIVE GROUPS RATHER THAN INDIVIDUALLY. MANAGEMENT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. UPDATES TO THE HINDSIGHT ANALYSIS ARE PERFORMED AT LEAST QUARTERLY USING PRIMARILY A ROLLING EIGHTEEN-MONTH COLLECTION HISTORY AND WRITE-OFF DATA. SUBSEQUENT CHANGES TO ESTIMATES OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT REVENUE IN THE PERIOD OF THE CHANGE.SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE RESULT OF AN ADVERSE CHANGE IN A THIRD-PARTY PAYOR'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE IN SERVICES AND OTHER IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. BAD DEBT EXPENSE FOR 2021 WAS NOT SIGNIFICANT.AGREEMENTS WITH THIRD-PARTY PAYORS TYPICALLY PROVIDE FOR PAYMENTS AT AMOUNTS LESS THAN ESTABLISHED CHARGES. NET PATIENT REVENUE INCLUDES ESTIMATED SETTLEMENTS UNDER PAYMENT AGREEMENTS WITH THIRD PARTY PAYORS. SETTLEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD IN WHICH THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. THESE SETTLEMENTS ARE ESTIMATED AND EVALUATED BASED ON THE TERMS OF THE PAYMENT AGREEMENT WITH THE PAYOR, CORRESPONDENCE FROM THE PAYOR, AND HISTORICAL SETTLEMENT ACTIVITY. PART III, LINE 8: COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $47,306,782 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. PART III, LINE 9B: THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY APPLIES TO ALL INDIVIDUALS PRESENTING FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE POLICY CONTAINS PROVISIONS FOR COLLECTING AMOUNTS DUE FROM THOSE PATIENTS WHO THE ORGANIZATION KNOWS TO QUALIFY FOR FINANCIAL ASSISTANCE EITHER THROUGH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS OR THROUGH PRESUMPTIVE ELIGIBILITY PROCESSES. BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS (ECAS) TO OBTAIN PAYMENT FOR EMCARE, HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IN NO EVENT WILL AN ECA BE INITIATED PRIOR TO 120 DAYS FROM THE DATE THE FACILITY PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT (I.E., DURING THE NOTIFICATION PERIOD) UNLESS ALL REASONABLE EFFORTS HAVE BEEN MADE.HOSPITAL FACILITIES WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HAS INITIALLY APPLIED FOR FINANCIAL ASSISTANCE, AND THE HOSPITAL FACILITY HAS NOT YET MADE REASONABLE EFFORTS WITH RESPECT TO THE ACCOUNT. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. PATIENTS WHO QUALIFY FOR MEDICAID ARE PRESUMED TO QUALIFY FOR FULL CHARITY WRITE OFF. ANY CHARGES FOR DAYS OR SERVICES WRITTEN OFF (EXCLUDING MEDICAID DENIALS RELATED TO TIMELINESS OF BILLING, INSUFFICIENT MEDICAL RECORD DOCUMENTATION, MISSING INVOICES, AUTHORIZATION, OR ELIGIBILITY ISSUES) AS A RESULT OF A MEDICAID ARE BOOKED AS CHARITY.SOME MEDICAID PLANS OFFER COVERAGE FOR A LIMITED OR RESTRICTED LIST OF SERVICES. IF A PATIENT IS ELIGIBLE FOR MEDICAID, ANY CHARGES FOR DAYS OR SERVICES NOT COVERED BY THE PATIENT'S COVERAGE MAY BE WRITTEN OFF TO CHARITY WITHOUT A COMPLETED APPLICATION. THIS DOES NOT INCLUDE ANY SHARE OF COST (SOC) OR OTHER PATIENT COST-SHARING AMOUNTS SUCH AS DEDUCTIBLES OR COPAYMENTS, AS SUCH COSTS ARE DETERMINED BY THE STATE TO BE AN AMOUNT THAT THE PATIENT MUST PAY BEFORE THE PATIENT IS ELIGIBLE FOR MEDICAID. HEALTH AND HUMAN SERVICES (HSS) USES THE TERM "SPEND DOWN" INSTEAD OF SHARE OF COST.ALL COLLECTION ACTIVITIES CONDUCTED BY THE FACILITY, A DESIGNATED SUPPLIER, OR ITS THIRD-PARTY COLLECTION AGENTS WILL BE IN CONFORMANCE WITH ALL FEDERAL AND STATE LAWS GOVERNING DEBT COLLECTION PRACTICES. ALL THIRD-PARTY AGREEMENTS GOVERNING COLLECTION AND RECOVERY ACTIVITIES MUST INCLUDE A PROVISION REQUIRING COMPLIANCE WITH THE HOSPITAL FACILITIES' FINANCIAL ASSISTANCE AND BILLING AND COLLECTIONS POLICY AND INDEMNIFICATION FOR FAILURES AS A RESULT OF ITS NONCOMPLIANCE. THIS INCLUDES, BUT IS NOT LIMITED TO, AGREEMENTS BETWEEN THIRD PARTIES WHO SUBSEQUENTLY SELL OR REFER DEBT OF THE HOSPITAL FACILITY. PART VI, LINE 2: THE CHNA IS THE PRIMARY WAY BY WHICH THE HOSPITAL FORMALLY ASSESSES COMMUNITY HEALTH NEEDS. PART VI, LINE 3: NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM CHI HOSPITAL ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO: - CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS; - NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND - PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT. SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE CHI HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.IN ADDITION, HOSPITAL REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. ONCE IT IS DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR ANY THIRD PARTY FUNDING, THE PATIENT IS VERBALLY NOTIFIED ABOUT THE EXISTENCE OF A FINANCIAL ASSISTANCE APPLICATION AND ADDITIONAL SCREENING TAKES PLACE BY A HOSPITAL EMPLOYEE TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY SERVICE PRIOR TO DISCHARGE. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY OF THAT POLICY, AND AN APPLICATION FOR ASSISTANCE. HOSPITAL REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON-ENGLISH-SPEAKING INDIVIDUALS. PATIENTS THAT HAVE BEEN DISCHARGED PRIOR TO CHARITY SCREENING, SUCH AS EMERGENCY ROOM PATIENTS, RECEIVE A WRITTEN NOTIFICATION OF POSSIBLE ELIGIBILITY FOR SERVICES. IF THE PATIENT IS DETERMINED NOT TO BE ELIGIBLE FOR GOVERNMENT ASSISTANCE, HE/SHE MAY NOTIFY THE HOSPITAL THAT THEY SEEK CHARITY ASSISTANCE. THE APPROPRIATE CHARITY FORM IS SENT TO THE PATIENT/GUARANTOR FOR COMPLETION AND THEN RETURNED TO THE HOSPITAL FOR EVALUATION AND QUALIFICATION. ONCE DETERMINATION OF ELIGIBILITY IS MADE, THE PATIENT IS SENT A NOTICE INFORMING HIM/HER IF THEY QUALIFY FOR FULL, PARTIAL, OR NO CHARITY CARE SERVICES.HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER ANY INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: THE COMMUNITY SERVED BY CHI ST. LUKE'S HEALTH IS DEFINED AS THE CONTIGUOUS ZIP CODES DETERMINED BY BAYLOR ST. LUKE'S HOSPITAL DISCHARGE DATA. LOCATED IN HOUSTON, TEXAS, THE BAYLOR ST. LUKE'S HOSPITAL SERVICE AREA INCLUDES A LARGE METROPOLITAN AREA, AS WELL AS MANY SMALLER SUBURBAN AND RURAL COMMUNITIES. THE HOSPITAL SERVICE AREA INCLUDES 39 TEXAS COUNTIES, WITH THE MAJORITY OF THE SERVICE AREA FOUND WITHIN HARRIS, FORT BEND, BRAZORIA, AND GALVESTON COUNTIES. BAYLOR ST. LUKE'S SERVES AN AREA THAT IS HOME TO A POPULATION OVER TWO MILLION RESIDENTS THAT REPRESENT DIVERSE ETHNICITIES, BACKGROUNDS AND NEEDS. KEY DESCRIPTORS OF THE COMMUNITY INCLUDE: AGE: THE LARGEST POPULATION IN THE COMMUNITY FALLS IN THE AGE CATEGORY OF 18-44 YEARS (38.2%). THE SECOND-LARGEST AGE CATEGORY IS 00-17 YEARS (26.3). THERE IS THE SMALLEST NUMBER OF PERSONS IS IN THE OLDEST TWO CATEGORIES OF 45-64 YEARS (24.2%) AND 65+ YEARS (11.3%). RACE/ETHNICITY: THE MAJORITY OF COMMUNITY RESIDENTS IDENTIFY AS HISPANIC (38.4%) AND WHITE/NON-HISPANIC (32.5%). 17.6% OF THE POPULATION IDENTIFIES AS BLACK/NON-HISPANIC AND 9.5% AS ASIAN/NON-HISPANIC.EDUCATION: 16.9% OF THE POPULATION HAD LESS THAN A HIGH SCHOOL DIPLOMA AND 31.7% HAD A BACHELOR'S DEGREE OR HIGHER.INCOME: 18.2% OF THE POPULATION HAS A HOUSEHOLD INCOME OF LESS THAN $25,000 PER YEAR, WHILE 44.2% HAD AN INCOME OF $75,000 OR MORE. PART VI, LINE 5: CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER CONTRIBUTES TO ENHANCING COMMUNITY HEALTH BY DELIVERING SUPERIOR VALUE IN HIGH-QUALITY, COST-EFFECTIVE CARE. AS A COMMUNITY TEACHING HOSPITAL AND A TERTIARY REFERRAL CENTER, CHI ST. LUKE'S SERVES BOTH THE GREATER HOUSTON AREA AND GLOBAL COMMUNITY. THE HOSPITAL ENGAGES IN MEDICAL RESEARCH THAT BENEFITS THE WIDER SOCIETY BY THE PRODUCTION OF NEW MEDICAL KNOWLEDGE. IN COLLABORATION WITH ITS MEDICAL STAFF, CHI ST. LUKE'S IS DEDICATED TO EXCELLENCE AND COMPASSION IN CARING FOR THE WHOLE PERSON - MIND, BODY AND SPIRIT. THE HOSPITAL PROMOTES HEALTH FOR THE BENEFIT OF THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. ITS BOARD OF TRUSTEES IS COMPOSED OF CITIZENS IN THE COMMUNITY. EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT IN PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. THE HOSPITAL TREATS PERSONS PAYING THEIR BILLS WITH THE AID OF PUBLIC PROGRAMS LIKE MEDICARE AND MEDICAID. ALL PATIENTS PRESENTING AT THE HOSPITAL FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH TREATMENT.ADDITIONALLY, CHI ST. LUKE'S HEALTH - BAYLOR ST. LUKE'S MEDICAL CENTER WORKED TO FURTHER ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH A VARIETY OF PROJECTS AND ACTIVITIES. EDUCATION/ STROKE (THESE ARE ALL CONTINUING VIA VIRTUAL PORTALS).STROKE SUPPORT GROUP: MEETS MONTHLY NEAR THE HOSPITAL- OPEN TO PATIENTS AND GENERAL PUBLIC. COMMUNITY SCREENINGS: STROKE SCREENING & EDUCATION CONDUCTED THROUGHOUT THE YEAR AT COMMUNITY EVENTS, HEALTH FAIRS AND SCHOOLS. TARGET POPULATION- BROAD COMMUNITY.AMERICAN HEART/STROKE WALK - THE HEART WALK IS THE AMERICAN HEART ASSOCIATION'S PREMIERE EVENT FOR RAISING FUNDS TO SAVE LIVES FROM THIS COUNTRY'S NO. 1 AND NO. 5 KILLERS - HEART DISEASE AND STROKE. EMPLOYEES VOLUNTEER ONE DAY IN NOVEMBER TO HELP WITH ACTIVITIES.FOR MORE INFORMATION REGARDING THE HOSPITAL'S ACTIVITIES AND ACCOMPLISHMENTS, PLEASE VISIT HTTP://WWW.CHISTLUKESHEALTH.ORG/BAYLORSTLUKES. PART VI, LINE 6: ST. LUKE'S HEALTH SYSTEM CORPORATION IS A SEPARATE LEGAL ENTITY AND IS A TEXAS NONPROFIT MEDICAL EDUCATION CORPORATION UNDER THE DIRECTION OF CHI AND A SEPARATE BOARD OF DIRECTORS. THE SYSTEM PROVIDES DIRECT SERVICES AND EMPLOYEES TO BCMMC FOR THE OPERATION OF THE MEDICAL CENTER. ALL OF THE MEDICAL CENTER EMPLOYEES ARE CONTRACTED FROM THE SYSTEM. THE SYSTEM CHARGES THE MEDICAL CENTER FOR THE WAGES AND BENEFITS PAID TO THESE EMPLOYEES, WHICH ARE REFLECTED AS PERSONNEL COSTS IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. THE SYSTEM PROVIDES CORPORATE SERVICES FOR HUMAN RESOURCES, FINANCE, INFORMATION MANAGEMENT, PURCHASING, COMPLIANCE, MANAGED CARE CONTRACTING, LEGAL, RISK MANAGEMENT, MEDICAL RECORDS, PATIENT FINANCIAL SERVICES, AND QUALITY.BAYLOR COLLEGE OF MEDICINE IS A SEPARATE LEGAL ENTITY AND IS A TEXAS NONPROFIT MEDICAL EDUCATION CORPORATION UNDER THE DIRECTION OF A SEPARATE BOARD OF DIRECTORS. THE MEDICAL CENTER EXECUTED AN ACADEMIC AFFILIATION AGREEMENT WITH BCM EFFECTIVE JANUARY 1, 2014. UNDER THIS AGREEMENT, AS AMENDED, BCM PROVIDES OVERSIGHT AND MANAGEMENT OF MAJOR CLINICAL PROGRAMS, RESEARCH SERVICES, MEDICAL DIRECTORSHIPS, COVERAGE SERVICES FOR KEY AREAS, GRADUATE MEDICAL EDUCATION, AND MISCELLANEOUS SERVICES. PART VI, LINE 7, REPORTS FILED WITH STATES TX 1 WINNIE-STOWELL HOSPITAL PO BOX 1997 WINNIE TX 77665 611500560 46600 PROGRAM SUPPORT JOHN STATIN DBA PRIVATE CARE 3318 ENDICOTT LANE PEARLAND TX 77584 851430358 56000 PROGRAM SUPPORT SAN JOSE CLINIC 2615 FANNIN ST HOUSTON TX 77002 760373703 501-C-3 319095 PROGRAM SUPPORT PARAGON INFUSION CARE 6721 PORTWEST DR SUITE 100 HOUSTON TX 77024 061639157 16033 PROGRAM SUPPORT 1 3 PART I, LINE 2: THE ORGANIZATION GRANTS FUNDS TO OTHER ORGANIZATIONS AND REQUIRES ALL GRANT RECIPIENTS TO MEASURE THEIR SUCCESS IN ATTAINING PROGRAM GOALS. 1 1 0 0 0 0 0 0 0 T DOUGLAS LAWSON PHD EX-OFFICIO/CEO SLHS 958843 0 1006996 0 150480 0 182377 0 21437 0 2320133 0 117000 0 ELIZABETH YOUNGBLOOD PRESIDENT BSLMC/SVP & COO SLHS 584769 0 234098 0 4083 0 73684 0 22168 0 918802 0 0 0 BRADLEY LEMBCKE CMO BSLMC/ SVP & CMO SLHS 554613 0 178484 0 4083 0 17641 0 37714 0 792535 0 0 0 MARK TERESI INTERIM CFO OF SLHS 625246 0 0 0 0 0 0 0 0 0 625246 0 0 0 JOHN BYRNE FORMER MKT SVP-MEDICAL OPERATIONS 54019 0 23920 0 532376 0 9647 0 55 0 620017 0 0 0 VERONICA MARTIN DIV SVP CNO 314483 0 56976 0 1694 0 9098 0 13025 0 395276 0 0 0 GAY NORD FORMER PRESIDENT 0 0 0 0 352194 0 0 0 0 0 352194 0 0 0 CAROLYN DOUGLAS-CURRY RN II 284389 0 2506 0 5593 0 12735 0 34881 0 340104 0 0 0 TANIA MATAR SYS VP INTERNAL HEALTH SVCS 218520 0 92003 0 1075 0 16600 0 4409 0 332607 0 0 0 JASON PELTON MD CARDIOLOGIST 285260 0 0 0 21226 0 2565 0 2591 0 311642 0 0 0 PRISCILLA NEEDHAM TREASURER/VP-FINANCE (PARTIAL YEAR) 255342 0 0 0 587 0 13046 0 19584 0 288559 0 0 0 ALENE JACKSON DIRECTOR-PATIENT CARE (PARTIAL YEAR) 162947 0 8919 0 839 0 11571 0 13416 0 197692 0 0 0 JESUS GOMEZ TREASURER/VP-FINANCE 168745 0 6646 0 349 0 10124 0 2442 0 188306 0 0 0 PART I, LINES 4A-B COMPENSATION FOR BAYLOR ST. LUKE'S MEDICAL CENTER IS DETERMINED BY COMMONSPIRIT HEALTH (CSH), AN AFFILIATE OF ST. LUKE'S HEALTH SYSTEM CORPORATION. THE FOLLOWING DISCLOSURE EXPLAINS CSH'S PROCESSES IN DETERMINING COMPENSATION FOR ST. LUKE'S MEDICAL CENTER EMPLOYEES. FOR REPORTABLE INDIVIDUALS EMPLOYED PRIOR TO 2019, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. OFFICERS, KEY EMPLOYEES AND CERTAIN HIGHLY COMPENSATED EMPLOYEES WHO BEGAN EMPLOYMENT AFTER NOVEMBER 1ST OF 2019 ARE COVERED BY THE COMMONSPIRIT HEALTH EXECUTIVE SEVERANCE POLICY. THIS POLICY PROVIDES FOR SEVERANCE PAY WHICH VARIES BASED UPON THE EXECUTIVE'S POSITION LEVEL, IN THE EVENT OF A POSITION ELIMINATION OR OTHER QUALIFYING EVENT, IN ACCORDANCE WITH THE GUIDELINES OF THE EXECUTIVE SEVERANCE POLICY. AN EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT SHALL CONTROL WHERE THE SEVERANCE PAY AMOUNTS IN THE POLICY CONFLICT WITH THE EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT. IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT OF CLAIMS. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM CSH DURING THE 2020 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): GAY NORD, $352,194; JOHN BYRNE, $531,737. DURING THE 2020 CALENDAR YEAR, COMMONSPIRIT MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/HOSPITAL PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2020 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: T. DOUGLAS LAWSON, $136,636. SCHEDULE J, PART II - COMPENSATION FROM AN UNRELATED ORGANIZATION LIST OF OFFICERS WHO RECEIVED COMPENSATION FROM COMMONSPIRIT HEALTH, AN UNRELATED ORGANIZATION: T. DOUGLAS LAWSON, PHD - $2,320,133 LIST OF OFFICERS, AND KEY EMPLOYEES WHO RECEIVED COMPENSATION FROM ST. LUKE'S HEALTH SYSTEM CORPORATION, AN UNRELATED ORGANIZATION: ELIZABETH YOUNGBLOOD - $525,274 BRADLEY LEMBCKE - $452,820 MARK TERESI - $625,246 JESUS GOMEZ - $178,182 LIST OF HIGHEST COMPENSATED EMPLOYEES WHO RECEIVED COMPENSATION FROM JACK STEPHENS HEART INSTITUTE, AN UNRELATED ORGANIZATION: JASON PELTON, MD - $244,092 FORM 990, PART V, LINE 1A - FORM 1096 REPORTING PAYMENTS TO VENDORS ARE MADE BY COMMONSPIRIT HEALTH (CSH), AN AFFILIATE OF ST. LUKE'S HEALTH SYSTEM CORPORATION, ON BAYLOR ST. LUKE'S MEDICAL CENTER'S BEHALF. THEREFORE, NO FORM 1099S ARE ISSUED BY THE ORGANIZATION. CSH FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. THE 1099S ISSUED BY CSH ON BEHALF OF THE ORGANIZATION ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 1 PURSUANT TO SECTION 8.5 OF THE BYLAWS OF CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER, THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, AT LEAST ONE BCM APPOINTEE, AND AT LEAST ONE ST. LUKE'S APPOINTEE, AND THE PRESIDENT, WHO SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY VOTING BOARD MEMBERS OF THE CORPORATION. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY VOTING BOARD MEMBERS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.5 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS, BOTH CHI ST. LUKE'S HEALTH SYSTEM CORPORATION, A TEXAS NONPROFIT CORPORATION, AND BAYLOR COLLEGE OF MEDICINE SHALL BE MEMBERS OF CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO THE OTHER ACTIONS SPECIFIED IN THE BYLAWS REQUIRING THE APPROVAL OF BOTH CORPORATE MEMBERS, THE FOLLOWING ACTIONS SHALL REQUIRE THE PRIOR APPROVAL OF SOLELY BAYLOR COLLEGE OF MEDICINE ("BCM"): (A) ANY SUBSTANTIAL CHANGE TO THE MISSION, VALUES, PURPOSE, OR GENERAL CHARACTER OF THE CORPORATION; (B) INCURRENCE OF DEBT BY THE CORPORATION THAT RESULTS IN THE CORPORATION MAINTAINING AN EQUIVALENT MOODY'S RATING OF BBB OR LOWER; (C) ADMISSION OF ANY NEW MEMBERS OF THE CORPORATION; (D) MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION, OR BANKRUPTCY OF THE CORPORATION; (E) CHANGES IN TAX-EXEMPT STATUS OF THE CORPORATION OR ANY CHANGE THAT CAUSES A CHANGE IN THE CORPORATION'S TAX-EXEMPT STATUS; (F) TRANSFER OF MEMBERSHIP INTERESTS IN THE CORPORATION OTHER THAN AS PERMITTED BY THE MEMBERSHIP AGREEMENT; (G) AGREEMENTS WITH AN ANNUAL VALUE OF $2.5 MILLION OR MORE (OR AMENDMENTS TO AGREEMENTS) WITH AFFILIATES OF THE CORPORATE MEMBERS (I.E., ANY AGREEMENT BETWEEN THE CORPORATION, ON THE ONE HAND, AND CHI ST. LUKE'S, BCM OR ANY OF THEIR RESPECTIVE AFFILIATES, ON THE OTHER HAND); PROVIDED, HOWEVER, THAT THE CORPORATION SHALL BE PERMITTED, WITHOUT APPROVAL OF BCM TO ENTER INTO ANY AGREEMENTS AS MAY BE PROVIDED IN THE MEMBERSHIP AGREEMENT; (H) SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (I) ANY CHANGE TO THE NAME OF THE MEDICAL CENTER; (J) ANY CHANGES TO THE CORPORATION'S MEDICAL STAFF BYLAWS THAT WOULD AFFECT ACADEMIC ACCREDITATION, THE MEDICAL STAFF LEADERSHIP APPOINTMENT PROCESS; (K) ANY MATERIAL CHANGES TO THE CORPORATION'S MEDICAL STAFF APPOINTMENT PROCESS THAT ADVERSELY AFFECTS BCM; (L) APPROVAL OF THE CORPORATION'S STRATEGIC PLANS; (M) ELIMINATION OF ANY OF THE CORPORATION'S SERVICE LINES OR PROGRAMS REQUIRED FOR ACADEMIC ACCREDITATION OF BCM AND NOT DUE TO FINANCIAL EXIGENCY; (N) SALE OR CONVEYANCE OF ANY REAL PROPERTY OR BUILDING LOCATED AT THE MEDICAL CENTER; (O) SUBJECT TO THE MEMBERSHIP AGREEMENT, ADDITIONAL CAPITAL CONTRIBUTION OR OTHER CONTRIBUTIONS OR ASSUMPTION OR GUARANTEE OF DEBT BY BCM; AND (P) APPROVAL OF THE MASTER FACILITY PLAN AS RELEVANT TO THE MEDICAL CENTER, IN ADDITION TO THE OTHER ACTIONS SPECIFIED IN THE BYLAWS REQUIRING THE APPROVAL OF BOTH CORPORATE MEMBERS, THE FOLLOWING ACTIONS SHALL REQUIRE THE PRIOR APPROVAL OF SOLEY ST. LUKE'S HEALTH SYSTEM CORPORATION ("CHI ST. LUKE'S"): (A) ANY SUBSTANTIAL CHANGE TO THE MISSION, VALUES, PURPOSE, OR GENERAL CHARACTER OF THE CORPORATION; (B) ADMISSION OF ANY NEW MEMBERS OF THE CORPORATION; (C) MERGER, CONSOLIDATION, REORGANIZATION, DISSOLUTION, OR BANKRUPTCY OF THE CORPORATION; (D) CHANGES IN TAX-EXEMPT STATUS OF THE CORPORATION OR ANY CHANGE THAT CAUSES A CHANGE IN THE CORPORATION'S TAX-EXEMPT STATUS; (E) TRANSFER OF MEMBERSHIP INTERESTS IN THE CORPORATION OTHER THAN AS PERMITTED BY THE MEMBERSHIP AGREEMENT; (T) AGREEMENTS WITH AN ANNUAL VALUE OF $2.5 MILLION OR MORE (OR AMENDMENTS TO AGREEMENTS) WITH AFFILIATES OF THE CORPORATE MEMBERS (I.E., ANY AGREEMENT BETWEEN THE CORPORATION, ON THE ONE HAND, AND CHI ST. LUKE'S, BCM OR ANY OF THEIR RESPECTIVE AFFILIATES, ON THE OTHER HAND); PROVIDED, HOWEVER, THAT THE CORPORATION SHALL BE PERMITTED, WITHOUT APPROVAL OF BCM, TO ENTER INTO ANY AGREEMENTS AS MAY BE PROVIDED IN THE MEMBERSHIP AGREEMENT; (G) SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (H) CONSISTENT WITH THE PRESIDENT SEARCH PROCESS SET FORTH IN SECTION 7.2.1 OF THE BYLAWS, THE APPOINTMENT AND REMOVAL OF THE CORPORATION'S PRESIDENT; (I) APPROVAL OF THE CORPORATION'S STRATEGIC PLANS; (J) ANY CHANGE TO THE CORPORATION'S FACILITY NAME; (K) ANY CHANGES TO THE CORPORATION'S MEDICAL STAFF BYLAWS THAT AFFECT ACADEMIC ACCREDITATION OR THE MEDICAL STAFF LEADERSHIP APPOINTMENT PROCESS; AND (L) OTHER RESERVE POWERS AS REQUIRED BY GAAP TO EFFECT ECONOMIC CONSOLIDATION ON CHPS FINANCIAL STATEMENTS; PROVIDED, HOWEVER, THAT, IN THE SPIRIT OF THE CORPORATE MEMBERS' AGREEMENT IN THE MEMBERSHIP AGREEMENT, ANY SUCH ADDITIONAL RESERVE POWERS WILL BE MINIMIZED TO THE MAXIMUM EXTENT POSSIBLE SO AS TO LIMIT TO THE MAXIMUM EXTENT POSSIBLE THE IMPACT ON THE CORPORATE MEMBERS' RIGHTS AND OBLIGATIONS SET FORTH IN THE MEMBERSHIP AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS MADE AVAILABLE TO THE OFFICERS AND DIRECTORS BEFORE FILING. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. THE POLICY WAS LAST UPDATED DURING THE TAX YEAR ENDED 6/30/2021. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY. - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP (WHICH INCLUDES KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE). DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. FORM 990, PART VI, SECTION B, LINE 15B COMPENSATION FOR THE OTHER OFFICERS OF THE ORGANIZATION WAS ESTABLISHED BY THE HUMAN RESOURCES DIRECTOR USING COMPENSATION SURVEYS OR STUDIES BASED ON GEOGRAPHICAL LOCATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, LINE 14 WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY: ST LUKE'S HEALTH SYSTEM CORPORATION AND RELATED ENTITIES HAVE A WRITTEN GENERAL POLICY RELATED TO DOCUMENT RETENTION AND DESTRUCTION. DOCUMENTS AND RECORDS ARE RETAINED FOR VARIOUS FEDERAL, STATE OR OTHER JURISDICTION STATUTES FOR MEDICAL OR FINANCIAL REVIEW ON A DEPARTMENT BY-DEPARTMENT BASIS. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 1,204,341. MANAGEMENT AND GENERAL EXPENSES 63,386. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,267,727. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 13,487,193. MANAGEMENT AND GENERAL EXPENSES 1,498,577. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,985,770. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 66,703,403. MANAGEMENT AND GENERAL EXPENSES 3,510,705. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 70,214,108. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 41,014,388. MANAGEMENT AND GENERAL EXPENSES 2,158,652. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 43,173,040. OTHER FEES: PROGRAM SERVICE EXPENSES 99,781,589. MANAGEMENT AND GENERAL EXPENSES 5,251,663. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,033,252. FORM 990, PART XI, LINE 9: REALLOCATION OF CARES ACT REVENUE 80,835. NONCONTROLLING INTEREST IN OWNERSHIP CHANGES -5,625,000. BENEFICIAL INTEREST ADJUSTMENT 2,488,768. FORM 990, PART XI, LINE 8 PRIOR PERIOD ADJUSTMENT: CENTRALIZED TRANSACTIONS: TRANSFERS FOR JOURNAL ENTRIES RECORDED CENTRALLY AT COMMONSPIRIT TO STANDARDIZE CONTRACTUAL ALLOWANCE METHODOLOGY ACROSS ALL COMMONSPIRIT AFFILIATES AND SUBSIDIARIES. RECORDED CENTRALLY AT YEAR END AND TRANSFERRED TO FACILITIES IN THE FOLLOWING YEAR. ST LUKE'S MEDICAL TOWER CORPORATION 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760531713 PROPERTY MGMT TX 501(C)(3) LINE 12A, I CHI-SLHBCM 1 CHI ST LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER CONDOMINIUM 6624 FANNIN ST STE 1100 HOUSTON TX 77030 465079545 CONDO ASSOC TX CHI-SLHBCM C 1.00000 1 ST LUKE'S EPISCOPAL HOSPITAL PHYSICIAN HOSPITAL ORGANIZATION INC 6720 BERTNER MC4-262 HOUSTON TX 77030 760377932 PHO TX CHI-SLHBCM C 1.00000 1 THE TEXAS HEART INSTITUTE AT ST LUKE'S EPISCOPAL HOSPITAL DENTON A COOLEY B 6624 FANNIN ST STE 1100 HOUSTON TX 77030 900064009 CONDO ASSOC TX CHI-SLHBCM C 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0