2018-08-15T14:26:59-05:00 2017-09-30 861065772 Deloitte Tax LLP 250 East Fifth Street STE 1900 Cincinnati OH 45202 990 2016-10-01 273311774 St Luke's McCall Ltd STLU 2087069585 190 E Bannock Boise ID 83712 Pete DiDio Vice-President, Controller 2087069585 2018-08-14 1 Rebecca Lyons P01487105 5137847100 2016 2022-09-23 18:48:47Z Kathy Moore 190 E Bannock Boise ID 83712 43663773 0 X www.stlukesonline.org X 2010 ID Provide healthcare services to the community. 17 10 0 79 0 0 578721 553027 36335095 39854019 86860 137732 81716 88005 37082392 40632783 11464 10604 0 0 20383891 0 0 0 194945 12741855 37208774 33137210 37219378 3945182 3413405 32932635 36015357 3123068 2803931 29809567 33211426 Improve the health of people in the communities we serve by aligning physicians and other providers to deliver integrated, patient centered, quality care. 0 0 26920897 10604 32421054 Medical and SurgicalServices at St. Luke's McCall include a 24-hour emergency department, outpatient surgery, orthopedic surgery, general surgery, diagnostics, maternity services, inpatient physical therapy, intensive care and medical/surgical units. During fiscal year 2017, St. Luke's McCall provided patient care for 665 admissions covering 1,505 patient days. They also provided patient care associated with 21,599 outpatient visits. 6171980 7432965 Physician ServicesSt. Luke's McCall has two physician clinics:(1) Payette Lakes Medical Clinic has nine family medicine physicians, and seven family medicine P.A.'s and N.P.'s who collectively completed 23,076 clinic visits in fiscal year 2017.(2) McCall Medical Clinic has one internal medicine physician, one general surgeon, one orthopedic surgeon and one orthopedic P.A. who collectively completed 7,443 clinic visits in fiscal year 2017. 33092877 1 1 0 0 0 0 0 0 0 0 1 0 0 1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 17 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X X Peter Didio Vice-President Controller 2087069585 190 E Bannock Boise ID 83712 X Ms Kathy Moore CEO-St. Luke's West Reg 2.00 48.00 X X 0 627448 35476 Ron Jutzy MD Director 2.00 44.00 X 0 539991 22391 Cliff Tenley MD Director 2.00 46.00 X 0 342100 41616 Bayo Crownson MD Director 2.00 46.00 X 0 319519 28332 Mr Ron Sali Director 2.00 6.00 X 0 0 0 Mr AJ Balukoff Chairman 2.00 6.00 X X 0 0 0 Mr Mike Mooney Director 2.00 6.00 X 0 0 0 Mr George Illif Director 2.00 6.00 X 0 0 0 Catherine Reynolds MD Director 2.00 6.00 X 0 0 0 Chris Keller MD Director 2.00 6.00 X 0 0 0 Bishop Brian Thom Director 2.00 6.00 X 0 0 0 Mr Darin DeAngeli Director 2.00 6.00 X 0 0 0 Mr Dean Hovdey Director 2.00 6.00 X 0 0 0 Ms Kami Faylor Director 2.00 6.00 X 0 0 0 Mr Lloyd Knight Director 2.00 6.00 X 0 0 0 Mr Mark Robinson Director 2.00 6.00 X 0 0 0 Ms Jill Calhoun Director 2.00 6.00 X 0 0 0 Mr Jeffrey S Taylor SR VP/CFO/Treasurer 2.00 52.00 X 0 863498 206690 Ms Christine Neuhoff VP/Legal Affairs/Secretary 2.00 52.00 X 0 433193 32437 Sean McCallister Site Administrator 40.00 0.00 X 0 151934 23570 Gregory W Irvine MD Physician 40.00 0.00 X 0 544034 35684 Amy Ocmand MD Physician 40.00 0.00 X 0 359173 13692 John A Kremer MD Physician 40.00 0.00 X 0 342963 20723 Todd J Arndt MD Physician 40.00 40.00 X 0 337001 39294 Patrick Kinney MD Physician 40.00 0.00 X 0 319262 10788 0 5180116 510693 0 0 1 0 Anesthesia Associates Of Boise 2537 W State St Suite 200 Boise ID 83702 Physician Services 541167 Sodexo Operations LLC 9801 Washingtonian Blvd Gaithersburg MD 20878 Facilities Management 156695 Amn Healthcare Inc 12400 High Bluff Drive San Diego CA 92130 Medical Staffing 121592 Jordan Wilcomb Construction 406 South 6th Street Boise ID 83702 Construction Services 105487 4 449381 103646 553027 Net Patient Revenue 900099 37837424 37837424 2016595 2016595 39854019 97032 97032 5775 0 5775 5775 5775 2410835 660855 2415735 615255 -4900 45600 40700 40700 Cafeteria/Catering/Ven 900099 82230 82230 82230 40632783 39854019 0 225737 10604 10604 667620 652053 675 14892 26674 26674 497316 455163 42153 13495 13075 420 346436 327122 18186 1128 2396214 2396214 386097 385297 800 179317 122462 54011 2844 25 18 7 2725165 2642883 82282 Allocated Salaries and 21333042 18103959 3083832 145251 Supplies 4156907 4058385 85029 13493 Allocated SLHS exp 2846273 2846273 Repairs 692050 277665 414385 942143 775030 149776 17337 37219378 33092877 3931556 194945 5770725 5321485 862416 950262 887190 875330 16332521 7328979 10330376 9003542 4264420 4316348 43091 22407 10774417 15525983 32932635 36015357 2145344 1047813 977724 1756118 3123068 2803931 X 29809567 33211426 29809567 33211426 32932635 36015357 3413405 -11546 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 428354 169054 597408 42975 8682581 3890036 4835520 6811542 3438943 3372599 198015 198015 9003542 Due from Related Organizations 15525983 15525983 Medicare/Medicaid Program 1756118 1756118 X Part X, Line 2: Footnote Disclosure-Uncertain Tax Positions Under FIN #48 (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 accounts for uncertain tax positions in accordance with ASC Topic 740. Income tax liabilities are recorded for the impact of positions taken on income tax returns, which management believes are not more likely than not to be sustained on tax audit. Management is not aware of any uncertain tax positions that should be recorded. Unrelated Business Income: The Health System is subject to federal excise tax on its unrelated business taxable income(UBTI). As of September 30, 2017, the company had approximately $8,446 UBTI Net Operating Losses incurred from operating losses incurred from 1998 to 2017 which expire in years 2018 to 2038. The Health System does not believe that it is more likely than not they will utilize these losses prior to their expiration and as such has provided a full valuation allowance against these losses. 1 1 X 1 X 1 X 1 1 1 0 0 1080857 1080857 0.02900 2395629 2155700 239929 0.00640 181631 190829 0 0.00000 3658117 2346529 1320786 0.03540 305708 154232 151476 0.00410 320780 320780 0.00860 73217 73217 0.00200 699705 154232 545473 0.01470 4357822 2500761 1866259 0.05010 1 1040270 0 11345605 11317686 27919 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 15 1 0 0 1 X www.stlukesonline.org/about-st-lukes/supporting-the-community X 1 16 0 1 0 1 X 200.000000000000 400.000000000000 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 in-depth interviews with people representing the broad interests of our community were conducted in order to assist us in defining, prioritizing, and understanding our most important community health needs. Many representatives participating in our process are individuals who have devoted decades to helping others lead healthier, more independent lives. The representatives we interviewed have significant knowledge of our community. To ensure they came from distinct and varied backgrounds, we included multiple representatives from each of these 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 was scored by the community representative on a scale of 1 to 10. Higher scores represent potential needs the community representatives believed were important to address with additional resources. Lower scores usually meant our leaders thought our community was healthy in that area already or we had relatively good programs addressing the potential need. These scores were incorporated directly into our health need prioritization process. In addition, we invited the leaders to suggest programs, legislation, or other measures they believed to be effective in addressing the needs.Community Representatives Contacted 1. Affiliation: U.S. Department of Veterans Affairs - Boise VA Medical Center2. Affiliation: Family Medicine Residency of Idaho 3. Affiliation: Idaho Department of Health and Welfare4. Affiliation: Idaho Central District Health, District 45. Affiliation: Southwest District Health, Idaho District 36. Affiliation: Idaho Department of Labor7. Affiliation: Idaho Health and Welfare8. Affiliation: Idaho Health and Welfare9. Affiliation: Cascade Medical Center10. Affiliation: St. Luke's Health System11. Affiliation: McCall Donnelly School District12. Affiliation: Adams County Health Center (FQHC)13. Affiliation: The Community Care Clinic14. Affiliation: McCall Rehab and Care Center 15. Affiliation: Valley County16. Affiliation: St. Luke's Health System17. Affiliation: McCall-Donnelly School District18. Affiliation: St. Luke's Health System and City of McCall19. Affiliation: Cascade Medical Center20. Affiliation: Valley County21. Affiliation: Hiking for Healthy Hooters Event22. Affiliation: Idaho Health and Welfare23. Affiliation: McCall - Donnelly School District24. Affiliation: Adams County Health Center25. Affiliation: The Community Care Clinic 26. Affiliation: Meadows Valley Ambulance27. Affiliation: Lamm and Company Certified Public Accountants28. Affiliation: New Meadows Food Bank29. Affiliation: McCall Senior Center and Payette Lakes Community Association - After-School Programs30. Affiliation: St. Luke's McCall Medical Center St. Luke's McCall Part V, Section B, Line 11: We organized all of our significant all of the community health needs into four groups:Program Group 1: Improve the Prevention and Management of Obesity-Develop a short and long term, region-wide plan to promote walkability and destination hiking.-Promote a healthy food culture-Develop the Best U program. A 16 week, twice weekly group exercise and health related educational presentations on nutrition, stress management, exercise, sleep and motivation.-Education classes on various nutrition, weight management and exercise topics.Program Group 2: Improve Mental Health and Reduce Substance Abuse-Youth advocacy coalition: Prevention of youth drug abuse-Providing alternative healthcare stress reduction and mindfulness modalities (yoga, meditation)-Slate of single classes on various mental health topics-Workforce wellness programs (walking, nutrition, mental resilience)-Youth summits-Committed high school program promoting kindness and drug avoidanceProgram Group 3: Improve Access to Affordable Health Care and Affordable Health Insurance-Unreimbursed care/Financial care-Senior foot clincs-Fostering a culture of health (economic, social, environmental, behavioral)-Leading and administering valley county health improvement coalition-Grant writing for health improvement programs-Prevention and screenings for chronic conditions-Childbirth Education-Child care seat-Nutrition and fitness programs for schools-Free community health improvement services offered at clinicProgram Group 4: Prevention and Reduce Tobacco Use-Planning best tobacco prevention inverventions for service area-School base tobacco prevention educations 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. 7 1 - St Luke's McCall Medical Clinic 209 Forest Street McCall ID 83638 Various Specialty Physician Clinics 2 - Payette Lakes Family Medicine 211 Forest Street McCall ID 83638 Family Medicine & Surgery-Physician Clinic 3 - St Luke's Integrative Medicine Clinic 203 Hewitt Street McCall ID 83638 Integrative Medicine-Physician Clinic 4 - Meadow Valley Family Medicine 320 Virginia Street New Meadows ID 83638 Family Medicine-Physician Clinic 5 - Salmon River Family Medicine 214 N Main Street Riggins ID 83638 Family Medicine-Physician Clinic 6 - St Luke's Behavioral Health 301 Dienhard Ln McCall ID 83638 Behavioral Health-Physician Clinic 7 - St Luke's Rehabilitation McCall 1010 State Street McCall ID 83638 Rehabilitation-Physician Clinic Part I, Line 3c: (A) St. Luke's does provide charity care services to patients who meet one or both of the following guidelines based on income and expenses:1. Income. Patients whose family income is equal to or less than 400% of the then current Federal Poverty Guideline are eligible for possible fee elimination or reduction on a sliding scale.2. Expenses. Patients may be eligible for charity care if his or her allowable medical expenses have so depleted the family's income and resources that he or she is unable to pay for eligible services. The following two qualifications must apply:a. Expenses- The patients allowable medical expenses must be greater than 30% of the family income. Allowable medical expenses are the total of the family medical bills that, if paid, would qualify as deductible medical expenses for Federal income tax purposes without regard to whether theexpenses exceed the IRS-required threshold for taking the deduction. Paid and unpaid bills may be included.b. Resources- The patient's excess medical expenses must be greater than available assets. Excess medical expenses are the amount by which allowable medical expenses exceed 30% of the family income. Available assets do not include the primary residence, the first motor vehicle, and a resourceexclusion of the first $4,000 of other assets for an individual, or $6,000 for a family of two, and $1,500 for each additional family member.(B) Service Exclusions:1. Services that are not medically necessary (e.g. cosmetic surgery) are not eligible for charity care. 2. Eligibility for charity care for a patient whose need for services arose from injuries sustained in a motor vehicle accident where the patient, driver, and/or owner of the motor vehicle had a motor vehicle liability policy, and only if a claim for payment has been properly submitted to the motor vehicle liability insurer, where applicable.(C) Eligibility Approval Process:1. St. Luke's screens patient for other sources of coverage and eligibility in government programs. St. Luke's documents the results of each screening. If St. Luke's determines that a patient is potentially eligible for Medicaid or another government program, then St. Luke's shall encourage the patient toapply for such a program and shall assist the patient in applying for benefits under such a program.2. The patient must complete a Financial Assistance Application and provide required supporting documentation in order to be eligible.3. St. Luke's verifies reported family and compares to the latest Poverty Guidelines published by the U.S. Department of Health and Human Services.4. St. Luke's verifies reported assets.5. St. Luke's provides a written notice of determination of eligibility to the patient or the responsible party within 10 business days of receiving a completed application and the required supporting documentation.6. St. Luke's reserves the right to run a credit report on all patients applying for charity care services.(D) Eligibility Period: The determination that an individual is approvedfor charity care will be effective for six months from the date the application is submitted, unless during that time the patient's family income or insurance status changes to such an extent that the patient becomes ineligible. Part I, Line 7: The cost to charge ratio was used to calculate charity care at cost. Worksheet S-10 of the FY'17 Medicare Cost Report was the source of information for unreimbursed Medicaid costs. 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 McCall, Ltd. 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 four. St. Luke's McCall, Ltd. 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: Our community benefit reports the under-reimbursed services provided to patients by Medicare. St. Luke's McCall, Ltd. 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. The source of the information is the Medicare Cost Report for fiscal year 2017. The amount is calculated by comparing the total Medicare apportioned costs (allowable costs) to interim payments received during FY'16. 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 fiscal year ending 9/30/2015. Information related to the 2015 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:www.stlukesonline.org/about-st-lukes/supporting-the-community Part VI, Line 3: (A) St. Luke's McCall, Ltd. 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) All notices are 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 served by St. Luke's McCall. The area is a 65 mile radius around the city of McCall, and it includes six small rural communities (McCall, Cascade, Council, New Meadows, Donnelly, and Riggins) and surrounding residents. The year-round residents total approx. 14,000. Additionally, this being a tourist and second home area, on average, there are 6,000 visitors and part-time residents in the service area each day. The service area had one of the highest unemployment rates in Idaho during most of fiscal year 2012, and one of the highest uninsured rates in Idaho as well. (Adams and Valley counties are part of Idaho Health Districts 3 and 4.)The criteria used in selecting this area as the community served is to include the entire population of the counties where at least 70% of inpatients reside. The residents of these counties comprise about 80% of inpatients with approximately 62% of inpatients living in Valley County and 18% in Adams County.Both Idaho and our service territory are comprised of about a 95% white population while the nation as a whole is 78% white. The Hispanic population in Idaho represents 12% of the overall population and about 4% of our defined service area. Adams County is approximately 3% Hispanic, and Valley County is 4% Hispanic. Idaho experienced a 25% increase in population from 2000 to 2013, ranking it as one of fastest growing states in the country. Adams and Valley Counties have followed that trend, experiencing a 21% increase in population within that timeframe. St. Luke's McCall is working to manage the volume and scope of services in order to meet the needs of a growing population.Over the past ten years the 45 plus year old age group was the fastest growing segment of our community. Currently, about 19% of the people in our community are over the age of 65. According to the U.S. Census, about 14% of the people in the U.S. are over age 65The official United States poverty rate increased from 12.5% in 2003 to 15.6% in 2013. Our service area poverty rate has also increased. The poverty rate in Valley County is currently well below the national average at 12% but above the national average in Adams County. The poverty rate in our community for children under the age of 18 is again below the national average for Valley County and above the national average for Adams County. Although both Adams and Valley county poverty rates have started to level out, they are still well above where they were prior to the recession in 2008.Median income in the United States has risen by 20% since 2003. However, growth in income was slower in Idaho and in our service area during that period. 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 lower 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 SLMV. 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.(6) Mountain States Tumor Institute (MSTI) is the region's largest provider of cancer services and a nationally recognized leader in cancer research. MSTI provides advanced care to thousands of cancer patients each year at clinics in Boise, Fruitland, Meridian, Nampa, and Twin Falls, Idaho. MSTI is home to Idaho's only cancer treatment center for children, only federally sponsored center for hemophilia, and only blood and marrow transplant program. MSTI's services and therapies include breast care services, blood and marrow transplant, chemotherapy, genetic counseling, hematology, hemophilia treatment, hospice, integrative medicine, marrow donor center, mobile mammography, mole mapping, nutritional counseling, PET/CT scanning, patient/family support, pediatric oncology, radiation therapy, rehabilitation, research and clinical trials, Schwartz Center Rounds for Caregivers, spiritual care, support groups/classes, tumor boards, and Wound Ostomy, and Continence Nursing. MSTI is expanding as rapidly as today's cancer treatment. Patients can now visit a MSTI clinic or Breast Cancer detection center at 13 different locations in southwest Idaho and Eastern Oregon. Locations include Boise, Meridian, Nampa, Twin Falls, and Fruitland.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 through management service contracts. These facilities include:(1) Challis Area Health Center(2) North Canyon Medical Center(3) Salmon River Clinic(4) Weiser Memorial Hospital 0 1 0 0 0 0 0 0 0 Ms Kathy Moore CEO-St. Luke's West Reg 0 579659 0 0 0 47789 0 16180 0 19296 0 662924 0 0 Ron Jutzy MD Director 0 533133 0 0 0 6858 0 8230 0 14161 0 562382 0 0 Cliff Tenley MD Director 0 242755 0 74103 0 25242 0 24410 0 17206 0 383716 0 0 Bayo Crownson MD Director 0 267260 0 38017 0 14242 0 10615 0 17717 0 347851 0 0 Mr Jeffrey S Taylor SR VP/CFO/Treasurer 0 535702 0 0 0 327796 0 194145 0 12545 0 1070188 0 0 Ms Christine Neuhoff VP/Legal Affairs/Secretary 0 431545 0 0 0 1648 0 16180 0 16257 0 465630 0 0 Sean McCallister Site Administrator 0 145143 0 6586 0 205 0 4647 0 18923 0 175504 0 0 Gregory W Irvine MD Physician 0 468470 0 30000 0 45564 0 16180 0 19504 0 579718 0 0 Amy Ocmand MD Physician 0 214357 0 109278 0 35538 0 7597 0 6095 0 372865 0 0 John A Kremer MD Physician 0 285207 0 8898 0 48858 0 12065 0 8658 0 363686 0 0 Todd J Arndt MD Physician 0 289028 0 11163 0 36810 0 16180 0 23114 0 376295 0 0 Patrick Kinney MD Physician 0 251242 0 67588 0 432 0 513 0 10275 0 330050 0 0 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 CY'16, the following individual participated in a supplemental non-qualified executive retirement plan: SERP SERP-Gross Up Total Jeffrey Taylor $155,638 $126,060 $281,698 Maureen Okeeffe $40,230 $108,096 $148,326 During CY'16, Jeffrey S. Taylor was a participant in the supplemental non-qualified executive retirement plan. There were no additional benefits were accrued during CY'16 on behalf of the participant. 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 Regional Medical Center, Ltd. (Corporation), which in turn is the governing board for St. Luke's McCall, Ltd. (SLM). Effective April 1, 2014, the Corporation became the fiduciary board over SLM. In addition, SLM maintains a community board to ensure the overall health needs of the community are addressed. The chairperson of this community board also serves on the SLRMC governing board. 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 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 related to the conflict. Form 990, Part VI, Section B, line 15 Executive compensation is set by St. Luke's Board 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 of those surveyed. These surveys are usually done every two years, with the most recent compensation survey completed during calendar year 2017. 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 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: Kathy Moore: St. Luke's Regional Medical Center, Ltd. Mountain States Tumor Institure, Inc. St. Luke's McCall, Ltd. St. Luke's Clinic Coordinate Care, Ltd. Jeff Taylor: St. Luke's Health System, Ltd. St. Luke's Regional Medical Center, Ltd. Mountain States Tumor Institute, Inc. 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. Christine Neuhoff: St. Luke's Health System, Ltd. St. Luke's Regional Medical Center, Ltd. Mountain States Tumor Institute, Inc. 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. Bayo Crownson, M.D. St. Luke's Regional Medical Center, Ltd. Mountain States Tumor Institute, Inc. St. Luke's McCall, Ltd. Ron Jutzy, M.D. St. Luke's Regional Medical Center, Ltd. Mountain States Tumor Institute, Inc. St. Luke's McCall, Ltd. Thomas Huntington, M.D. St. Luke's Regional Medical Center, Ltd. Mountain States Tumor Institute, Inc. St. Luke's McCall, Ltd. Catherine Reynolds, M.D. St. Luke's Regional Medical Center, Ltd. Mountain States Tumor Institute, Inc. St. Luke's McCall, Ltd. In addition, Catherine Reynolds, M.D. is a member of Syringa Family Medicine, P.A., (Syringa) a physician practice that has a professional service agreement with St. Luke's Regional Medical Center, Ltd. (SLRMC). Dr. Reynolds works at least 40 hours per week on behalf of this practice for SLRMC. During CY'16, SLRMC paid Syringa $203,388 for services rendered to St. Luke's patients. Form 990 Part V, Line 1 & 2: During tax reporting year 2017 accounts payable and payroll process were consolidated to the supporting organization level (St. Luke's Health System, Ltd). Therefore, corresponding reporting for 1099's and W-2's occurs at that level. St Luke's Clinic-McCall LLC 190 E Bannock Boise ID 83712 452715717 Physician Clinic Services ID 5298465 214047 St Luke's McCall Ltd 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 Mountain State Tumor Institute Inc 100 E Idaho Boise ID 83712 820295026 Healthcare Services ID 501(c)(3) 3 St Luke's Regional Medical Center 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 St Luke's Health Foundation Ltd 190 E Bannock Boise ID 83712 810600973 Fundraising ID 501(c)(3) 12C, III-FI 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 801 Pole Line Road Twin Falls ID 83301 562570686 Healthcare Services ID 501(c)(3) 3 St Luke's Health System Ltd 0 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 Foundation Ltd 0 St Luke's McCall Foundation Inc 190 E Bannock Boise ID 83712 820384205 Fundraising ID 501(c)(3) 12C, III-FI N/A 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 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0