2022-08-11T18:24:54-05:00 2021-09-30 861065772 Deloitte Tax LLP 695 Town Center Drive Suite 1200 Costa Mesa CA 926261924 990 2020-10-01 562570681 St Luke's Health System Ltd STLU 2087069585 190 E Bannock Boise ID 83712 Pete DiDio Vice President, Controller 2087069585 2022-08-11 1 Pete DiDio 999009999 John Sadoff Jr P00540589 7144367100 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Chris Roth 190 E Bannock Boise ID 83712 658388132 0 X www.stlukesonline.org X 2006 ID Management of the delivery of healthcare services. 16 12 17230 390 1690000 0 1999976 11291338 590290550 622881086 -105381 18000226 2724699 5475482 594909844 657648132 7539036 6216009 0 0 418838218 455350719 0 0 0 168532590 195949809 594909844 657516537 0 131595 576024199 557259828 606189523 596995384 -30165324 -39735556 To improve the health of the people in the communities we serve. 0 0 506914681 6216009 622881086 St. Luke's Health System (SLHS) supports and oversees the operations of qualified inpatient and outpatient care services for all of the supported hospital organizations within SLHS, including St. Luke's Regional Medical Center, Ltd., St. Luke's Wood River Medical Center, Ltd., St. Luke's Magic Valley Regional Medical Center, Ltd., St. Luke's McCall, Ltd. and St. Luke's Nampa Medical Center, Ltd.In addition, St. Luke's Health Foundation, Ltd., St. Luke's Clinic Coordinated Care, Ltd. (Accountable Care Organization), and Select Medical Network of Idaho, Inc. (Clinical Integration Network) receive administrative and operational support within SLHS. 506914681 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 1 1 1039 0 1 17230 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 16 12 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X Peter DiDio Vice-President Controller 2087069585 190 E Bannock Boise ID 83712 X Chris Roth CEO & Director 40.00 14.00 X X 1091130 0 50570 Bob Lokken Chair (Start 11/2020) 1.00 2.50 X X 0 0 0 Rich Raimondi Chair (End 11/2020) 1.00 4.50 X X 0 0 0 Alan Korn MD Director 1.00 2.50 X 0 0 0 Andy Scoggin Director 1.00 2.50 X 0 0 0 Arthur F Oppenheimer Director 1.00 2.50 X 0 0 0 Bill Whitacre Director 1.00 2.50 X 0 0 0 Brigette Bilyeu Director 1.00 2.50 X 0 0 0 Dan Krahn Director 1.00 2.50 X 0 0 0 Jeff Fox Director (End 5/2021) 1.00 2.50 X 0 0 0 Jon Miller Director 1.00 2.50 X 0 0 0 Karen Vauk Director 1.00 2.50 X 0 0 0 Lisa Grow Director 1.00 2.50 X 0 0 0 Lucie DiMaggio MD Director 1.00 2.50 X 0 0 0 Mark Durcan Director 1.00 2.50 X 0 0 0 Rosa Davila Director (Start 9/2021) 1.00 2.50 X 0 0 0 Tom Corrick Director 1.00 2.50 X 0 0 0 Jeffrey S Taylor SR VP/CFO/Treasurer 40.00 12.00 X 785231 0 47998 Christine Neuhoff SVP/Chief Legal Officer/Secretary 40.00 12.00 X 733152 0 41525 Pamela Lindemoen SVP COO (End 3/2021) 40.00 12.00 X 916656 0 19741 James Souza MD SVP, Chief Physician Executive 40.00 2.00 X 749482 0 43608 David Self SVP, Chief Admin Officer 40.00 2.00 X 611107 0 26237 Nathan Green MD Physician 40.00 0.00 X 853294 0 46247 Barton F Hill MD VP,Chief Quality Officer 40.00 0.00 X 661364 0 46895 Robert Cavagnol MD President, St. Luke's Clinic 40.00 2.00 X 516488 0 27134 Cynthia Gearhard CNO VP Patient Care Svcs SLHS 40.00 0.00 X 499575 0 35916 Robert Walker MD Physician 40.00 0.00 X 754409 0 38835 David C Pate MD JD Former President & CEO 0.00 0.00 X 508200 0 5406 Maureen O'Keeffe Former VP 0.00 0.00 X 139766 0 0 8819854 0 430112 1942 1 1 0 Layton Construction Co 9090 S Sandy Parkway Sandy UT 84070 Construction 13990795 Compunet Inc 1111 S Silverstone Way Meridian ID 83642 IT Projects/Consulting 7790978 EPIC Systems Corp 1979 Milky Way Verona WI 53593 IT Projects/Consulting 5309795 Infor US 641 Avenue of the Americas New York NY 10011 Data & Analytics 3709141 CM Company Inc 431 West McGregor Drive Boise ID 83705 Construction 3293039 268 507006 7485518 3298814 11291338 Admin Services 561000 621191086 621191086 Joint Venture Income/L 900099 1690000 1690000 622881086 18066290 18066290 5122278 0 5122278 5122278 5122278 673936 740000 -66064 -66064 -66064 Cafeteria/Catering/Ven 722514 353204 353204 353204 657648132 621191086 1690000 23475708 6216009 6216009 5303830 5303830 125432 125432 255929036 209086639 46842397 46669491 37335593 9333898 129361314 103489051 25872263 17961616 14369293 3592323 14350691 11480553 2870138 3149859 3149859 489681 489681 174633 174633 94445 94445 12902032 6742113 6159919 705301 564241 141060 2594767 52955 2541812 53100562 26550281 26550281 18971 18971 607924 159872 448052 549507 549507 31496345 31496345 10224345 10224345 Supplies 17881110 17881110 Allocated SLHS Expense 13398188 13398188 Collection Services 10240812 9083836 1156976 Telephone 5270281 850 5269431 18700355 8764436 9935919 657516537 506914681 150601856 0 9640973 39623936 89917278 92996360 5581711 3875673 8447826 4831202 8046069 8213414 19942968 13210294 547904537 409516716 184227915 138387821 231182186 223350389 13281488 8983554 5755785 23787185 576024199 557259828 253677363 253839902 12278521 12304010 340233639 330851472 606189523 596995384 X -30165324 -39735556 -30165324 -39735556 576024199 557259828 X 131595 -9701827 X 0 1 X 1 1 1 X X X 7 St Luke's Regional Medical Center Ltd 820161600 3 1 0 0 St Luke's Magic Valley Regional Medical Center Ltd 562570686 3 1 0 0 St Luke's Health Foundation Ltd 810600973 7 0 0 0 St Luke's McCall Ltd 273311774 3 1 0 0 St Luke's Clinic Coordinated Care Ltd 455195864 10 0 0 0 St Luke's Wood River Medical Center Ltd 841421665 3 1 0 0 St Luke's Nampa Medical Center Ltd 821162805 3 1 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 Schedule A, Part IV, Section A, Line 1: The governing documents for St. Luke's Health System, Ltd. (SLHS) lists the following entities of which it is the sole member: 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 Nampa Medical Center, Ltd. In addition, SLHS is the sole member of the following organizations that are not listed within its bylaws, but are listed in Schedule A, Part 1, line 12g: St. Luke's Clinic Coordinated Care, Ltd. St. Luke's Health Foundation, Ltd. In addition, SLHS is the sole member of the following organization that is not listed within its bylaws, and is not listed in Schedule A, Part 1, line 12g because it is not a 509 (a) (1), (2), (3) organization: Select Medical Network of Idaho, Inc. (dba St. Luke's Health Partners) SLHS provides administrative and management oversight to this entity. Schedule A, Part IV, Section E, Line 3a: The board composition of the following supported organizations is identical to the board composition for SLHS: 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 Nampa Medical Center, Ltd. The following entities have separate boards: St. Luke's Clinic Coordinated Care,Ltd. St. Luke's Health Foundation,Ltd With the exception of ex-officio board members, the election or appointment of the members of the board of directors for these supported organizations are subject to the approval by the SLHS board of directors. In other words, the supporting organizations can elect and appoint their board members. However, these appointments are subject to the approval of the SLHS Board of directors. Schedule A, Part IV, Section E, Line 3b: To ensure consistency in the execution of its strategic goals across all of its supported organizations' operations, St. Luke's Health System, Ltd., through its board of directors, committees, and management structure, has established various policies, procedures and support functions which include, but are not limited to, the following: (1) Human Resource Policies (2) Financial Assistance Policies (3) Bad Debt and Collections Policies (4) Finance support functions, including payroll processing, accounts payable, supply chain management, procurement, budgeting, financial reporting and treasury. (5) Credentialing of physicians (6) Physician Services Administration (7) Information technology Support (8) Environmental Services (9) Property Management (10) Construction (11) Patient Safety (12) Legal (13) Compliance (14) Internal Audit (15) Risk Management RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 174633 174633 174633 174633 506914682 506914682 507089315 507089315 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 490674 141541 157948 174633 964796 250000 250000 250000 250000 1000000 1500000 7868258 747046 7121212 619675 619675 0 488769796 408078644 80691152 50646808 71351 50575457 138387821 Professional Liability 24217754 Workers Comp 3092943 Health Insurance IBNR 13037594 LT Disability 8010070 SERP Plan Accrued Tax Grossup -76376 SERP DC Plan 5074492 SERP Liability 24304061 Annual Employer Contribution Plan 30001049 ESL Liability 9365432 457 Plan Liability 80538592 CAAII Plan Liability 618965 CMS Accel Pmt Liabilty 130997282 Unemployment reserve 64946 Other Liabilities -5742299 Accr'd Std Benefit-25% 7346967 330851472 X Part X, Line 2: Footnote Disclosure-Uncertain Tax Positions Under ASC 740 (Source: Consolidated Financial Statements-St. Luke's Health System) 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 a taxable subsidiary, SLHP, 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 on the basis of 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 Ageless Senior Center Inc PO Box 403 Kimberly ID 833410403 820303448 501(c)(3) 9500 Support Ageless Senior Center Inc American Cancer Society 250 Williams St Atlanta GA 303031002 131788491 501(c)(3) 7000 Support American Cancer Society American Heart Association 270 S Orchard St Boise ID 83705 135613797 501(c)(3) 15000 Support American Heart Association Americas Essential Hospitals PO Box 404058 Atlanta GA 303844058 521236600 501(c)(6) 121500 Support Americas Essential Hospitals Assistance League Of Boise PO Box 140104 Boise ID 83714 820331595 501(c)(3) 10000 Support Assistance League Of Boise Baker School District 5J 2090 4Th Street Baker City OR 97814 936000179 GOVERNMENT ENTITY 10000 Support Baker School District 5J Because Kids Grieve Inc PO Box 5533 Twin Falls ID 83301 820525955 501(c)(3) 7000 Support Because Kids Grieve Inc Big Brothers Big Sisters Of Sw Id Inc 7609 Emerald St Boise ID 83702 820349401 501(c)(3) 18000 Support Big Brothers Big Sisters Of Sw Id Inc Bishop Kelly High School 7009 Franklin Rd Boise ID 83709 820332399 501(c)(3) 20000 Support Bishop Kelly High School Bogus Basin Mountain Resorts 2600 Bogus Basin Rd Boise ID 83702 820212207 501(c)(3) 80000 Support Bogus Basin Mountain Resorts Boise Bicycle Project 1027 S Lusk St Boise ID 83706 800268725 501(c)(3) 15000 Support Boise Bicycle Project Boise Professional Baseball 5600 N Glenwood St Boise ID 83714 471615125 501(c)(3) 35000 Support Boise Professional Baseball Boise Public Schools Educ Fndn 8169 West Victory Road Boise ID 83709 820400689 501(c)(3) 20000 Support Boise Public Schools Educ Fndn Boise State Univ Fndn 2225 University Drive Boise ID 83706 826010706 501(c)(3) 35000 Support Boise State Univ Fndn Boise State University 1910 University Drive Boise ID 837251247 820290701 GOVERNMENT ENTITY 16000 Support Boise State University Boys And Girls Club Of Ada 610 E 42Nd St Garden City ID 83714 820481687 501(c)(3) 10000 Support Boys And Girls Club Of Ada Boys And Girls Club Of Mv 999 Frontier Rd Twin Falls ID 83301 943176622 501(c)(3) 17450 Support Boys And Girls Club Of Mv Boys And Girls Club Of Nampa 316 Stampede Dr Nampa ID 83687 820504332 501(c)(3) 10500 Support Boys And Girls Club Of Nampa Boys And Girls Club Of W Tv PO Box 876 Ontario OR 97914 208035378 501(c)(3) 10000 Support Boys And Girls Club Of W Tv Business Plus Inc PO Box 929 Twin Falls ID 833030929 203898333 501(c)(3) 6000 Support Business Plus Inc Camp Rainbow Gold 216 W Jefferson Boise ID 83702 900961926 501(c)(3) 105000 Support Camp Rainbow Gold Canyon County 111 N 11Th Ave Ste 320 Caldwell ID 83605 826000290 GOVERNMENT ENTITY 10000 Support Canyon County CATCH Inc 503 S Americana Blvd Boise ID 83702 273483457 501(c)(3) 10000 Support CATCH, Inc. Childrens Home Society Of Id 740 Warm Springs Ave Boise ID 83712 820201128 501(c)(3) 20000 Support Childrens Home Society Of Id City Of Boise 150 N Capitol Blvd Boise ID 83702 826000165 GOVERNMENT ENTITY 219800 Support City Of Boise City Of Good Inc 246 8Th Street Boise ID 83702 850616750 501(c)(3) 10000 Support City Of Good Inc City Of Mountain Home 160 S 3Rd E Mountain Home ID 83647 826000229 GOVERNMENT ENTITY 40000 Support City Of Mountain Home Council School District 13 101 E Bleeker Ave Council ID 83612 826004153 GOVERNMENT ENTITY 5500 Support Council School District 13 Create Common Good 2760 W Excursion Lane Meridian ID 83642 931277434 501(c)(3) 12212 Support Create Common Good David A Hindson Md PO Box 393 Boise ID 83702 800279825 501(c)(3) 45453 Support David A Hindson Md Elderly Opportunity Agency Inc 134 N Washington Ave Emmett ID 83617 820306372 501(c)(3) 10000 Support Elderly Opportunity Agency Inc Everybody House 360 Shoshone St E Twin Falls ID 83301 854166686 501(c)(3) 19950 Support Everybody House Faces Of Hope Foundation 417 S 6Th St Boise ID 83702 204883532 501(c)(3) 45000 Support Faces Of Hope Foundation Family Advocate Program 3010 W State Street Boise ID 83703 820344205 501(c)(3) 10000 Support Family Advocate Program Family Health Services 794 Eastland Dr Twin Falls ID 83301 820371093 501(c)(3) 14500 Support Family Health Services Family Justice Center 524 3rd Street South Suite 115 Nampa ID 83651 264423289 501(c)(3) 7500 Support Family Justice Center Family Med Residency Of Id 777 N Raymond Street Boise ID 837049251 205934739 501(c)(3) 2325747 Support Family Med Residency Of Id Filer School District 413 700 B Stevens Ave Filer ID 83328 826000894 GOVERNMENT ENTITY 6000 Support Filer School District 413 Friends Of Zoo Boise 355 Julia Davis Dr Boise ID 83702 826005995 501(c)(3) 7000 Support Friends Of Zoo Boise Genesis Community Health Inc 215 West 35Th Street Garden City ID 83714 820505073 501(c)(3) 11000 Support Genesis Community Health Inc Giraffe Laugh Early Learning 4094 W Chinden Blvd Garden City ID 83714 820481812 501(c)(3) 10000 Support Giraffe Laugh Early Learning Girl Scouts Of Silver Sage 8948 W Barnes Boise ID 83709 820259644 501(c)(3) 10000 Support Girl Scouts Of Silver Sage Hansen School District 415 550 S Main Street Hansen ID 83334 826001325 GOVERNMENT ENTITY 11889 Support Hansen School District 415 Helping Hearts And Hands Inc PO Box 201 Gooding ID 83330 208322514 501(c)(3) 10000 Support Helping Hearts And Hands Inc Home Partnership Foundation PO Box 7899 Boise ID 837071899 753162969 501(c)(3) 150000 Support Home Partnership Foundation Hospice Visions Inc 1770 Park View Drive Twin Falls ID 83301 820483284 501(c)(3) 12500 Support Hospice Visions Inc Id Aeyc 4355 W Emerald St Boise ID 837062072 820409133 501(c)(3) 26000 Support Id Aeyc Id Food Bank 3630 E Commercial Ct Meridian ID 83642 820425400 501(c)(3) 153857 Support Id Food Bank Id Governors Cup PO Box 983 Boise ID 83701 208277116 501(c)(3) 16000 Support Id Governors Cup Id Hunger Relief Task Force 963 S Orchard Street Suite 206 Boise ID 83705 813084559 501(c)(3) 9200 Support Id Hunger Relief Task Force Id Shakespeare Festival PO Box 9365 Boise ID 83707 820316246 501(c)(3) 20000 Support Id Shakespeare Festival Idaho Farmers Market Assoc PO Box 6992 Boise ID 83707 454519400 501(c)(3) 10000 Support Idaho Farmers Market Assoc Idaho Senior Games PO Box 45464 Boise ID 83711 820452442 501(c)(3) 7000 Support Idaho Senior Games Interfaith Sanctuary Housing PO Box 9334 Boise ID 83707 260510072 501(c)(3) 20000 Support Interfaith Sanctuary Housing Interlink Volunteer Caregivers 650 Addison Ave W Ste 201 Twin Falls ID 83301 841417706 501(c)(3) 10000 Support Interlink Volunteer Caregivers Jannus Inc 1607 W Jefferson St Boise ID 83702 816035382 501(c)(3) 66000 Support Jannus Inc Jerome County Senior Citizens 520 N Lincoln Jerome ID 83338 820313405 501(c)(3) 14000 Support Jerome County Senior Citizens Jesse Tree Of Idaho 1121 W Miller Street Boise ID 83702 820534777 501(c)(3) 10000 Support Jesse Tree Of Idaho La Posada Inc PO Box 1962 Twin Falls ID 833031962 820468830 501(c)(3) 8000 Support La Posada Inc Learning Lab Inc 308 E 36Th Street Garden City ID 83714 820461933 501(c)(3) 6000 Support Learning Lab Inc Lee Pesky Learning Center Inc 3324 Elder Street Boise ID 83705 133878574 501(c)(3) 7000 Support Lee Pesky Learning Center Inc Lifes Kitchen PO Box 45632 Boise ID 83711 800008918 501(c)(3) 57213 Support Lifes Kitchen Living Independence Network 1878 W Overland Rd Suite 101 Boise ID 837053142 820426465 501(c)(3) 25000 Support Living Independence Network Make A Wish Foundation 310 W Idaho Street Boise ID 83702 820408150 501(c)(3) 6500 Support Make A Wish Foundation Mccall Public Library PO Box 4016 Mccall ID 83638 611886895 GOVERNMENT ENTITY 25000 Support Mccall Public Library Mountain Home Senior Center 1000 North 3Rd East Mountain Home ID 83647 820442672 501(c)(3) 15000 Support Mountain Home Senior Center Mountain Rides Transportation Authority 800 1St Avenue North Ketchum ID 83340 820382250 501(c)(3) 8000 Support Mountain Rides Transportation Authority Mountain View Christian Center 317 Mountain View Lane Burley ID 83318 820374961 501(c)(3) 6800 Support Mountain View Christian Center Mv Area Humanitarian Center PO Box 601 Rupert ID 83350 821317096 501(c)(3) 10000 Support Mv Area Humanitarian Center Nampa Housing Authority 211 19Th Ave N Nampa ID 83687 826001197 501(c)(3) 10000 Support Nampa Housing Authority Nampa School District 619 S Canyon St Nampa ID 83686 826000727 GOVERNMENT ENTITY 11000 Support Nampa School District Nampa Schools Foundation Inc PO Box 874 Nampa ID 836530874 820456603 501(c)(3) 10360 Support Nampa Schools Foundation Inc Oats Family Center 911 S Hwy 30 Heyburn ID 83336 261301778 501(c)(3) 7000 Support Oats Family Center Roaring Springs Water Park 400 W Overland Road Meridian ID 83642 820505226 501(c)(3) 10000 Support Roaring Springs Water Park Roman Catholic Diocese Boise 1501 S Federal Way Boise ID 83705 820200748 501(c)(3) 18000 Support Roman Catholic Diocese Boise Ronald Mcdonald House Id 139 E Warm Springs Ave Boise ID 83712 943030996 501(c)(3) 110000 Support Ronald Mcdonald House Id Salmon River Senior Citizens PO Box 1285 Riggins ID 83549 900815231 501(c)(3) 6000 Support Salmon River Senior Citizens Salvation Army 1617 N 24Th Street Boise ID 83702 941156347 501(c)(3) 12461 Support Salvation Army Selecthealth Inc 5381 Green St Murray UT 84123 870409820 501(c)(4) 94950 Support Selecthealth Inc Snake River Stampede Cure 16114 Idaho Center Blvd Ste 4 Nampa ID 83687 464244298 501(c)(3) 12500 Support Snake River Stampede Cure South Central District Health 1020 Washington St N Twin Falls ID 83301 820335043 GOVERNMENT ENTITY 23000 Support South Central District Health St Michaels Parish Inc 518 N 8Th St Boise ID 83702 820204262 501(c)(3) 8000 Support St Michaels Parish Inc St Luke's Health Foundation 190 East Bannock Street Boise ID 83712 810600973 501(c)(3) 10000 Support St. Luke's Health Foundation Success In Education 111 East Broadway Ste 900 Salt Lake City UT 84111 453567196 501(c)(3) 10000 Support Success In Education Swiftsure Ranch Therapeutic 114 Calypso Lane Bellevue ID 83313 820461587 501(c)(3) 10000 Support Swiftsure Ranch Therapeutic TF Area Chamber Of Commerce 2015 Neilsen Point Place Twin Falls ID 83301 820172213 501(c)(6) 26700 Support TF Area Chamber Of Commerce Third District Guardian Ad Po Box 789 Caldwell ID 83606 811368126 501(c)(3) 10000 Support Third District Guardian Ad Times News Po Box 540 Waterloo IA 507040540 910891886 5044 Support Times News Treasure Valley Family Ymca 1177 W State St Boise ID 83702 820200908 501(c)(3) 30000 Support Treasure Valley Family Ymca Treasure Valley Food Coalition 5323 Hill Road Boise ID 83703 453620811 501(c)(3) 8000 Support Treasure Valley Food Coalition Twin Falls County Safe House 650 Addison Ave W Ste 200 Twin Falls ID 833030126 826000318 GOVERNMENT ENTITY 13000 Support Twin Falls County Safe House Twin Falls Optimist Youth 255 Blue Lakes Blvd N Box 663 Twin Falls ID 83301 831319663 501(c)(3) 8000 Support Twin Falls Optimist Youth Twin Falls School District 411 201 Main Ave West Twin Falls ID 83301 826000892 GOVERNMENT ENTITY 67361 Support Twin Falls School District 411 United Way Of South Central Id Po Box 65 Twin Falls ID 83303 820256978 501(c)(3) 10500 Support United Way Of South Central Id United Way Of Treasure Valley Po Box 16330 Boise ID 83705 820299013 501(c)(3) 25000 Support United Way Of Treasure Valley University Of Id Foundation 875 Perimeter Drive Ms 3143 Moscow ID 838443143 237098404 501(c)(3) 200000 Support University Of Id Foundation University Of Washington PO Box 358047 Seattle WA 981958047 916001537 GOVERNMENT ENTITY 692293 Support University Of Washington Voices Against Violence 212 2Nd Avenue West Ste 200 Twin Falls ID 83301 820372006 501(c)(3) 20000 Support Voices Against Violence Wassmuth Ctr For Human Rights 775 W Fulton St Boise ID 83702 820490848 501(c)(3) 50000 Support Wassmuth Ctr For Human Rights Wellness Tree Cmnty Clinic 173 Martin St Twin Falls ID 83301 261249939 501(c)(3) 18600 Support Wellness Tree Cmnty Clinic Westend Senior Center 1010 Main St Buhl ID 83316 820313172 501(c)(3) 6000 Support Westend Senior Center WICAP 315 South Main Street Payette ID 83661 826009826 501(c)(3) 5250 Support WICAP 98 4 Part I, Line 2: The Organization endeavors to monitor its grants to ensure that such grants are used for proper purposes and not otherwise diverted from their intended use. This is accomplished by requesting recipient organizations to affirm that funds must be used solely in accordance with the grant request and budget on which the grant was based and that funds not expended for the stated purpose are to be returned to the organization. Reports are requested from time to time as deemed appropriate. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 Chris Roth CEO & Director 947758 0 0 0 143372 0 21519 0 29051 0 1141700 0 0 0 Pamela Lindemoen SVP COO (End 3/2021) 830828 0 50000 0 35828 0 12873 0 6868 0 936397 0 0 0 Nathan Green MD Physician 738436 0 68116 0 46742 0 17196 0 29051 0 899541 0 0 0 Jeffrey S Taylor SR VP/CFO/Treasurer 723661 0 0 0 61570 0 25842 0 22156 0 833229 0 0 0 Robert Walker MD Physician 625455 0 59493 0 69461 0 25842 0 12993 0 793244 0 0 0 James Souza MD SVP, Chief Physician Executive 677816 0 0 0 71666 0 25842 0 17766 0 793090 0 0 0 Christine Neuhoff SVP/Chief Legal Officer/Secretary 681172 0 0 0 51980 0 21519 0 20006 0 774677 0 0 0 Barton F Hill MD VP,Chief Quality Officer 546426 0 0 0 114938 0 21519 0 25376 0 708259 0 0 0 David Self SVP, Chief Admin Officer 578276 0 0 0 32831 0 16463 0 9774 0 637344 0 0 0 Robert Cavagnol MD President, St. Luke's Clinic 446605 0 0 0 69883 0 12873 0 14261 0 543622 0 0 0 Cynthia Gearhard CNO VP Patient Care Svcs SLHS 413135 0 0 0 86440 0 25842 0 10074 0 535491 0 0 0 David C Pate MD JD Former President & CEO 380321 0 0 0 127879 0 3833 0 1573 0 513606 0 111749 0 Maureen O'Keeffe Former VP 0 0 0 0 139766 0 0 0 0 0 139766 0 108096 0 Part I, Line 1a St. Luke's has agreed to directly or indirectly pay all taxes caused by the vesting of accruals of the adjusted benefit prior to termination of employment. The payment shall be made in such a manner which results in the executive having no personal outlay for taxes resulting from or related to the adjusted benefit for any associated taxes. Part I, Line 4b During CY'20, the following individuals participated in a supplemental non-qualified executive retirement plan: Jeffrey Taylor received $19,754 of benefits for service in a supplemental retirement plan. David C. Pate received $369,324 of benefits for service in a supplemental retirement plan. Maureen O'Keeffe received $148,326 of benefits for prior service in a supplemental retirement plan. Part II-Column (c) During CY'20 the following individual participated in the basic pension plan. Due to enhanced benefits adopted in 2019 and changes in actuarial assumptions this individual experienced an increase in the vested balance of the plan. Jeffrey Taylor $414,222 Cynthia Hart Family member of Director/Officer 43209 Compensation of family member of a Director and Officer 0 Laurie Martin Family member of Director/Officer 91728 Compensation of family member of a Director and Officer 0 Form 990, Part VI, Section A, line 2 Andy Scoggin has a business relationship with Dan Krahn. 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 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. 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 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 Coordinate Care, Ltd. St. Luke's Nampa Medical Center, Ltd. Pamela Lindemoen: 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 Coordinate Care, Ltd. St. Luke's Nampa Medical Center, Ltd. Jeffrey S. Taylor: 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. 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. James Souza, MD: St. Luke's Health System, Ltd. St. Luke's Clinic Coordinated Care, Ltd. David Self: St. Luke's Health System, Ltd. St. Luke's Clinic Coordinated Care, Ltd. Robert Cavagnol, MD: St. Luke's Health System, Ltd. St. Luke's Clinic Coordinated Care, Ltd. Form 990, Part XI, line 9: Change in Minim Liability - Supplemental Executive Retirement Plan (SERP) -9,701,827. Form 990, Part IX, Line 1 During the fiscal year 2021 the Health System received significant funding related to the Cares Act including deferral of employer portion of certain payroll taxes which contributed increase certain asset and liability accounts. Form 990, Part I, Line 6 Volunteer counts continue to be lower than in prior years due to restrictions on access to the hospitals and cancellations of in-person events due to COVID-19 concerns. 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