2017-08-15T20:12:37-05:00 2016-09-30 861065772 Deloitte Tax LLP 550 S Tyron St Suite 2500 Charlotte NC 28202 990 2015-10-01 820161600 St Luke's Regional Medical Center STLU 2087069585 190 E Bannock Boise ID 83712 Peter DiDio Vice-President,Controller 2087069585 2017-08-15 1 John W Sadoff Jr P00540589 7048871500 2015 2021-01-29 14:40:06Z Kathy Moore 190 E Bannock Boise ID 83712 2850410850 0 X www.stlukesonline.org X 1906 ID Provide healthcare services to the community. 17 10 0 592 9879932 -742058 8822852 5037076 1280024860 1393990637 4825881 7950948 269204 6712325 1293942797 1413690986 2332741 3218371 0 0 598127344 646432513 0 0 0 655231389 730844181 1255691474 1380495065 38251323 33195921 1532296537 1604897536 995926862 1034067629 536369675 570829907 X Improve the health of people in the communities we serve by aligningphysicians and other providers to deliver integrated,patient-centered,quality care. 0 0 1217447534 3025435 1301433615 Medical & Surgical:St. Luke's Regional Medical Center is comprised of three hospitalcampuses(Boise,Meridian and Mountain Home),three urgent carecenters(Eagle,Nampa,and Fruitland),two free-standing emergencydepartments(Nampa and Fruitland),and physician clinics throughoutthe Treasure Valley. The hospitals provide 24-hour emergency care,diagnostic procedures,a variety of inpatient and outpatientcare,and maternity and pediatric care. Known for its clinical excellence,St. Luke's has been recognized for quality and patient safety,and is proud to be designated a Magnet Hospital,the goldstandard for nursing care. In addition,St. Luke's has the onlychildren's hospital in the state of Idaho.During FY'16,St. Luke's Hospital locations in the Treasure Valleyprovided inpatient care for 37,595 admissions,covering 143,463patient days. Also,the hospitals provided patient care associated with 377,049 outpatient visits. In addition to hospital patient care,thevarious physician clinics located in the Treasure Valley providedpatient care asociated with 1,063,997 visits.St. Luke's provides more heart procedures than any other hospital in Idaho, providing cardiac care for heart patients throughout Idaho,and into parts of Oregon,Nevada,and Utah. St. Luke's supports the region through partnerships with physicians,hospitals,and regional clinics where patients are cared for in their own communities. Classes and screenings are offered to promote heart and vascular health and support those living with cardiovascular disease. In addition,St. Luke's has provided hundreds of automated external defibrillators(AEDs)to local schools,civic organizations and businesses,and has worked with area hospitals to achieve standardized clinical protocols for heart attack patients.Integral to the Heart & Vascular line is St. Luke's Cardiology Associates(SLICA),a 18-physician cardiology practice servicing Boise and the surrounding communities within Idaho. SLICA specializes in the treatment of diseases and disorders that affect the heart and its associated blood vessels. In-office diagnostic services include treadmill stress testing,echocardiography,heart rhythm monitoring,heart catheterization and nuclear cardiology. Also included in the practice are special clinics designed to manage irregular heart beats(arrhythmias)pacemakers and defibrillators,blood thinning medications,congestive heart failure,and lipds. 77638120 192936 82994015 St. Luke's Childrens Hospital/Specialty Center:St. Luke's Boise Medical Center is home to Idaho's only children's hospital. The Children's Hospital cares for more than 50,000 children every year,with more than 140 pediatricians and pediatric specialists working with referring physicians from around the region. Features of the Children's Hospital include Idaho's largest and most experienced Level III Newborn Intensive Care Unit,Pediatric Intensive Care Unit,and full service Pediatrics Unit. We also provide care in the state's only Pediatric Cancer Unit,Pediatric Emergency Department,and Pediatric Surgery Suites. At our Children's Hospital School,we help our young patients keep pace with their classmates. At CARES(Children at Risk Evaluation Services),medical evaluation,treatment,and documentation in cases of alleged abuse are provided.During FY'16 the Children's Hospital experienced the following patient volumes:Pediatrics: Admissions 2,264 Patient Days 7,533 Pediatric Intensive Care Unit: Admissions 160 Patient Days 1,826 1295085654 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 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 1 1 OR X X Peter DiDio Vice-PresidentController 2087069585 190 E Bannock Boise ID 83712 Mr Michael M Mooney Chairman 2.00 4.00 X X 0 0 0 Mr Ron Sali Planning Committee Chair 2.00 4.00 X 0 0 0 Mr A J Balukoff Finance Committee Chair 2.00 4.00 X 0 0 0 Mr George Iliff QSSEC Committee Chair 2.00 4.00 X 0 0 0 Mr Jim Everett Director 2.00 4.00 X 0 0 0 Ms Kami Faylor Director 2.00 4.00 X 0 0 0 Bishop Brian Thom Director 2.00 4.00 X 0 0 0 Mr Brad Wiskirchen Director 2.00 4.00 X 0 0 0 Mr Dean Hovdey Director 2.00 4.00 X 0 0 0 Catherine ReynoldsMD Director 40.00 4.00 X 0 0 0 Ms Joy Kealey Director 2.00 4.00 X 0 0 0 Ron JutzyMD Director 40.00 4.00 X 0 553605 23733 Thomas R HuntingtonMD Director 40.00 4.00 X 0 2750 0 Ms Kathy Moore Chief Executive Officer-St 40.00 6.00 X X 0 599158 30594 Mr Mark Robinson Director 2.00 4.00 X 0 0 0 Mr Lloyd Knight Director 2.00 4.00 X 0 0 0 Bayo Crownson MD Director 2.00 4.00 X 0 267311 28671 MrJeffrey S Taylor SR VP/CFO/Treasurer 2.00 50.00 X 0 563576 721926 Ms Christine Neuhoff VP/Legal Affairs/Secretary 2.00 50.00 X 0 416920 32567 Ronald M KristensenMD Physician 40.00 0.00 X 0 1281111 61674 Colin E Poole MD Physician 40.00 0.00 X 0 1151927 39620 Andrew ForbesMD Physician 40.00 0.00 X 0 1046344 81358 Steven S HuerdMD Physician 40.00 0.00 X 0 1067803 60712 Jim F Valentine MD Physician 40.00 0.00 X 0 1134372 32543 Mr Chris Roth Former CEO and Director 0.00 48.00 X 0 654179 34055 Mr Gary L Fletcher Former CEO and Director 0.00 22.00 X 0 407139 1265 0 9146195 1148718 0 1 1 0 Emergency Medicine of Idaho 13960 W WainwrightSuite A Boise ID 83713 Emergency Medicine Services 22245457 Saltzer Medical Group 217 West Georgia Ste 115 Nampa ID 83686 Physician Services 7000427 Woman's ClinicLLP 100 E IdahoSte 400 Boise ID 83702 Physician Services 4987786 Architectural Nexus 2505 Parleys Way Salt Lake City UT 84109 Architectural Services 4132006 CH2M HILL ENGINEERS INC 9191 South Jamaica Street Englewood CO 80112 Engineering Services 3400347 164 1524830 2521751 990495 5037076 Net Patient Revenue 900099 1331384347 1331384347 Outpatient Retail Rx 446110 34417444 24854437 9563007 Joint Venture Income 900099 2192102 2192102 25996744 25996744 1393990637 115206 115206 8449473 8449473 2419746 766218 1653528 1653528 1653528 1433826478 1513437 1434446754 1506892 -620276 6545 -613731 -613731 CAFETERIA/CATERING/VEN 900099 4123611 4123611 DAYCARE SERVICE 624410 561752 561752 LAUNDRY 812300 316925 316925 56509 56509 5058797 1413690986 1384427630 9879932 14346348 3218371 3218371 1514835 1514835 518260785 483355505 34905280 11084254 8214261 2869993 82947580 66557120 16390460 32625059 29879589 2745470 67121155 66115117 1006038 2601631 2601631 126773 126773 702372 702372 19711572 16512425 3199147 521617 472205 49412 9780961 9607640 173321 75531264 75528028 3236 18018946 18018946 2978647 2815665 162982 26447666 26231704 215962 76002075 74946077 1055998 305236 304018 1218 Supplies 219170081 217569056 1601025 Provision for Bad Debt 64923755 64923755 0 Contract Services 40416413 38874840 1541573 Repairs 21425631 9861963 11563668 85058386 81376997 3681389 1380495065 1295085654 85409411 0 3583877 1098300 58243906 83907875 176240649 195108591 337705 335700 27243015 29945752 2206447 2854864 1041142044 406617759 607579919 634524285 469659482 565491833 8459728 7531533 2508342 796128 42234609 39142518 133998858 44160157 1532296537 1604897536 66800950 57889323 1849724 1925922 768938275 806008373 158337913 168244011 995926862 1034067629 X 535420293 569864432 949382 965475 536369675 570829907 1532296537 1604897536 X 33195921 13816571 -12552260 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 949382 64494 44601 3800 965475 1064387 -64709 43295 7001 949382 929477 178882 38724 5248 1064387 752623 262073 75872 9347 929477 752623 752623 1.00000 1 0 40655063 29421901 70076964 285000 645888490 279979097 366194393 2084641 245525 1839116 227395671 126393137 101002534 95411278 95411278 634524285 Accrued Interest Payable-Bonds 6385827 Capital Leases 53417177 Medicare/Medicaid 47207304 CAA II PLAN LIABILITY 1415571 Pension Liability 54458148 Due to related parties 5359984 168244011 X Part V, Line 4: The Humphreys Diabetes Center Endowment Fund was established in 2000 from donations by several Idahoans for the purpose of supporting its diabetes based mission in the State of Idaho. This fund is to be used only for ongoing operating needs in service to the diabetic community and to provide assistance for Sweet Kids Camp and other priorities determined by the Board of Directors. The fund is in the possession of and administered by The Idaho Community Foundation. Part X, Line 2: Explanation: 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 30,2016, the company had approximately $6,810 UBTI Net Operating Losses incurred from operating losses incurred from 1997 to 2016 which expire in years 2017 to 2037. 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 185.000000000000 1 X 1 1 1 0 1 1 21650564 21650564 0.01650 166987037 116053680 50933357 0.03870 9951799 6623569 3328230 0.00250 198589400 122677249 75912151 0.05770 6932723 755418 6177305 0.00470 11240793 62632 11178161 0.00850 11882990 4444842 7438148 0.00570 5786344 878813 4907531 0.00370 1356601 0 1356601 0.00100 37199451 6141705 31057746 0.02360 235788851 128818954 106969897 0.08130 1 29264036 182940385 261480898 -78540513 X 1 1 1 Ortho Neuro ManagementLLC MSO-Provides consulting services for Ortho Neuro service lines 0.58180 0.41820 2 1 St Luke's Regional Medical Center 190 E Bannock Boise ID 83712 www.stlukesonline.org State of Idaho License #03 X X X X A 2 St Luke's Elmore 895 N 6th E Street Mountain Home ID 83647 www.stlukesonline.org State of Idaho License #05 X X X X A Facility Reporting Group - A 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 15 0 1 0 1 X 185.000000000000 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 1 X 0 X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: St. Luke's Regional Medical Center, - Facility 2: St. Luke's Elmore Group A-Facility 1 -- St. Luke's Regional Medical Center 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.The following community leaders/representatives were contacted:(1) Idaho Central District Health, District 4(2) Boise Rescue Mission(3) Boise VA Medical Center(4) Community Council of Idaho(5) Family Medicine Residency of Idaho(6) Genesis World Mission(7) Southwest District Health, District 3(8) Idaho Department of Health and Welfare(9) Idaho Department of Labor: Provided unemployment information(10) Learning Lab(11) Idaho Office for Refugees(12) Terry Reilly Health Services(13) Treasure Valley Family YMCA(14) United Way(15) Canyon County Community Council(16) IDACORP & Idaho Power(17) Valley Regional Transit Or Compass(18) Community Planning Association (COMPASS)(19) Meridian School District(20) Nampa School District(21) City of Nampa(22) Idaho Foodbank(23) MWI Veterinary Supply(24) Clickbank(25) Micron Technology(26) National Alliance on Mental Illness(27) Women's and Children's Alliance (WCA)(28) St. Luke's Health System U.S. Department of Health and Human Services,Region X. Group A-Facility 1 -- St. Luke's Regional Medical Center Part V, Section B, line 11: We organized all of our significant health needs into three groups:Program Group 1:Improve the Prevention, Detection, and Treatment of Obesity and Diabetes -Investment in Programs Supporting the Prevention, Detection, and Treatment of Obesity and Diabetes through St. Luke's CHI Fund -The Hill -Promise partnerships (Community Schools) -YEAH! (Youth Engaged in Activities for Health) -St. Luke's Health Coaching -Built environment initiatives -Cooking matters -St. Luke's metabolic syndrome clinic -Health habits healthy U -The Y's healthy living center and diabetes prevention program -Breastfeeding and childhood obesity -FitOne Program Group 2:Improve the Prevention, Detection, and Management of Mental Illness and Reduce Suicide -Investment in Programs Supporting the Prevention, Detection, and Management of Mental Illness and Reduce Suicide through St. Luke's CHI Fund -Financial support of allumbaugh house -Behavioral health integration into St. Luke's clinics -Psychiatrists recruitment and retention -Transforming idaho with childand and adolescent training in evidence-based psychotherapies (CATIE) -Psychiatric wellness services -St. Luke's children center for neurobehavioral medicine -Housing 1st single site initiative -Region 4 mental health crisis center -Youth substance abuse prevention -Supportice oncology at St. Luke's Mountain States Tumor Institute (MSTI) -Children's counseling collabrative -Ada county psychiatric emergency team (PET) -SHIP-community health EMS Program Group 3:Improve Access to Affordable Health Care and Affordable Insurance -Investment in programs supporting improvement of access to affordable health care and affordable health insurance through St. Luke's CHI fund -Health window -SHIBA-Senior health insurance benefits advisors -Rides 2 wellness -St. Luke's financial care program -SHIP-Community health emergency medical services (CHEMS) -Your health Idaho/Smart choice Group A-Facility 1 -- St. Luke's Regional Medical Center Part V, Section B, line 16i: A Financial Care application is provided to the patient which contains Patient Financial Advocate contact information. Group A-Facility 2 -- St. Luke's Elmore 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.The following community leaders/representatives were contacted:(1) Idaho Department of Health and Welfare(2) VA Medical Center-Boise, Idaho(3) Idaho Department of Labor-provided unemployment information(4) Idaho Central District Health, District 4(5) Mountain Home Senior Center(6) Family Medicine Residency of Idaho (7) Elmore County Drug and DUI Court(8) Central District Health(9) Elmore County(10) Various Physician Clinics, St. Vincent DePaul, Idaho Foodbank(11) The Tooth Dome(12) Various Community Events(13) Glenns Ferry Helath Clinic(14) Thrift Car Rental, Mountain Home High School, Idaho Elite AAU(15) Pine - Featherville EMS/Elmore Ambulance Service(16) LG Davidson and Sons(17) Glenns Ferry School District(18) Doctors Clinic of Elmore County(19) Idaho Department of Labor - Mountain Home Group A-Facility 2 -- St. Luke's Elmore Part V, Section B, line 11: We organized our significant health needs into three groups:Program Group 1:Improve the Prevention and Management of Obesity and Diabetes -Health and wellness day (Health Fair) -St. Luke's Elmore children's health fair -Sports physicals -SLHS Healthy U -Foot clinic -Diabetes prevention program -Mayor/School walk challenge -Step it up -First teeth matter -Fitness RX-prescription for improved physical health -Heighten your health -Step it upProgram Group 2:Mental Health Programs -Health and wellness day (Health Fair) -Step it up -Heighten your health -Fitness RX-prescription for improved physical healthProgram Group 3:Prevent and Reduce Tobacco Use -Extreme challenge -Health and wellness day (Health Fair) -You can quit tobacco Next we examined whether it would be effective and efficient for St. Luke's Elmore(SLE)to address each significant health need directly. To make this determination,we reviewed the resources we had available and determined whether the health need was in alignment with our mission and strengths. Where a high priority need was not in alignment with our mission and strengths,St. Lukes tried to identify a community group or organization better able to serve the need. Significant community health needs not addressed by SLE areas follows:(1) Tobacco Prevention: Tobacco prevention/cessation is not a strength of St. Luke's Elmore and due to resource constraints SLE will support CDHDs program by recruiting tobacco users to attend their classes. Currently working with CDHD to determine advertisement and class dates and time. St Luke's will assist with disseminating the information to patients and the public.(2) Improve Mental Health and Suicide Prevention: Although mental health and suicide prevention programs are aligned with our mission and are ranked in the CHNAs top 10th percentile, due to resource constraints and because this need is not a strength, SLE will offer limited programs to support this need, and we will continue to collaborate with the Mountain Home Air Force Base, the Domestic Violence Council, and other local mental health providers, to see where we can further contribute or assist to help our community address this need. Programs St. Luke's directly supports are described in our Implementation Plan.(3) Availability of Behavioral Health Services: Although mental health programs and providers are aligned with our mission and are ranked in the CHNAs top 10th percentile, due to resource constraints and because this need is not a strength, SLE we will continue to depend on community resources to address this need. Group A-Facility 2 -- St. Luke's Elmore Part V, Section B, line 16i: A Financial Care application is provided to the patient which containsPatient Financial Advocate contact information. 57 1 - Children's Specialty Center 100 E Idaho St Boise ID 83712 Specialty Peds Physician Clinics 2 - St Luke's RehabIntermountain Ortho 600 W Robbins Rd Boise ID 83702 Rehab/Orthopedics/Rheumatology Physician Clinics 3 - St Luke's Clinic-Intermountain Ortho 1109 W Myrtle St Boise ID 83702 Orthopedics-Physician Clinic 4 - Saltzer Rehabilitation South 290 W Georga Ave Nampa ID 83686 Physical Therapy Clinic 5 - Saltzer Hearing and Balance 210 W Georga Ave Suite 100 Nampa ID 83686 Hearing and Balance Clinic 6 - Portico East MOB 3277 E Louise Dr Meridian ID 83642 Speciality Physician Clinics 7 - Caldwell Medical Arts Bldg 1818 S 10th AveSuite 220 Suite 120 Caldwell ID 83605 Speciality Physician Clinics 8 - Idaho Sleep Health-Saltzer 7272 Potomac Dr Boise ID 83704 Sleep Disorders Clinic 9 - Saltzer-Idaho Pain Management 8950 W Emerald StSuite 168 Boise ID 83704 Pain Management-Physician Clinic 10 - Saltzer Imaging 4403 E Flamingo Ave Nampa ID 83687 Outpatient Imaging Services 11 - St Luke's Eagle Urgent Care 3101 E State St Eagle ID 83616 Urgent Care and Specialty Physician Clinics 12 - St Luke's Imaging Center 703 S Americana Blvd Boise ID 83702 Imaging Services and Specialty Physician Clinics 13 - Meadowlake Village MOB 3525 E Louise Dr Meridian ID 83642 Specialty Physician Clinics 14 - St Luke's Nampa 9850 W St Lukes Drive Nampa ID 83687 Free Standing ED,Physician Clinics,Physical Therapy Clinic 15 - St Luke's Clinics-Park Center 701 E Parkcenter Blvd Boise ID 83706 Specialty Physician Clinics 16 - Anderson Plaza Medical Office Plaza 222 N 2nd St Boise ID 83702 Specialty Physician Clinics 17 - Idaho Professional Building 125 E Idaho St Boise ID 83712 Specialty Physician Clinics 18 - St Luke's-Caldwell Urology 1620 S Kimball Ave Caldwell ID 83605 Physician Clinic-Urology 19 - St Luke's Clinic-Fruitland 1210 NW 16th St Fruitland ID 83619 Physician Clinic-Surgery 20 - St Luke's Clinic-EOMA 3950 17th StSuite A Baker City OR 97814 Family Medicine-Physician Clinic 21 - St Luke's Clinic-Capital City Family 1520 W State StSuite 100 Boise ID 83702 Family Medicine-Physician Clinic 22 - St Luke's Family Health 3399 E Louise Dr Suite 100 Meridian ID 83642 Family Medicine-Physician Clinic 23 - St Luke's Clinic-Idaho Family Phys 130 E Boise Ave Boise ID 83706 Family Medicine-Physician Clinic 24 - St Luke's Family Health 12080 W McMillan Rd Boise ID 83713 Family Medicine-Physician Clinic 25 - St Luke's Mountain States Urology 510 N 2nd StSuite 103 Boise ID 83702 Physician Clinic-Urology 26 - St Luke's Idaho Cardiology Assoc 315 E Elm Suite 350 Boise ID 83608 Cardiology-Physician Clinic 27 - St Luke's Medical Office Plaza 333 N 1st Street Boise ID 83702 Surgery Center/Specialty Physician Clinics 28 - St Luke's Clinic-MtView Family Med 3301 N Sawgrass Way Boise ID 83704 Family Medicine-Physician Clinic 29 - St Lukes's Treasure Valley Pediatrics 1620 S Celebration Ave Meridian ID 83642 Pediatric Physician Clinic 30 - St Luke's Internal Medicine 4840 N Cloverdale Rd Boise ID 83713 Internal Medicine-Physician Clinic 31 - St Luke's Clinic-Idaho Endocrinology 403 S 11th St Suite 100 Boise ID 83702 Endocrinology-Physician Clinic 32 - St Luke's Family Health 2083 Hospitality Lane Boise ID 83716 Family Medicine-Physician Clinic 33 - St Luke's Clinic-Warm Springs 100 E Warm Springs Ave Suite B Boise ID 83712 Physician Clinic-Surgery 34 - St Luke's Clinic-Boise Heart 287 W Jefferson St Boise ID 83702 Cardiology-Physician Clinic 35 - St Luke's Clinic-Family Medicine 3165 Greenhurst Rd Nampa ID 83686 Family Medicine Physician Clinic 36 - St Luke's Family Health 3140 W Milano DrSuite 150 Meridian ID 83646 Family Medicine-Physician Clinic 37 - St Luke's Clinic-Family Medicine 824 S Diamond St Nampa ID 83686 Family Medicine-Physician Clinic 38 - St Lukes Clinic-Stark Medical 932 W Idaho Suite 100 Ontario OR 97914 Family Medicine-Physician Clinic 39 - St Lukes's Treasure Valley Pediatrics 450 W State St Eagle ID 83616 Pediatric Physician Clinic 40 - St Luke's Clinic-OBGYN 300 Main StSuite 100 Boise ID 83702 Obstetrics and Gynecology-Physician Clinic 41 - St Luke's Clinic-Family Medicine 1107 NW 11th St Fruitland ID 83619 Family Medicine-Physician Clinic 42 - St Luke's Clinic-Syringa Family Med 2347 E Gala StSuite 150 Meridian ID 83642 Specialty Physician Clinics 43 - Jefferson Medical Office Plaza 300 E Jefferson St Boise ID 83712 Cardiology & Internal Medicine Physician Clinics 44 - St Luke's Meridian MOB 520 S Eagle Road Meridian ID 83642 Specialty Physician Clinics 45 - St Luke's Idaho Pulmonary Associates 2347 E Gala St Meridian ID 83642 Pulmonary Physician Clinic 46 - St Luke's Boise Orthopedic Surgery 1425 W River Street Boise ID 83702 Orthopedic Surgery Center 47 - St Luke's Idaho Cardiology-Saltzer 215 E Hawaii Nampa ID 83687 Specialty Physician Clinics 48 - St Luke's Ref Lab & Central Laundry 3000 S Denver Way Boise ID 83705 Reference Lab and Central Laundry Facility 49 - St Luke's Clinic-Pain Management 2275 S Eagle Rd Suite 160 Meridian ID 83642 Physician Clinic-Pain Management 50 - St Lukes Clinic-Trinity Mountain 465 McKenna Drive Mountain Home ID 86347 Family Medicine & OB/GYN clinic 51 - St Luke's Fruitland 1210 NW 16th St Fruitland ID 83619 24-7 Emergency Department/Urgent Care/Physician Offices 52 - St Luke's Humphreys Diabetes Center 1226 River St Boise ID 83702 Speciality Diabetes Clinic 53 - St Luke's Surgery Center 500 S Eagle Rd Eagle ID 83642 Surgery Center 54 - St Luke's Children's Center 608 and 610 Hays St Boise ID 83702 Speciality Physician Clinics 55 - St Luke's Clinic 115 Main St Boise ID 83702 Physician Bariatric Clinic and General Surgery 56 - St Luke's Rehabilitation-Boise 6052 W State St Boise ID 83702 Speciality Rehabilitation Clinic 57 - St Luke's Children Rehabilitation 170 2nd St S Nampa ID 83651 Speciality Rehabilitation 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 the expenses 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 resource exclusion 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 patients 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,St. Luke's shall encourage the patient to apply 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 income 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 approved for 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 6a: St. Luke's Regional Medical Center,Ltd.(SLRMC) includes the activity of Mountain States Tumor Institute(MSTI) within its community benefit report since SLRMC is the sole member of MSTI. Part I, Line 7: The cost to charge ratio was used for the calculation of charity care at cost,unreimbursed Medicaid and other means-tested programs. Part I, Line 7g: Subsidized services represent unreimbursed costs incurred(excluding impact of unreimbursed Medicare and Medicaid) for the following services:Home CareMaternal Fetal MedicinePalliative Care and MedicineRent Payments on behalf of the Terry Reilly ClinicRent Free space provided at various locations to County Emergency Medical Services. Part I, Ln 7 Col(f): Bad Debt is defined as expenses resulting from services provided to a patient and/or guarantor who,having the requisite financial resources to pay for health care services,has demonstrated an unwillingness to do so. The amount of bad debt expense included in Form 990,Part IX,line 25 is $64,923,755. Part II, Community Building Activities: The community building activities for St. Luke's Regional Medical Center, Ltd.("SLRMC") include the following:Economic Development:SLRMC CEO particpated in Chamber of Commerce Meetings.Coalition Building:Air St. Luke's program director attended monthly/quarterly EMS Council meetings throughout the region to build relationships and discuss emergency management procedures.SLRMC research leadership and staff particpated in an annual researchsymposium. The research symposium brought together leading physicians, scientists,and business executives for a day of information sharing, collaboration,and innovation. Participants learned the role investment in research and development plays in long-term viability and business performance,and to consider how clinical research efforts at St. Luke's and research and development at leading regional businesses might collaborate with shared benefit to our community and those we serve. Participants learned about different types of translational research, providing an overview of biomedical research being conducted at academic centers in our region. Attendees considered how regular interchange of information between St. Luke's research investigators and academicians might best occur to increase collaboration in research. 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 Regional Medical has a very robust financial assistance program, therefore, no estimate is made for bad debt attributable to patients elibible under the financial assistance policy. Part III, Line 4: Per the audited financial statements in footnote four. St. Luke's Regional Medical Center,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 Regional Medical Center,Ltd. provides medicalcare to all patients eligble 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 2016. The amount is calculated by comparing the total Medicare apportioned costs(allowable costs) to reimbursements received during FY'16. It should be noted that the unreimbursed costs reported within this schedule are significantly less than the amount reported in the annual Community Benefit Report to Ada County("County"). In the report to the County,unreimbursed costs include program costs allocated to the Medicare Advantage program,along with costs that offset the provider-based physician clinic operations;i.e. professional component billing for physician time and effort. The Medicare Cost Report does not include these components. In addition,the report to the County includes all allocated costs to the Medicare Programs,whereas the Medicare Cost Report reports allowable costsonly. 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 forfiscal year ending 9/30/2016. Information related to the2016 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 hospitalsoperating within the St. Luke's Health System can be found atthe following website:www.stlukesonline.org/about-st-lukes/supporting-the-community Part VI, Line 3: (A) St. Luke's Regional Medical Center 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: St. Luke's Regional Medical Center(SLRMC)serves Idaho's Ada and Canyon Counties,with its secondary service area covering southwest and south central Idaho and Eastern Oregon. Certain tertiary areas routinely provide care to residents from throughout Idaho and into its surrounding states.SLRMC's primary service area includes Ada and Canyon counties and are used to define the community served. The criteria used in selecting this area was to include the entire population of the counties where greater than 70% of the inpatients reside. The residents of these counties comprise about 82% of the inpatients with approximately 62% of the inpatients living in Ada County and 20% in Canyon County. Ada and Canyon counties are part of Idaho Health Districts 3 and 4.Both Idaho and the service territory are comprised of about 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 13% of the defined service area. Canyon County is approximately 24% Hispanic,and Ada County is 8% Hispanic.Idaho experienced a 25% increase in population from 2000 to 2013 ranking it is one of the fastest growing states in the country. Ada and Canyon Counties followed that trend,experiencing an even more rapid 42% increase in population within the timeframe. St. Luke's Regional Medical Center is constantly working to manage the volume and scope of its services in order to meet the needs of an increasing population.Over the past ten years the 45 to 64 year old age group was thefastest growing segment of the community. Over the next ten years, however,the 65 years or older age group is expected to grow by over 50%, making it the fastest growing segment. Currently,about 11% of the people in the community are over the age of 65 and by 2020 about 13% of the population in the community is expected to be over the age of 65.The official United States poverty rate increased from 12.5% in 2003 to 15.6% in 2013. Ourservice area poverty rate has increased more rapidly than the national average since 2003especially in Canyon County. The poverty rate in Canyon County is currently over 20%. Thepoverty rate in our community for children under the age of 18 is well below the nationalaverage for Ada County and slightly above the national average for Canyon County. Althoughboth Ada and Canyon County poverty rates have started to level out, they are still well abovewhere they were prior to the recession in 2008.Median income in the United States has risen by 20% since 2003. However, growth inincome was slower in Idaho and in our service area during that period. Median income inCanyon County is well below the national median and lower than Idaho's median income.Median income in Ada County is still slightly higher than the national median income. Part VI, Line 5: The people who serve on the various boards for subsidiaries within the St. Lukes 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 Regional Medical Center,Ltd.(SLRMC)maintains an open medical staff. Any physician can apply for practicing privileges as long as they meet the standards of SLRMC. 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 our communities." 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 Childrens Hospital --St. Luke's Boise/Meridian/Nampa/Caldwell/Fruitland Physician Clinics --St. Luke's Nampa Emergency Department/Urgent Care --St. Luke's Eagle Urgent Care --St. Luke's Elmore Hospital with physician clinic --St. Luke's Fruitland Emergency Department/Urgent Care --St. Luke's Rehabilitation(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) 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 Part VI, Line 7, Reports Filed With States ID 1 St Luke's Health FoundationLtd 190 East Bannock Street Boise ID 83712 810600973 501(c)(3) 1459705 Provide support for overall operational needs of St. Luke's Health Foundation, Inc. City of Boise Planning PO Box 500 Boise ID 83701 826000165 115 165726 Donations represent rent paid on behalf of the Allumbaugh House (operated by Terry Reilly) Boise State University 1910 University Drive Boise ID 83725 826010706 501(c)(3) 100000 Provide financial support for nursing building Idaho State University FoundationInc 921 South 8th Avenue Stop 8050 Pocatello ID 83209 826013543 501(c)(3) 50000 Support Treasure Valley Anatomy and Physiology Laboratory at ISU - Meridian Health Science Center Women's and Children's Alliance 720 West Washington Street Boise ID 83702 820204464 501(c)(3) 40500 Support Sue B. Memorial Walk, Financial Literacy Tools, Facility expansion of Serena's House Treasure Valley Family YMCA 1050 West State Street Boise ID 83702 820200908 501(c)(3) 30500 Support Healthy Living Financial Assistance, Cancer Fitness Fundamentals, Moving for Better Balance, Enhance Fitness and the YMCA Diabetes Prevention Program Boise Metro Chamber of Commerce PO Box 2368 Boise ID 83701 820100595 501[c](6) 30000 Support of regional economic development Family Advocacy Center and Education Services 417 S 6th Street Boise ID 83702 204883532 501(c)(3) 30000 Support mission of reducing victimization The Salvation Army 180 E Ocean Boulevard 9th Floor Long Beach CA 90802 941156347 501(c)(3) 30000 Support new facility construction for the school and community center Boys and Girls Club of Ada County 610 East 42nd Street Boise ID 83714 820481687 501(c)(3) 25000 Support Triple Play and new facility The Momentum Group DBA Create Common Good 2513 South Federal Way No 104 Boise ID 83705 931277434 501(c)(3) 15000 Support the Healthy Feeding Program Genesis World MissionInc 215 West 35th Street Garden City ID 83714 820505074 501(c)(3) 10750 Support Garden City Community Clinic Snake River Stampede for the Cure Foundation 16114 Idaho Center Blvd STE 4 Nampa ID 83687 464244298 501(c)(3) 10000 Support Stampede for the Cure JannusInc 1607 West Jefferson Street Boise ID 83702 816035382 501(c)(3) 8000 Support of Caregiver Conference and Legacy Corps Caregiver Support Community Health Clinics Inc DBA Terry Reilly Health Services 211 16th Ave North PO Box 9 Nampa ID 83653 820300537 501(c)(3) 7500 Support SANE Solutions and Annual Gala Children's Home Society 740 Warm Springs Avenue Boise ID 83712 820201128 501(c)(3) 6250 Support Community Support Program and the World Tour Annual Gala Big Brothers Big Sisters of SW ID Inc 110 N 27th Street bOISE ID 83705 820349401 501(c)(3) 6000 Support Mentoring Matters The Learning Lab Inc 308 East 36th Street Garden City ID 83714 820461933 501(c)(3) 6000 Support Healthy Families literacy program and Lunch for Literacy Hands of Hope NorthwestInc 1201 Powerline Road Nampa ID 83686 841398889 501(c)(3) 554630 FMV Medical equipment and supplies Provide durable medical equipment and medical supplies to people in need in the Treasure Valley 19 0 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. 0 1 0 0 0 0 0 0 0 Ron JutzyMD Director 0 546559 0 0 0 7046 0 8230 0 15503 0 577338 0 0 Ms Kathy Moore Chief Executive Officer-St 0 553445 0 0 0 45713 0 12065 0 18529 0 629752 0 0 Bayo Crownson MD Director 0 252535 0 0 0 14776 0 10865 0 17806 0 295982 0 0 MrJeffrey S Taylor SR VP/CFO/Treasurer 0 517797 0 0 0 45779 0 705980 0 15946 0 1285502 0 0 Ms Christine Neuhoff VP/Legal Affairs/Secretary 0 397661 0 0 0 19259 0 16180 0 16387 0 449487 0 0 Ronald M KristensenMD Physician 0 940107 0 275156 0 65848 0 42518 0 19156 0 1342785 0 22534 Colin E Poole MD Physician 0 896959 0 211692 0 43276 0 24410 0 15210 0 1191547 0 0 Andrew ForbesMD Physician 0 887765 0 75166 0 83413 0 64410 0 16948 0 1127702 0 40008 Steven S HuerdMD Physician 0 908835 0 70306 0 88662 0 60295 0 417 0 1128515 0 51775 Jim F Valentine MD Physician 0 660320 0 431757 0 42295 0 16180 0 16363 0 1166915 0 0 Mr Chris Roth Former CEO and Director 0 634949 0 0 0 19230 0 16180 0 17875 0 688234 0 0 Mr Gary L Fletcher Former CEO and Director 0 162531 0 0 0 244608 0 880 0 385 0 408404 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 Regional Medical Center,Ltd.(SLRMC). 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 SLRMC. 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'15, Jeffrey S. Taylor was a participant in the supplemental non-qualified executive retirement plan. There were no additional benefits were accrued during CY'15 on behalf of the participant. Part II-Column (f) Reportable compensation is based on the total amount paid during calendar year 2015, including current year payments of amounts reported in prior years as contributions to employee benefit plans and deferred compensation, together with investment earnings from those prior year contributions. As a result, certain amounts have been reported twice, both in prior years when earned or accrued, and again in the current year when paid. Part II-Column (c) During CY'15 the following individual participated in the basic pension plan. Due to enhanced benefits adopted in 2015 and changes in actuarial assumptions this individual experienced a increase in the vested balance of the plan. Jeffrey Taylor $681,570 A Idaho Health Facilities Authority 826051863 451295TW9 2008-12-04 126435101 Capital Projects for Health Care Facilities 0 0 0 B Idaho Health Facilities Authority 826051863 451295VK2 2010-09-09 210427891 Current Refunding of Bonds Issued 7/20/2000 and 5/26/2005 0 0 0 C Idaho Health Facilities Authority 826051863 451295VN6 2012-07-11 75896250 Capital Projects for Health Care Facilities 0 0 0 D Idaho Health Facilities Authority 826051863 000000000 2012-07-31 75000000 Capital Projects for Health Care Facilities 0 0 0 A 9155000 126443653 16961139 1410199 112389945 2009 0 0 1 1 B 35955000 210427891 3658672 210427891 1 0 1 1 C 76185123 41 946613 75238511 2013 0 0 1 1 D 10465000 75000000 75000000 2013 0 0 1 1 A 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: Idaho Health Facilities Authority Date the Rebate Computation was Performed: 01/14/2014 Issuer Name: Idaho Health Facilities Authority Date the Rebate Computation was Performed: 11/24/2015 Schedule K Supplental Information Differences between the issue price(Part I)and total proceeds(Part II, line 3)are due to investment earnings or losses. Part II, Line 4,Column A,(Entity 1 page): 2008A Bonds Amounts presented consist of Debt Reserve Fund deposits of $13,746,470 and Debt Service Fund Deposits of $3,214,669. Part II, Line 4,Column B,(Entity 1 Page): 2010 Bonds Amounts presented consist of Debt Service Fund Deposits of $3,658,672. Part II, Line 4,Column A,(Entity 2 page): 2012 C,D Bonds Amounts presented consist of Debt Service Fund Deposits of $179,986.31 Schedule K, Part IV, Arbitrage, Line 2c: (B) Issuer Name: Idaho Health Facilities Authority Date the Rebate Computation was Performed: 11/24/2015 A Idaho Health Facilities Authority 826051863 451295VP1 2012-10-24 150000000 Current Refunding of Bonds issued 3/4/2009 0 0 0 B Idaho Health Facilities Authority 826051863 451295WC9 2014-08-20 176779592 Capital Projects for Health Care Facilities 0 0 0 A 150000000 179986 150000000 1 0 1 1 B 170000 178073958 1798967 87277712 88997278 0 0 0 1 A 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 Syringa Family Medicine PA Board Member is a member of Syringa Family Medicine, P.A. 201395 Catherine Reynolds, M.D., is a member of Syringa Family Medicine, P.A. Compensation for Dr. Reynolds was paid to Syringa Family Medicine under a Professional Service Agreement. 0 Colliers Paragon dba Colliers International Board Member is owner of Colliers Paragon 686189 Colliers Paragon dba Colliers International provides property management services for St. Luke's Regional Medical Center,Ltd. 0 Form 990, Part VI, Section A, line 6 St. Luke's Health System,Ltd. is the sole member of St. Luke's Regional Medical Center,Ltd. Form 990, Part VI, Section A, line 7a St. Luke's Health System,Ltd.(Member)and St. Luke's Regional Medical Center,Ltd.(Corporation)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). 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 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 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 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 11 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 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 of those surveyed. These surveys are usually done every two years,with the most recent compensation survey completed during calendar year 2016. 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,which contains financial information,is available for public inspection. Form 990, Part XI, line 9: Change in Minimum Liability-Defined Benefit Plan -15,552,260. Southern Idaho Health Partners Investment 3,000,000. Form 990 Part VII Section A 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. Chris Roth: St. Luke's Health System,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. 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'15, SLRMC paid Syringa $201,731 for services rendered to St. Luke's patients. Also, it should be noted that the hours reported for the directors (employed by St. Luke's) officers, key employees, and highest-paid employees are based on a minimum 40 hour work week. However,due to the demands of their roles within the St. Luke's Health System, the hours worked by these individuals often exceed the minimum required 40 hours. Form 990 Part V, Line 1&2 During tax reporting year 2016 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-Treasure ValleyLLC 190 E Bannock Boise ID 83712 452716222 Physician Clinic Services ID 157952743 -424681365 St Luke's Regional Medical CenterLtd Southern Idaho Health PartnersLLC 190 E Bannock Boise ID 83712 471589095 Physician Clinic Services ID 24223577 5319998 St Luke's Regional Medical CenterLtd St Luke's Health SystemLtd 190 E Bannock Boise ID 83712 562570681 Supporting Organization ID 501(c)(3) 11-3 N/A 0 Mountain States Tumor InstituteInc 100 E Idaho Boise ID 83712 820295026 Healthcare Services ID 501(c)(3) 3 St Luke's Regional Medical CenterLTd 1 St Luke's Wood River Medical CenterLtd 190 E Bannock Boise ID 83712 841421665 Healthcare Services ID 501(c)(3) 3 St Luke's Health SystemLtd 0 St Luke's Health FoundationLtd 190 E Bannock Boise ID 83712 810600973 Fundraising ID 501(c)(3) 7 St Luke's Health SystemLtd 0 St Luke's Magic Valley Regional Medical CenterLtd 801 Pole Line Road Twin Falls ID 83301 562570686 Healthcare Services ID 501(c)(3) 3 St Luke's Health SystemLtd 0 St Luke's McCallLtd 190 E Bannock Boise ID 83712 273311774 Healthcare Services ID 501(c)(3) 3 St Luke's Health SystemLtd 0 St Luke's Clinic Coordinated CareLtd 190 E Bannock Boise ID 83712 455195864 Accountable Care Organization ID 501(c)(3) 9 St Luke's Health SystemLtd 0 SL Phys Realty-LouiseLLC 190 E Bannock Boise ID 83712 263731325 Real Estate Lease ID N/A Related 1157025 2037018 1 1 0.87000 1500 ShorelineLLC 190 E Bannock Boise ID 83712 270681501 Real Estate Lease ID N/A Related 447054 1267018 1 1 0.55000 3399 East Louise MOBLLC 190 E Bannock Boise ID 83712 270848198 Real Estate Lease ID N/A Related 772947 1906128 1 1 0.67000 Ortho-Neuro ManagementLLC 190 E Bannock Boise ID 83712 264483076 Mgmt. Consulting ID N/A Related 331803 1618409 1 1 0.58000 Anderson Plaza Medical Building Inc 190 E Bannock St Boise ID 83702 820448741 Medical Offices ID 0 St Luke's Office Plaza 190 E Bannock St Boise ID 83702 820389626 Medical Offices ID 0 St Luke's Elmore Medical Building Inc 190 E Bannock St Boise ID 83702 813992116 Medical Offices ID 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 1 1 1 1 0 St Luke's Health FoundationLtd B 1459795 Operating Loss Subsidy St Luke's Health FoundationLtd C 1524830 Donations specified for SLRMC Ortho Neuro Management ServicesLLC P 2346100 Per Mgmt. Agreement SL Phys Realty-LouiseLLC K 1968860 Per Master Lease Agreement 1500 ShorelineLLC K 1200033 Per Master Lease Agreement 3399 East LouiseMOB-LLC K 1751762 Per Master Lease Agreement