2014-11-05T11:02:35-06:00 2013-12-31 990 2013-01-01 410714079 ST LUKE'S HOSPITAL OF DULUTH STLU 2182495555 915 EAST FIRST STREET DULUTH MN 55805 ERIC LOHN CHIEF FINANCIAL OFFICER 2182495555 2014-11-05 2013 2015-11-30 17:44:51Z JOHN STRANGE 915 EAST FIRST STREET DULUTH MN 55805 393591568 0 X WWW.SLHDULUTH.COM X 1881 MN TO SERVE AS A LEADING HEALTHCARE PROVIDER OF QUALITY HEALTHCARE SERVICES IN OUR SURROUNDING REGION. 16 12 2837 340 7810634 -57318 893443 901203 346213726 372868817 666761 1985523 2140075 2137537 349914005 377893080 310090 370500 0 0 208770427 224069906 0 0 0 136566876 150494466 345647393 374934872 4266612 2958208 191730114 193445478 187687919 162460176 4042195 30985302 X THE PATIENT ABOVE ALL ELSE. 0 0 318509946 370500 372868817 ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFIT:A. OUR MISSION IS TO SERVE AS A LEADING PROVIDER OF QUALITY HEALTHCARE SERVICES IN OUR LOCAL COMMUNITY AND THE SURROUNDING 17-COUNTY REGION OF NORTHEASTERN MINNESOTA, NORTHWESTERN WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. AS THE FEDERALLY DESIGNATED REGIONAL TRAUMA CENTER FOR THIS REGION, ST. LUKE'S PROVIDES CRITICAL ACCESS TO HIGH QUALITY ACUTE HEALTHCARE SERVICES.B. ST. LUKE'S RECOGNIZES ITS RESPONSIBILITY TO THE COMMUNITY BY PROVIDING FINANCIAL SUPPORT TO COMMUNITY ORGANIZATIONS; OFFERING EDUCATION PROGRAMS, OUTREACH PROGRAMS AND SUPPORTING THE COMMUNITY THROUGH EMPLOYEE VOLUNTEER EFFORTS AND DONATIONS. WE SUPPORT THE LAKE SUPERIOR COMMUNITY HEALTH CENTER AND THE HEALTH CARE ACCESS OFFICE. IN 2013, ST. LUKE'S DONATED MORE THAN 800 HOURS TO ENRICH THE HEALTHCARE OF THE COMMUNITY, INCLUDING SERVING ON BOARDS OF THE MN HOMECARE ASSOCIATION,UNITED WAY, AND OTHER NON-PROFIT ORGANIZATIONS IN OUR COMMUNITY.C. ST. LUKE'S SERVES A DISPROPORTIONATE SHARE OF MEDICARE AND MEDICAID PATIENTS. ALSO, THROUGH OUR PATIENT ASSISTANCE PROGRAM, WE PROVIDE FULL OR PARTIALLY SUBSIDIZED SERVICES TO INDIVIDUALS AND FAMILIES WHO ARE UNABLE TO PAY. AT ADMISSION AND THROUGH PATIENT HANDBOOKS, PATIENTS ARE GIVEN INFORMATION TO CONTACT ST. LUKE'S FINANCIAL COUNSELORS FOR INFORMATION ON OUR FINANCIAL ASSISTANCE PROGRAMS. ALSO, ST. LUKE'S PROVIDES MEDICAL TRANSPORT SERVICES AT LESS THAN COST TO OUR PATIENTS IN THE REGION. ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTION:ST. LUKE'S IS A NOT-FOR-PROFIT, COMMUNITY-BASED, NON-DENOMINATIONAL HOSPITAL, GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS. OUR MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS AND ALLIED HEALTH PROFESSIONALS. ST. LUKE'S EMERGENCY DEPARTMENT SERVES PATIENTS REGARDLESS OF ABILITY TO PAY. ST. LUKE'S RESEARCH DEPARTMENT, THE WHITESIDE INSTITUTE FOR CLINICAL RESEARCH, PARTICIPATES IN INVESTIGATIONAL DRUG PROTOCOLS THAT ARE NON-FUNDED OR UNDER-FUNDED.ST. LUKE'S IS A CLINICAL TRAINING SITE FOR MANY HEALTHCARE STUDENTS. IN ADDITION TO MEDICAL STUDENTS AND RESIDENTS, WE PROVIDE CLINICAL TRAINING FOR STUDENTS IN NURSING, PHYSICAL MEDICINE, RADIOLOGY, RESPIRATORY, LAB, MEDICAL ASSISTANT, OCCUPATIONAL THERAPY, PHYSICIAN ASSISTANT, DIETETICS, SOCIAL WORK, MEDICAL RECORD CODING, PARAMEDIC, HEALTH UNIT COORDINATOR, SURGICAL TECHNOLOGY, ANESTHESIA AND PHARMACY.WE CONTRIBUTED TO SCHOLARSHIP FUNDS FOR MEDICAL STUDENTS AT THE UNIVERSITY OF MINNESOTA, DULUTH SCHOOL OF MEDICINE AND NURSING STUDENTS AT THE COLLEGE OF ST. SCHOLASTICA AND LAKE SUPERIOR COLLEGE.OTHER EDUCATION ACTIVITIES REACH TENS OF THOUSANDS OF PEOPLE THROUGH COMMUNITY EDUCATION AND OUTREACH, HEALTH SCREENINGS, SUPPORT GROUPS AND OTHER COMMUNITY SERVICES. OUR SPEAKERS BUREAU OFFERED PROGRAMS AT NO CHARGE TO THOUSANDS MORE. TOPICS PRESENTED INCLUDED MEN'S HEALTH, WOMEN AND BREAST CANCER, CHILDREN'S NUTRITION, MENTAL HEALTH ISSUES, CARDIAC ISSUES, FALL PREVENTION, FIRST AID, DIABETES, EYE AND LUNG ISSUES, AND INFECTION CONTROL.WE ALSO OFFERED TOURS TO DOZENS OF COMMUNITY AND SCHOOL GROUPS, MADE MEDICAL SUPPLIES/EQUIPMENT DONATIONS TO COMMUNITY AND MEDICAL RELIEF ORGANIZATIONS, DONATED NEWSPAPER ADVERTISING SPACE FOR THE JUNIOR LEAGUE OF DULUTH, PARTICIPATED IN THE COMMUNITY COALITION FOR FALL PREVENTION AND OFFERED BROCHURE PRINTING SERVICES TO A LOCAL MEDICAL PROFESSIONAL GROUP. ANNUALLY, WE PROVIDE RENT-FREE, HUNDREDS OF HOURS OF FREE MEETING SPACE FOR COMMUNITY GROUPS, SUCH AS LYME DISEASE SUPPORT GROUP, MOTHERS OF MULTIPLES AND THE OSTOMY CLUB, AND ORGANIZATIONS SUCH AS THE MINNESOTA HOMECARE ASSOCIATION, THE BOY SCOUTS, AND THE COLLEGE OF ST. SCHOLASTICA.WE OFFER SUPPORT GROUPS TO THE COMMUNITY, INCLUDING: - HEART-TO-HEART SUPPORT GROUP - PARKINSON'S DISEASE - LOOK GOOD, FEEL GOOD GROUP (THROUGH THE AMERICAN CANCER SOCIETY) - CANCER INFORMATION AND SUPPORT GROUP - OSTOMY CLUB - BREAST CANCER SUPPORT GROUP - DIABETES SUPPORT GROUP (SPONSORED BY ST. LUKE'S, DULUTH DIABETES CENTER AND THE DULUTH FAMILY PRACTICE CENTER) - INSULIN PUMP SUPPORT GROUP (SPONSORED BY ST. LUKE'S, DULUTH DIABETES CENTER AND THE DULUTH FAMILY PRACTICE CENTER) - CELIAC SUPPORT GROUP (SPONSORED BY ST. LUKE'S AND ST. MARY'S/DULUTH CLINIC)WE PARTICIPATE IN MEDICAID, MEDICARE, CHAMPUS, TRICARE AND OTHER GOVERNMENT SPONSORED HEALTH CARE PROGRAMS.DURING 2013, THERE WERE 10,070 ADMISSIONS, 48,314 PATIENT DAYS, 517,305 CLINIC VISITS, 149,258 OUTPATIENT REGISTRATIONS AND 35,105 EMERGENCY/URGENT CARE VISITS. 318509946 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 70 0 2837 0 1 1 0 0 0 0 0 0 0 X 16 12 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X ERIC LOHN 2182495475 915 EAST FIRST STREET DULUTH MN 55805 MARK EMMEL BOARD CHAIR 1.00 X X 0 0 0 DALE MOE PAST CHAIR 1.00 X X 0 0 0 DAVE MCMILLAN BOARD VICE CHAIR 1.00 X X 0 0 0 GAIL BALDWIN BOARD SECRETARY 1.00 X X 0 0 0 JESSE FRYE BOARD TREASURER 1.00 X X 0 0 0 LISA BODINE BOARD MEMBER 1.00 X 0 0 0 JEFF BORLING BOARD MEMBER 1.00 X 0 0 0 JOHN CLOUTIER BOARD MEMBER 1.00 X 0 0 0 MARLENE DAVID BOARD MEMBER 1.00 X 0 0 0 EDWIN KING HALL BOARD MEMBER 1.00 X 0 0 0 BRIAN MURPHY BOARD MEMBER 1.00 X 0 0 0 KATHLEEN NELSON EDD BOARD MEMBER 1.00 X 0 0 0 MARSHALL WATSON MD BOARD MEMBER/PHYSICIAN 40.00 X 823742 0 24927 RUTH WESTRA DO BOARD MEMBER 1.00 X 0 0 0 ELISABETH REVOIR MD BOARD MEMBER/CHIEF OF STAFF 40.00 X 330567 0 28715 DEL PREVOST BOARD MEMBER (THRU MAY 2013) 1.00 X 0 0 0 KRISTI STOKES BOARD MEMBER (THRU APR 2013) 1.00 X 0 0 0 JOHN STRANGE PRESIDENT/CEO 36.00 4.00 X X 607585 0 150766 ERIC LOHN VICE PRESIDENT/CFO 36.00 4.00 X 144020 0 42315 SUSAN BENJAMIN VICE PRESIDENT/CFO (THRU JAN 2013) 36.00 4.00 X 137879 0 4183 JOHN YOON MD PHYSICIAN 40.00 X 1257669 0 29915 JOHN WATKINS MD PHYSICIAN 40.00 X 881035 0 23369 DAVID FOGARTY MD PHYSICIAN 40.00 X 800167 0 13365 DIONYSIOS KLIRONOMOS MD PHYSICIAN 40.00 X 799236 0 19751 MARY BOYLEN MD PHYSICIAN 40.00 X 798280 0 31548 6580180 0 368854 332 0 1 0 STONEARCH CREATIVE 710 S 2ND ST 7TH FLOOR MINNEAPOLIS MN 55401 MARKETING SERVICES 1672361 MAYO COLLABORATIVE SERVICES PO BOX 9416 MINNEAPOLIS MN 55480 LABORATORY SERVICES 1499907 ECLINICALWORKS LLC 2 TECHNOLOGY DRIVE WESTBOROUGH MA 01581 IT SERVICES 793944 NORTHLAND CONSTRUCTORS OF DULUTH LLC 4843 RICE LAKE ROAD DULUTH MN 55803 CONSTRUCTION SERVICES 745758 CONSULTING RADIOLOGISTS LTD 1221 NICOLLET AVE SUITE 600 MINNEAPOLIS MN 55403 RADIOLOGICAL SERVICES 714892 42 636057 202723 62423 901203 MEDICAL SERVICES 621990 280099321 280099321 PHARMACY 446110 92534634 84936875 7433889 163870 TRANSCRIPTION 541900 97165 34941 62224 CREDENTIALING 541900 78885 78885 GUEST CARE 541900 37945 37945 20867 11230 9637 372868817 2049192 2049192 1457847 1451182 6665 6665 6665 14030182 13918560 175291 111622 -175291 -63669 -63669 155243 153455 1788 1788 MEALS/VENDING INCOME 900099 1340961 1340961 PARKING LOT INCOME 900099 471997 471997 LAUNDRY SERVICES 812300 171788 107351 64437 144338 144338 2129084 377893080 365036196 7810634 4145047 370500 370500 2293510 2293510 173092813 155829252 17263561 8692673 7723366 969307 29549270 26254274 3294996 10441640 9053380 1388260 313012 313012 131387 131387 23674 23674 84119 84119 14880445 5438334 9442111 566867 566867 8953345 4750973 4202372 3007273 2518470 488803 19544211 12150005 7394206 1586959 1396291 190668 3768182 3737758 30424 8205394 5671780 2533614 2100564 2100564 MEDICAL SUPPLIES 35826055 35826055 DRUGS 28330996 28330996 CHARITY CARE 9348515 9348515 BAD DEBT EXPENSE 6444542 1689821 4754721 7378926 5729071 1649855 374934872 318509946 56424926 0 7199835 13599836 48424395 41153754 6840869 6983226 1989089 2189964 169683369 115936459 50436952 53746910 31065194 23973059 28879235 28438197 2841149 1647491 1568393 15247054 18950990 191730114 193445478 37552232 35790530 83138315 81620077 881827 289900 66997372 43877842 187687919 162460176 X 4042195 30985302 4042195 30985302 191730114 193445478 X 2958208 -572864 24557763 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 23674 23674 0 PART II-B, LINE 1: A PORTION OF THE DUES THAT ST. LUKE'S HOSPITAL PAYS TO THE AMERICAN HOSPITAL ASSOCIATION AND MINNESOTA HOSPITAL ASSOCIATION ARE USED TO ADVOCATE ON BEHALF OF THE HOSPITAL AND ISSUES RELATING TO HEALTHCARE. IN ADDITION TO THE ABOVE, ST. LUKE'S HOSPITAL ALSO PAID A LAW FIRM TO LOBBY ON BEHALF OF THE HOSPITAL. 6260352 6260352 70691141 50466856 20224285 2656692 1198218 1458474 85173060 64271385 20901675 4902124 4902124 53746910 SHORT TERM INVESTMENTS 28438197 F 28438197 DEFERRED COMPENSATION 11210416 PREPAID BOND EXPENSE 2331255 CASH SURRENDER LIFE INSURANCE 1243140 OTHER ASSETS 22567 DUE FROM RELATED PARTY 771338 DUE FROM THIRD PARTY 3372274 18950990 EMPLOYEE BENEFIT OBLIGATIONS 41232762 THIRD PARTY PAYABLE 224860 DUE TO RELATED PARTY 59380 SECURITY DEPOSITS 8617 DEFERRED RENT LIABILITY 794079 ASSET RETIREMENT OBLIGATION 1224544 MALPRACTIVE LIABILITY RESERVE 333600 43877842 X 362916642 -15793060 -15793060 378709702 -816623 -816623 377893079 360746450 1604638 1604638 359141812 15793060 15793060 374934872 PART X, LINE 2: THE SYSTEM IS COMPRISED OF THREE SEPARATE NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE THAT ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(C)(3) OF THE CODE. THE SYSTEM HAS ELECTED TO ADOPT GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE SYSTEM FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAS NO EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL TAX AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2011 TO 2013 ARE OPEN TO EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHARITY CARE -9,348,518. PROVISION FOR BAD DEBT -6,444,542. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT INCOME 788,015. RENTAL EXPENSES -1,451,182. GIFT SHOP EXPENSES -153,456. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 1,451,182. GIFT SHOP EXPENSES 153,456. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHARITY CARE 9,348,518. PROVISION FOR BAD DEBT 6,444,542. 1 1 X 1 X 1 X 1 1 0 1 1 3125967 3125967 0.00830 44275718 32348790 11926928 0.03180 47401685 32348790 15052895 0.04010 268723 268723 0.00070 6405125 6405125 0.01710 5145260 5145260 0.01370 619008 619008 0.00170 12438116 12438116 0.03320 59839801 32348790 27491011 0.07330 78942 78942 0.00020 344 344 0.00000 251 251 0.00000 83439 83439 0.00020 123148 123148 0.00030 238 238 0.00000 286362 286362 0.00070 1 6444542 126991000 172217816 -45226816 X 1 1 1 CENTER FOR DIAGNOSTIC IMAGING DIAGNOSTIC IMAGING 0.21000 0.00000 0.21000 2 PAVILION SURGERY CENTER OUTPATIENT AMBULATORY SURGERY 0.50000 0.05000 0.45000 1 1 ST LUKES HOSPITAL 915 EAST FIRST STREET DULUTH MN 55805 WWW.SLHDULUTH.COM 365862 X X X X X ST LUKE'S HOSPITAL OF DULUTH 1 1 X X X X X X X X X 13 1 1 1 X HTTP://WWW.SLHDULUTH.COM/FIND-A-LOCATION/ X X X X X X X X 0 0 1 1 100.000000000000 1 300.000000000000 1 X X X X X X X 1 1 X X X X X X 1 0 X X X X 1 X 0 0 ST LUKE'S HOSPITAL OF DULUTH PART V, SECTION B, LINE 3: THROUGHOUT THE PROCESS, ST. LUKE'S WORKED WITH THE GENERAL COMMUNITY AND ORGANIZATIONS REPRESENTING MINORITY AND PATIENT-TYPE GROUPS, OTHER HEALTHCARE PROFESSIONALS WITH SPECIALIZED KNOWLEDGE OF OUR COMMUNITY'S HEALTH NEEDS AND SYSTEMS WERE ENGAGED THROUGHOUT THE PROCESS TO ENSURE BROADER COMMUNITY SUPPORT. THEY INCLUDED LEADERS FROM THE CITY/COUNTY HEALTH DEPARTMENT AND LEADERS FROM LOCAL HEALTH ORGANIZATIONS. THEY INCLUDED THE FOLLOWING: AMERICAN LUNG ASSOCIATION, ARROWHEAD ECONOMIC OPPORTUNITY AGENCY, ARROWHEAD HEAD START, ARROWHEAD PARISH NURSE ASSOCIATION, ARROWHEAD REGIONAL DEVELOPMENT COMMISSION, CHURCHES UNITED IN MINISTRY, COMMUNITY ACTION DULUTH, ACCOMUNITY HEALTH BOARD, ELY COMMUNITY RESOURCES, ELY-BLOOMENSON COMMUNITY HOSPITAL, ESSENTIA HEALTH, ESSENTIA HEALTH-NORTHERN PINES, ESSENTIA HEALTH-VIRGINIA (FORMERLY VIRGINIA REGIONAL HEALTH CENTER), EVELETH GLIBERT PUBLIC SCHOOL, FAIRVIEW RANGE, FAMILY SERVICE COLLABORATIVE, GENERATIONS HEALTH CARE INITIATIVES, GLORIA DEI LUTHERAN CHURCH, HIBBING FAMILY MEDICAL CLINIC (ST. LUKE'S), INSTITIUTE FOR A SUSTAINABLE FUTURE, INTEGRITY HEALTH NETWORK, ITASCA COUNTY HEALTH AND HUMAN SERVICES, LAKE COUNTY, LAKE COUNTY HUMAN SERVICES, LAKE COUNTY PUBLIC HEALTH, LAKE COUNTY PUBLIC HEALTH ADVISORY COMMITTEE, LAKE COUNTY SHIP COORDINATOR, LAKE SUPERIOR COLLEGE-DEPARTMENT OF ALLIED HEALTH NURSING, LAKE SUPERIOR COMMUNITY HEALTH CENTER, LAKE SUPERIOR SCHOOL DISTRICT, LAKE VIEW CLINIC, LAKE VIEW HOSPITAL, LAURENTIAN MEDICAL CLINIC (ST. LUKE'S), LOCAL INITIATIVE SUPPORT CORPORATION, MINNESOTA DEPARTMENT OF HEALTH, SALVATION ARMY, SCENIC RIVERS HEALTH, ST. LOUIS COUNTY ADVISORY COMMITTEE, ST. LOUIS COUNTY PUBLIC HEALTH AND HUMAN SERVICES DEPARTMENT, ST. LUKE'S CARDIOVASCULAR ASSOCIATES, ST. LUKE'S FOUNDATION, TWO HARBORS AREA PARTNERS, AND UNITED WAY. COMMUNITY INPUT WAS GATHERED THROUGH A SERIES OF FOCUS GROUPS AND COMMUNITY MEETINGS THAT TOOK PLACE BETWEEN OCTOBER 2012 AND OCTOBER 2013. THIS INPUT INCLUDED INDIVIDUALS REPRESENTING PERSONS WITH EXPERTISE IN PUBLIC HEALTH; LEADERS, REPRESENTATIVES AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, MINOIRITY POPULATIONS; AND POPULATIONS WITH CHRONIC DISEASE NEEDS FROM THE COMMUNITY SERVED BY THE HOSPITAL. ST LUKE'S HOSPITAL OF DULUTH PART V, SECTION B, LINE 4: ST. LUKE'S WORKED WITH LAKE VIEW MEMORIAL HOSPITAL, A RELATED ENTITY, WHEN COMPLETING THEIR COMMUNITY HEALTH NEEDS ASSESSMENT. ST LUKE'S HOSPITAL OF DULUTH PART V, SECTION B, LINE 7: THE NEEDS CHOSEN (OBESITY, PHYSICAL ACTIVITY, AND NUTRITION AND SMOKING CESSATION) ARE DIRECTLY RELATED TO MOST, IF NOT ALL OF THE OTHER HEALTH NEEDS IDENTIFIED. THE POPULATIONS FOR THE CHOSEN HEALTH NEEDS OVERLAP TO A LARGE DEGREE WITH THOSE OF THE NON-SELECTED HEALTH NEEDS:1. MENTAL HEALTH ISSUES IN YOUTH AND ADULTS2. INCREASED POVERTY3. YOUTH ENGAGED IN SEXUAL ACTIVITY4. ACCESS TO DENTAL CARE5. UNINSURED AND UNDERINSURED6. DIABETES7. FOOD INSECURTY8. LOW VACCINATIONS AND OTHER IMMUNIZATION RATES9. HIGH INCIDENCE OF HEART DISEASE10. HEALTHCARE NEEDS TO INTEGRATE PUBLIC HEALTH INTO MENTAL HEALTHTHE SYSTEM BELIEVES IT HAS THE BEST OPPORTUNITY TO POSITIVELY IMPACT A LARGER PORTION OF THE POPULATION WITH THE NEEDS SELECTED. ST LUKE'S HOSPITAL OF DULUTH PART V, SECTION B, LINE 20D: ST. LUKE'S HOSPITAL USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE MINIMUM DISCOUNT AVAILABLE UNDER THE FAP IS 42.4%, SO ALL INDIVIDUALS WHO QUALIFY FOR FINANCIAL ASSISTANCE RECEIVE A DISCOUNT AT LEAST AS LARGE AS THE AVERAGE INSURANCE DISCOUNT. THEREFORE, ALL INDIVIDUALS WHO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE FAP ARE ASKED TO PAY LESS THAN AMOUNTS GENERALLY BILLED. SCHEDULE H, PART V, SECTION B, LINE 1 THE COMMUNITY NEEDS HEALTH NEEDS ASSESSMENT WAS UPDATED TO INCLUDE ADDITIONAL DETAILS IDENTIFIED IN LINE 1C THRU LINE 1I SUBSEQUENT TO FISCAL YEAR END 12/31/2013 IN ORDER TO MORE FULLY COMPLY WITH THE IRS' PROPOSED REGULATIONS. 44 ST LUKE'S INTERNAL MEDICINE ASSOCIATES 1001 E SUPERIOR ST DULUTH MN 55802 OUTPATIENT MEDICAL ST LUKE'S RADIATION ONCOLOGY ASSOCIATES 1001 E SUPERIOR ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S CARDIOLOGY ASSOCIATES 1001 E SUPERIOR ST DULUTH MN 55802 OUTPATIENT MEDICAL MARINER MEDICAL CLINIC 109 N 28TH ST E SUPERIOR WI 54880 OUTPATIENT MEDICAL ST LUKE'S PAVILION SURGICAL ASSOCIATES 920 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL & AMBULATORY SURGERY CHEQUAMEGON CLINIC 415 ELLINS AVE ASHLAND WI 54806 OUTPATIENT MEDICAL ST LUKE'S CARDIOTHORACIC SURGICAL ASSOC 920 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL PS RUDIE MEDICAL CLINIC 26 EAST SUPERIOR STREET DULUTH MN 55802 OUTPATIENT MEDICAL HIBBING FAMILY MEDICAL CENTER 1120 E 34TH ST HIBBING MN 55746 OUTPATIENT MEDICAL ST LUKE'S GASTROENTEROLOGY ASSOCIATES 920 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S MENTAL HEALTH 220 N 6TH AVE E DULUTH MN 55802 OUTPATIENT MEDICAL DULUTH INTERNAL MEDICINE ASSOCIATES 220 MEDICAL ARTS BLDG DULUTH MN 55802 OUTPATIENT MEDICAL MOUNT ROYAL MEDICAL CLINIC 1400 WOODLAND AVE DULUTH MN 55803 OUTPATIENT MEDICAL MARINER CLINIC URGENT CARE 109 N 28TH ST E SUPERIOR WI 54880 OUTPATIENT MEDICAL ST LUKE'S PULMONARY MEDICINE ASSOCIATES 920 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S RHEUMOTOLOGY ASSOCIATES 1000 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S UROLOGY ASSOCIATES 1001 E SUPERIOR ST DULUTH MN 55802 OUTPATIENT MEDICAL ST LUKE'S NEUROSURGERY ASSOCIATES 920 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S ORTHOPAEDIC & SPORTS MEDICINE 1000 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL DENFELD MEDICAL CLINIC 4702 GRAND AVE DULUTH MN 55807 OUTPATIENT MEDICAL & OCCUPATIONAL THERAPY MARINER OUTPATIENT SURGERY CENTER 109 N 28TH ST E SUPERIOR WI 54880 OUTPATIENT MEDICAL & AMBULATORY SURGERY ST LUKE'S DERMATOLOGY ASSOC 920 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S HOME CARE 220 N 6TH AVE E DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S PEDIATRIC ASSOCIATES 1000 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL LAURENTIAN MEDICAL CLINIC 8373 UNITY DRIVE VIRGINIA MN 55792 OUTPATIENT MEDICAL & PHYSICAL THERAPY MILLER CREEK MEDICAL CLINIC 4884 MILLER TRUNK HWY HERMANTOWN MN 55811 OUTPATIENT MEDICAL & PHYSICAL THERAPY ST LUKE'S PHYSICAL MEDICINE & REHAB ASS 1011 E 1ST ST DULUTH MN 55805 PHYSICAL THERAPY ST LUKE'S PLASTIC SURGERY ASSOCIATES 920 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL BAY AREA MEDICAL CLINIC 50 OUTER DRIVE SILVER BAY MN 55614 OUTPATIENT MEDICAL & PHYSICAL THERAPY ST LUKE'S ENDOCRINOLOGY ASSOCIATES 1011 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S ALLERGY & IMMUNOLOGY ASSOCIAT 920 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S ONCOLOGY & HEMATOLOGY ASSOCIA 1001 E SUPERIOR ST DULUTH MN 55802 OUTPATIENT MEDICAL ST LUKE'S OCCUPATIONAL HEALTH 4702 GRAND AVE DULUTH MN 55807 OCCUPATIONAL HEALTH ST LUKE'S INFECTIOUS DISEASE ASSOCIATES 1001 E SUPERIOR ST DULUTH MN 55802 OUTPATIENT MEDICAL ST LUKE'S SURGICAL ASSOCIATES 920 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL Q-CARE EXPRESS CLINIC 619 W CENTRAL ENTRANCE DULUTH MN 55811 OUTPATIENT MEDICAL LESTER RIVER MEDICAL CLINIC 6351 E SUPERIOR ST DULUTH MN 55804 OUTPATIENT MEDICAL ST LUKE'S ANESTHESIA ASSOCIATES 915 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S EMERGENCY SERVICES 1011 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S OBSTETRICS AND GYNECOLOGY ASSO 1000 E 1ST ST SUITE LL DULUTH MN 55802 OUTPATIENT MEDICAL ST LUKE'S HOSPICE 1011 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S HOSPITAL REHAB 1011 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL ST LUKE'S OPHTHALMOLOGY ASSOC 324 W SUPERIOR ST SUITE 800 DULUTH MN 55802 OUTPATIENT MEDICAL ST LUKE'S URGENT CARE 915 E 1ST ST DULUTH MN 55805 OUTPATIENT MEDICAL PART I, LINE 7: ST. LUKE'S USED COST-TO-CHARGE RATIOS DERIVED FROM THE MOST RECENT COMPLETED MEDICARE COST REPORT. PART I, LINE 7G: ST. LUKE'S INCLUDED SUBSIDIZED HEALTH SERVICES FROM A MENTAL HEALTH CLINIC ($1,444,902), A PEDIATRICS CLINIC ($1,532,000), AND HOMECARE/HOSPICE SERVICES ($2,168,358). PART I, LN 7 COL(F): BAD DEBT EXPENSE FOR 2013 IS $6,444,542 AS REPORTED IN PART III, LINE 2. THIS AMOUNT HAS BEEN ELIMINATED WHEN CALCULATING THE COMMUNITY BENEFIT AS A PERCENT OF TOTAL EXPENSE. BAD DEBT ACCOUNTS WILL MEET ALL OF THE FOLLOWING CRITERIA:I. ATTEMPTS HAVE BEEN MADE TO CONTACT THE PATIENT OR GUARANTOR BY MAIL AND TELEPHONE.II. PATIENT OR GUARANTOR HAS NOT RESPONDED DURING THE COLLECTION CYCLE IN A TIMELY AND RESPONSIBLE MANNER OR HAS DEFAULTED ON A PAYMENT ARRANGEMENT.III. THERE ARE NO KNOWN CIRCUMSTANCES WHICH WOULD JUSTIFY RECONSIDERATION FOR FINANCIAL ASSISTANCE.APPROVAL FOR BAD DEBT WRITE OFFS ARE AS FOLLOWS:$0 TO 2,499 -- PATIENT ACCOUNTS MANAGER OR CBO MANAGER$2,500 TO 9,999 -- BUSINESS SERVICES DIRECTOR OR CBO MANAGER$10,000 AND OVER -- CHIEF FINANCIAL OFFICER PART II, COMMUNITY BUILDING ACTIVITIES: ST. LUKE'S COMMUNITY-BUILDING ACTIVITIES INCLUDE CASH, IN-KIND DONATIONS, AND OTHER EXPENDITURES FOR THE DEVELOPMENT OF COMMUNITY HEALTH PROGRAMS AND PARTNERSHIPS. PART III, LINE 3: ST. LUKE'S HAS NO RATIONALE FOR ESTIMATING THE PORTION OF BAD DEBT THAT ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE, THEREFORE, NO AMOUNT HAS BEEN REPORTED. PART III, LINE 4: ST. LUKE'S DOES NOT INCLUDE A FOOTNOTE IN IT'S AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT.ST. LUKE'S ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS THROUGH A RECORD KEEPING SYSTEM IN THE BUSINESS SERVICES DEPARTMENT. PAYMENT FOR SERVICES IS REQUIRED UPON RECEIPT OF A BILL OR STATEMENT. ALL SELF PAY ACCOUNTS ARE ANALYZED FOR COLLECTABILITY BASED ON THE MONTHS PAST DUE AND PAYMENT HISTORY. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CALCULATED BY APPLYING HISTORICAL EXPERIENCE TO AN AGING OF THESE ACCOUNTS. ACCOUNTS THAT ARE DETERMINED TO BE UNCOLLECTIBLE ARE SENT TO A COLLECTION AGENCY AND WRITTEN OFF AT THAT TIME.THE COST OF CHARITY CARE WAS REPORTED IN PART III, LINE 3. THIS AMOUNT IS CALCULATED USING THE MEDICARE COST REPORT RATIO FOR THE HOSPITAL, MULTIPLIED BY ST. LUKE'S CHARITY CARE EXPENSE FOR FY ENDING 12/31/13. PART III, LINE 8: THE COST-TO-CHARGE RATIO WAS THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED ON THE MEDICARE COST REPORT. THE ENTIRE SHORTFALL ($42,226,816) IS INCLUDED IN THE TOTAL VALUE OF COMMUNITY CONTRIBUTIONS LISTED UNDER "OTHER COMMUNITY CONTRIBUTIONS." PART III, LINE 9B: THE GENERAL DEBT COLLECTION PROCESS BEGINS EITHER AT THE TIME OF BILLING, OR AFTER ALL IDENTIFIED INSURANCE PAYMENTS HAVE BEEN RECEIVED AND POSTED. ANY REMAINING PATIENT LIABILITY WILL BE TRANSFERRED TO THE PATIENT RESPONSIBILITY CATEGORY. ANY MONTHLY PAYMENT LESS THAN $50 A MONTH MUST BE APPROVED BY THE BUSINESS SERVICES DIRECTOR OR THE CENTRAL BILLING OFFICE (CBO) MANAGER. UNINSURED PATIENTS WILL RECEIVE A DISCOUNT ON THEIR OUTSTANDING HOSPITAL BALANCE EQUAL TO THE RATE GIVEN TO ST. LUKE'S LARGEST CONTRACTED NON-GOVERNMENTAL PAYER. THIS DISCOUNT DOES NOT APPLY TO ELECTIVE PROCEDURES OR PHYSICIAN CLINIC BALANCES. THE DISCOUNT RATE WILL BE EVALUATED ON EACH JULY 1ST BASED ON THE PAYER DISCOUNT RATES FOR THE PREVIOUS CALENDAR YEAR'S ACTIVITY. COLLECTION, LITIGATION AND OR GARNISHMENT ACTIVITIES WILL NOT BE INITIATED UNTIL THE BUSINESS SERVICES DIRECTOR, PATIENT ACCOUNTING MANAGER AND/OR CBO MANAGER VERIFIES THAT:I. THE PATIENT OR GUARANTOR OWES THE DEBTII. ALL THIRD PARTY PAYERS HAVE BEEN BILLEDIII. WHEN APPLICABLE, THE PATIENT/GUARANTOR HAS BEEN OFFERED A REASONABLE PAYMENT PLANIV. THE PATIENT/GUARANTOR HAS BEEN MADE AWARE OF THE UNINSURED PATIENT DISCOUNT OR FINANCIAL ASSISTANCE PROGRAM, HAS BEEN OFFERED AN APPLICATION AND THE OFFER OF ASSISTANCE TO COMPLETE THE APPLICATION.PATIENTS WHO DESIRE ELECTIVE INPATIENT OR OUTPATIENT SERVICES AND ARE UNINSURED OR HAVE LARGE INSURANCE DEDUCTIBLES FIRST MEET WITH A FINANCIAL COUNSELOR TO DISCUSS FINANCIAL ARRANGEMENTS PRIOR TO SERVICES BEING RENDERED. A 100% DEPOSIT IS EXPECTED FOR THE EXPECTED PATIENT LIABILITY IN ADVANCE OF SERVICES BEING RENDERED. IF THE 100% DEPOSIT CANNOT BE MET, THEN A MINIMUM DEPOSIT OF 50% OF THE EXPECTED PATIENT LIABILITY WILL BE REQUIRED AND THE PATIENT MUST SIGN A PROMISSORY NOTE FOR THE REMAINING BALANCE TO BE PAID WITHIN 30 DAYS OF SERVICES. IF NEITHER OF THESE CONDITIONS CAN BE MET, AN ELECTIVE PROCEDURE MAY BE CANCELLED UNTIL SUCH TIME AS THESE FINANCIAL CONDITIONS CAN BE MET. PART VI, LINE 2: ST. LUKE'S HAS A LONG HISTORY OF PARTICIPATING IN SUCCESSFUL, SUSTAINABLE COLLABORATIVE INITIATIVES ON LOCAL, REGIONAL AND NATIONAL LEVELS. 1) ST. LUKE'S RESEARCH DEPARTMENT, THE WHITESIDE INSTITUTE FOR CLINICAL RESEARCH, WAS FORMED IN 1996 AS THE RESULT OF A PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL, DULUTH (UMMSD), AND CONTINUES TO PROVIDE SERVICES TO ST. LUKE'S PATIENTS IN ACCESS TO LOCAL, NATIONAL AND MULTI-NATIONAL CLINICAL STUDIES AS WELL AS TO ST. LUKE'S STAFF IN DEVELOPMENT OF RESEARCH STUDIES, REFERRAL TO UM COLLABORATORS AND GRANT WRITING RESOURCES. 2) ST. LUKE'S HAS COLLABORATED WITH THE MULTI-STATE CONSORTIUM OF ABOUT 56 SUPPORTING ORGANIZATIONS INCLUDING COUNTY PUBLIC HEALTH DEPARTMENTS, HOSPITALS AND CLINICS TO FUND THE BRIDGE TO HEALTH PROJECT. THIS PROJECT COLLECTED POPULATION-BASED, HEALTH STATUS DATA ON ADULTS (AGED 18+) IN THE REGION USING A 70 QUESTION TELEPHONE SURVEY FORMAT AND WAS CONDUCTED IN 1995, 2000, 2005 AND 2010. TO ADDRESS A NEED THAT BECAME APPARENT AS A RESULT OF THE BRIDGE TO HEALTH SURVEY, THE TWIN PORTS HEALTHCARE ACCESS GROUP WAS FORMED. ST. LUKE'S JOINED WITH OTHER HEALTHCARE PROVIDERS IN THE COMMUNITY TO DEVELOP TWO PROGRAMS: SHARECARE WHICH ESTABLISHED SLIDING FEE SCALES FOR CLINIC AND OUTPATIENT SERVICES TO DIMINISH THE FINANCIAL BARRIER TO PREVENTIVE, MENTAL HEALTH AND PRIMARY CARE SERVICES; AND HEALTHSHARE WHICH IS A COVERAGE MODEL FOR SMALL BUSINESSES FUNDED COLLABORATIVELY BY THE EMPLOYERS, EMPLOYEES AND THE COMMUNITY. THIS COVERAGE MODEL PROVIDES A CONTINUUM OF HEALTH CARE SERVICES FOR EMPLOYEES WITHIN A DEFINED NETWORK OF COMMUNITY PROVIDERS. 3) ST. LUKE'S WAS A LEAD PARTICIPANT IN THE WILDERNESS COALITION PHARMACY SERVICES PROJECT FUNDED BY THE AGENCY FOR HEALTHCARE RESEARCH AND QUALITY. THIS 3-YEAR PROJECT SUCCESSFULLY IMPLEMENTED 24/7 PROFESSIONAL PHARMACY SERVICES FOR 10 RURAL HOSPITALS IN NORTHEASTERN MINNESOTA USING ST. LUKE'S 24 HOUR PHARMACY, AN ITV-BASED SYSTEM OF CONTINUING EDUCATION FOR SITES, PHARMACY POLICIES AND PROCEDURES ADAPTABLE FOR INDIVIDUAL SITES, AS WELL AS BEDSIDE VERIFICATION OF MEDICATION ADMINISTRATION AND MEDICATION BAR CODING AT SOME LOCATIONS. THOUGH PROJECT FUNDING HAS ENDED, THE SERVICES REMAIN AND THE PROGRAM IS NOW SELF-SUSTAINING. 4) ST. LUKE'S IS AN ACTIVE PARTICIPANT IN THE COMMUNITY HEALTH INFORMATION COLLABORATIVE (CHIC) WHICH RECENTLY LAUNCHED "HIE-BRIDGE", A SECURE "HEALTH INFORMATION EXCHANGE" WHICH ALLOWS HEALTH CARE PROVIDERS TO QUICKLY DETERMINE THE LOCATION OF PATIENT MEDICAL RECORDS IN THE REGION AND COMMUNICATE WITH PATIENT'S HOME FACILITY IN ORDER TO PROVIDE PROMPT QUALITY CARE. ST. LUKE'S ASSISTED CHIC IN THE TEST PHASE OF THIS PROJECT FUNDED BY THE NATIONAL LIBRARY OF MEDICINE. PART VI, LINE 3: ST. LUKE'S INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT ELIGIBILITY FOR ASSISTANCE THE FOLLOWING WAYS:- INFORMATION IS INCLUDED ON THE ST. LUKE'S WEB SITE (WWW.SLHDULUTH.COM) REGARDING WHO PATIENTS SHOULD CONTACT FOR INFORMATION OR FINANCIAL ASSISTANCE.- THERE ARE POSTINGS IN ALL REGISTRATION AREAS WITH CONTACT INFORMATION AND PHONE NUMBERS REGARDING HOW PATIENTS CAN OBTAIN ASSISTANCE (BOTH FROM ST. LUKE'S AND EXTERNAL ORGANIZATIONS). - ALL ST. LUKE'S EXTERNAL BILLING AND COLLECTION VENDORS HAVE BEEN INSTRUCTED TO REFER ANY PATIENT INDICATING THEY LACK THE FINANCIAL WHEREWITHAL TO MEET THEIR FINANCIAL OBLIGATIONS TO ST. LUKE'S FINANCIAL COUNSELORS. AS REQUIRED UNDER A BILLING AND COLLECTION AGREEMENT WITH THE MINNESOTA ATTORNEY GENERAL, ST. LUKE'S PERFORMS AN ANNUAL AUDIT OF ALL EXTERNAL VENDORS TO ENSURE COMPLIANCE WITH THIS INSTRUCTION AND ALL OTHER ST. LUKE'S POLICIES AND PROCEDURES. - ST. LUKE'S FINANCIAL COUNSELORS' BUSINESS CARDS ARE PROMINENTLY DISPLAYED AND AVAILABLE AT ALL REGISTRATION AREAS (INCLUDING THE EMERGENCY/URGENT CARE AREA) WITH THEIR CONTACT INFORMATION AND PHONE NUMBERS. PATIENTS ARE ENCOURAGED TO CONTACT FINANCIAL COUNSELORS. - THE ST. LUKE'S FINANCIAL COUNSELORS' PHONE NUMBER IS LISTED PROMINENTLY ON THE PATIENT BILLING STATEMENTS.- THE FINANCIAL COUNSELORS ARE AVAILABLE WEEKDAYS BY PHONE OR IN PERSON TO DISCUSS AND APPLY FOR FINANCIAL ASSISTANCE PROGRAMS. - ST. LUKE'S HAS ENGAGED AN EXTERNAL VENDOR TO MEET WITH PATIENTS AT BEDSIDE TO DISCUSS ELIGIBILITY FOR ASSISTANCE WITH GOVERNMENTAL ASSISTANCE PROGRAMS OR ST. LUKE'S FINANCIAL ASSISTANCE PROGRAM.- ST. LUKE'S INPATIENT BOOKLET CONTAINS INFORMATION REGARDING FINANCIAL ASSISTANCE AND CONTACT INFORMATION.- AT LEAST ANNUALLY, THE ST. LUKE'S AND MEDICAL STAFF NEWSLETTERS CONTAIN ARTICLES REGARDING PATIENT FINANCIAL ASSISTANCE. HOSPITAL AND MEDICAL STAFF MEMBERS ARE INFORMED THAT THEY HAVE THE RESPONSIBILITY TO LISTEN FOR FINANCIAL CONCERNS EXPRESSED BY PATIENTS AND TO PROACTIVELY REFER THOSE PATIENTS TO ST. LUKE'S FINANCIAL COUNSELORS. PART VI, LINE 4: COMMUNITY OR COMMUNITIES THE ORGANIZATION SERVES: ST. LUKE'S SERVICE AREA CONSISTS OF A 17-COUNTY REGION OF NORTHEASTERN MINNESOTA, NORTHWESTERN WISCONSIN AND THE WESTERN UPPER PENINSULA OF MICHIGAN WITH A POPULATION OF APPROXIMATELY 500,000. THE PRIMARY MARKET CONSISTS OF DULUTH, CLOQUET AND TWO HARBORS, MINNESOTA, AND SUPERIOR, WISCONSIN. THIS PRIMARY MARKET SERVES URBAN AND SUBURBAN AREAS WITH A POPULATION OF APPROXIMATELY 166,000.DEMOGRAPHICS OF THE COMMUNITY OR COMMUNITIES (PRIMARY MARKET):POPULATIONS: DULUTH, MN (86,265); SUPERIOR, WI (27,244)MEDIAN HOUSEHOLD INCOME: DULUTH, MN ($33,766); SUPERIOR, WI ($31,921)MEDIAN FAMILY INCOME: DULUTH, MN ($46,394); SUPERIOR, WI ($41,093)% OF FAMILIES BELOW FPG: DULUTH, MN (8.6%); SUPERIOR, WI (9.6%)% OF INDIVIDUALS BELOW FPG: DULUTH, MN (15.5%); SUPERIOR, WI (13.4%)% OF HOSPITAL MEDICAID PAYOR MIX: INPATIENT (12%), OUTPATIENT (13%)% OF HOSPITAL SELF PAY PAYOR MIX: INPATIENT (4%), OUTPATIENT (3%)NUMBER OF HOSPITALS SERVING THE COMMUNITY OR COMMUNITIES (PRIMARY MARKET):ST. LUKE'S HOSPITALLAKE VIEW HOSPITALCLOQUET COMMUNITY MEMORIAL HOSPITAL ESSENTIA HEALTH SMDC MEDICAL CENTER (FORMERLY MILLER DWAN)ESSENTIA HEALTH ST. MARY'S HOSPITAL OF SUPERIORESSENTIA HEALTH ST. MARY'S MEDICAL CENTERNUMBER OF FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS PRESENT IN THE COMMUNITY:MUA/P: DULUTH, MN (11); SUPERIOR, WI (7) PART VI, LINE 5: ST. LUKE'S HAS BUILT A REPUTATION OF PROVIDING QUALITY CARE AND PUTTING THE PATIENT FIRST. SINCE OPENING IN 1881, ST. LUKE'S HAS GROWN INTO A NATIONALLY RECOGNIZED HEALTH CARE SYSTEM SERVING 17 COUNTIES THROUGHOUT NORTHEASTERN MINNESOTA, NORTHWESTERN WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. ST. LUKE'S HOSPITAL, ALONG WITH ITS PRIMARY AND SPECIALTY CARE CLINICS, OFFERS A COMPREHENSIVE CONTINUUM OF CARE THAT INCLUDES TRAUMA, MEDICAL, SURGICAL, DIAGNOSTIC, THERAPEUTIC AND REHAB SERVICES. MORE THAN 2,000 HEALTH CARE PROFESSIONALS, INCLUDING A MEDICAL STAFF OF 365 PHYSICIANS AND OTHER MEDICAL PROVIDERS, MAKE UP ST. LUKE'S STAFF. WITH RAPID ACCESS TO ST. LUKE'S ELECTRONIC MEDICAL RECORDS, PHYSICIANS CAN MAKE INFORMED TREATMENT DECISIONS FOR THEIR PATIENTS. ST. LUKE'S 13 PRIMARY CARE CLINICS INCLUDE 10 FAMILY PRACTICE CLINICS LOCATED IN DULUTH (4), AND ACROSS MINNESOTA IN SILVER BAY, HIBBING, MOUNTAIN IRON AND HERMANTOWN, MN AS WELL AS IN ASHLAND AND SUPERIOR, WI. IN ADDITION, ST. LUKE'S DULUTH INTERNAL MEDICINE ASSOCIATES (DIMA) IS LOCATED IN DOWNTOWN DULUTH WHILE ST. LUKE'S INTERNAL MEDICINE ASSOCIATES AND ST. LUKE'S PEDIATRIC ASSOCIATES ARE LOCATED ON THE ST. LUKE'S CAMPUS. AN ADDITIONAL 23 SPECIALTY CLINICS LOCATED PRIMARILY ON THE ST. LUKE'S CAMPUS, PROVIDE EXPERTISE IN MANY AREAS OF HEALTH CARE INCLUDING CANCER CARE, CARDIAC CARE, HOME CARE AND HOSPICE, ADULT PSYCHIATRY,PLASTIC SURGERY, ALLERGY, ENDOCRINOLOGY, DERMATOLOGY, GASTROENTEROLOGY, INFECTIOUS DISEASE, PHYSICAL MEDICINE AND REHAB,UROLOGY, RHEUMATOLOGY, NEUROSURGERY AND PULMONARY MEDICINE. 1 LAKE SUPERIOR COMMUNITY HEALTH CENTER 4325 GRAND AVENUE DULUTH MN 55807 237167576 501(C)(3) 82500 TO SERVE LOW INCOME, UNINSURED CLIENTS. PROGRAM FOR AID TO VICTIMS OF SEXUAL ASSAULT 32 EAST 1ST STREET SUITE 200 DULUTH MN 55802 411350021 501(C)(3) 65000 TRAINING AND SUPPORT FOR SEXUAL ASSAULT NURSE EXAMINER PROGRAM. AMERICAN HEART ASSOCIATION 130 W SUPERIOR ST STE700 DULUTH MN 55802 135613797 501(C)(3) 8500 SUPPORT THE HEART WALK AND GO RED FOR WOMEN CAMPAIGNS AMERICAN CANCER SOCIETY 130 WEST SUPERIOR STREET DULUTH MN 55802 410724036 501(C)(3) 9500 TO SUPPORT RELAY FOR LIFE FUNDRAISER. GENERATIONS HEALTH CARE INITIATIVES INC 130 W SUPERIOR ST STE700 DULUTH MN 55802 412000473 501(C)(3) 174000 SUPPORT FOR THE UNIVERSITY OF MINNESOTA DULUTH MEDICAL SCHOOL. DULUTH SUPERIOR SYMPHONY ASSOCIATION 331 WEST SUPERIOR STREET 100 DULUTH MN 55802 410760835 501(C)(3) 7500 SUPPORT FOR DULUTH SUPERIOR SYMPHONY DULUTH AREA CHAMBER OF COMMERCE 5 WEST FIRST STREET 101 DULUTH MN 55802 410225910 501(C)(6) 11000 SPONSOR FOR 2013 DULUTH DAYS AT THE CAPITAL ARROWHEAD EMS ASSOCIATION INC 4219 ENTERPRISE CIRCLE DULUTH MN 55811 411522627 501(C)(3) 5000 SPONSOR FOR THE ARROWHEAD EMS ANNUAL CONFERENCE COLLEGE OF ST SCHOLASTICA 1200 KENWOOD AVE DULUTH MN 55811 410598301 501(C)(3) 7500 SUPPORT FOR THE ST. SCHOLASTICA HEALTH SCIENCE SCHOLARSHIP PROGRAM PART I, LINE 2: THE HOSPITAL REQUESTS THAT GRANTEES PROVIDE AN UPDATE ON THE IMPACT OF THE GRANT SIX MONTHS AFTER THE GRANT HAS BEEN MADE. IN ADDITION, THE ACCOUNTING DEPARTMENT REVIEWS INVOICES SUPPORTING THE FUNDS USED FROM THE GRANT. THE AFOREMENTIONED PROCESS HELPS ENSURE THE GRANT WAS USED FOR THE INDENDED PURPOSE. X X X X X 0 0 0 0 0 0 0 0 0 MARSHALL WATSON MD BOARD MEMBER/PHYSICIAN 823447 0 0 0 295 0 4631 0 20296 0 848669 0 0 0 ELISABETH REVOIR MD BOARD MEMBER/CHIEF OF STAFF 330126 0 0 0 441 0 3431 0 25284 0 359282 0 0 0 JOHN STRANGE PRESIDENT/CEO 605643 0 0 0 1942 0 11671 0 139095 0 758351 0 0 0 ERIC LOHN VICE PRESIDENT/CFO 143882 0 0 0 138 0 0 0 42315 0 186335 0 0 0 JOHN YOON MD PHYSICIAN 1256970 0 0 0 699 0 4631 0 25284 0 1287584 0 0 0 JOHN WATKINS MD PHYSICIAN 880741 0 0 0 294 0 4632 0 18737 0 904404 0 0 0 DAVID FOGARTY MD PHYSICIAN 799726 0 0 0 441 0 2400 0 10965 0 813532 0 0 0 DIONYSIOS KLIRONOMOS MD PHYSICIAN 798971 0 0 0 265 0 4632 0 15119 0 818987 0 0 0 MARY BOYLEN MD PHYSICIAN 797015 0 0 0 1265 0 6264 0 25284 0 829828 0 0 0 A DULUTH ECONOMIC DEVELOPMENT AUTHORITY 416005105 26444CGT3 2012-10-10 83148022 REFINANCE SERIES 2002 BONDS: PURCHASE EQUIPMENT; FUND HOSPITAL ADDITION 0 0 0 A 164768099 83148022 5983801 1039149 1625011 33335774 42203756 1 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 0 0 0 0 A 0 BRUCE JESSEN FAMILY MEMBER OF BOARD MEMBER 115564 COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE CHAIRPERSON OF THE BOARD AS THE PRESIDING OFFICER, ALL OTHER OFFICERS OF THE HOSPITAL WHO ARE DIRECTORS, AND SUCH ADDITIONAL DIRECTORS AS THE CHAIRPERSON MAY APPOINT. WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL, INCLUDING THE AUTHORITY TO REVIEW THE COMPENSATION PAID TO THE HOSPITAL'S EMPLOYED PHYSICIANS, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD OR BY STATUTE, AND SHALL MEET AS NECESSARY. IN ADDITION, THE EXECUTIVE COMMITTEE SHALL OVERSEE THE HOSPITAL'S PUBLIC RELATIONS ACTIVITIES AND KEEP THE CORPORATION'S HEALTH CARE EFFORTS CONTINUALLY BEFORE THE COMMUNITIES SERVED THROUGH THE USE OF PUBLICATIONS AND OTHER COMMUNICATIONS DESCRIBING THE HOSPITAL'S SERVICES, PROGRAMS, AND NEEDS. FORM 990, PART VI, SECTION A, LINE 6 ST. LUKE'S HOSPITAL SHALL HAVE THREE CLASSES OF MEMBERSHIPS: A) PAST MEMBERS OF ST. LUKE'S HOSPITAL OF DULUTH - THE INDIVIDUALS AND ORGANIZATIONS LISTED ON THE HOSPITAL'S OFFICIAL ROSTER OF MEMBERS AS OF MAY 20, 2004 SHALL BE MEMBERS AND HAVE THE NUMBER OF VOTES AS IDENTIFIED ON THAT LIST. B) MEMBERS OF THE ST. LUKE'S HOSPITAL OF DULUTH - ANY INDIVIDUAL OR ORGANIZATION THAT, SUBSEQUENT TO MAY 20, 2004, CONTRIBUTES $100 OR MORE TO THE HOSPITAL SHALL, UPON REQUEST FROM SUCH INDIVIDUAL OR ORGANIZATION AND APPROVAL BY THE BOARD OF DIRECTORS, BE A MEMBER OF THE ORGANIZATION WITH ONE VOTE. C) EX OFFICIO MEMBERS - EACH DIRECTOR AND THE PRESIDENT/CEO OF THE HOSPITAL SHALL BE A VOTING MEMBER OF THE HOSPITAL DURING HIS OR HER TERM IN SUCH OFFICE AND SHALL HAVE ONE VOTE. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING RIGHTS OF THE MEMBERS OF THE CORPORATION SHALL BE LIMITED TO THE FOLLOWING MATTERS: A) APPROVAL OF ANY TRANSACTION THAT WOULD CULMINATE IN THE TRANSFER OF CONTROL OF HOSPITAL OPERATIONS TO A SECRETARIAN OR RELIGIOUS ORGANIZATION. B) APPROVAL OF ANY TRANSACTIONS WHICH WOULD CULMINATE IN THE TRANSFER OF CONTORL OF THE HOSPITAL'S OPERATIONS TO A FOR-PROFIT ENTITY. C) APPROVAL OF THE DISSOLUTION OF THE HOSPITAL OR THE CESSATION OF THE HOSPITAL OPERATIONS. THE FOREGOING ACTIONS SHALL BE APPROVED AND ADOPTED ONLY AFTER AUTHORIZATION BY THE BOARD OF DIRECTORS AND APPROVAL BY THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT REFERENCED MULTIPLE SOURCES OF INFORMATION IN ORDER TO ACCURATELY PREPARE THE 2013 FORM 990. THESE SOURCES INCLUDE THE INTERNAL REVENUE SERVICE WEBSITE, LEGAL COUNSEL, HEALTHCARE TRADE ASSOCIATIONS, AND OTHER VARIOUS PUBLICATIONS. ONCE THE FORM 990 WAS PREPARED, IT WAS REVIEWED BY THE FOLLOWING GROUPS: 1. ST. LUKE'S SENIOR MANAGEMENT (OCTOBER 2014) 2. ST. LUKE'S BOARD OF DIRECTORS (OCTOBER 2014) 3. ST. LUKE'S FINANCE COMMITTEE (OCTOBER 2014) ALL OF THE ABOVE GROUPS WERE PROVIDED WITH A COMPLETE COPY OF THE 2013 FORM 990. IN OCTOBER 2014, THE CHIEF FINANCIAL OFFICER MADE A PRESENTATION TO THE BOARD REGARDING THE FORM 990 AND THEIR RESPONSIBILITIES. IN THE CASE OF THE FINANCE COMMITTEE AND BOARD OF DIRECTORS, THE FORM 990 REVIEW WAS LISTED AS AN AGENDA ITEM AT THEIR RESPECTIVE MEETINGS. THE CFO OF ST. LUKE'S PROVIDED AN OVERVIEW OF THE RETURN AND ANSWERED ANY QUESTIONS OR CONCERNS FROM THE BOARD/COMMITTEE MEMBERS. ANY SUGGESTED CHANGES TO THE FORM 990 WERE EVALUATED, WITH LEGAL COUNSEL IF NECESSARY, AND INCORPORATED INTO THE RETURN AS APPROPRIATE. THE RETURN WAS THEN FILED ON OR BEFORE NOVEMBER 15, 2014. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER AND COMMITTEE MEMBER SHALL SIGN, AS A CONDITION TO SERVING THE CORPORATION IN HIS/HER RESPECTIVE ROLE AND ANNUALLY THEREAFTER, A STATEMENT AGREEING TO BE BOUND BY THE TERMS OF THE POLICY. PURSUANT TO THE POLICY, ANY DIRECTOR, OFFICER OR COMMITTEE MEMBER HAVING A FINANCIAL INTEREST IN A CONTRACT OR OTHER TRANSACTION PRESENTED TO THE BOARD OF DIRECTORS OR A COMMITTEE THEREOF FOR AUTHORIZATION, APPROVAL, OR RATIFICATION SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE OF SUCH PERSON'S INTEREST TO THE BOARD OR COMMITTEE PRIOR TO ITS ACTING ON SUCH CONTRACT OR TRANSACTION. SUCH DISCLOSURE SHALL INCLUDE ANY RELEVANT AND MATERIAL FACTS, KNOWN TO SUCH PERSON, ABOUT THE CONTRACT OR TRANSACTION WHICH MIGHT REASONABLY BE CONSTRUED TO BE ADVERSE TO THE CORPORATION'S INTEREST. THE BOARD OR COMMITTEE TO WHICH SUCH DISCLOSURE IS MADE SHALL THEREUPON DETERMINE, BY MAJORITY VOTE, WHETHER THE DISCLOSURE SHOWS THAT A CONFLICT OF INTEREST EXISTS OR CAN REASONABLY BE CONSTRUED TO EXIST. IF A CONFLICT IS DEEMED TO EXIST, SUCH PERSON SHALL NOT VOTE ON, NOR USE PERSONAL INFLUENCE ON, OR PARTICIPATE (OTHER THAN TO PERSENT FACTUAL INFORMATION TO OR RESPOND TO QUESTIONS) IN THE DISCUSSIONS AND DELIBERATIONS WITH RESPECT TO SUCH CONTRACT OR TRANSACTIONS. SUCH PERSON MAY BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM AT ANY MEETING WHERE THE CONTRACT OR TRANSACTION IS UNDER DISCUSSION OR IS BEING VOTED UPON. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE MADE, THE VOTE AND, WHERE APPLICABLE, THE ABSTENTION FROM VOTING AND PARTICIPATION, AND WHETHER A QUORUM WAS PRESENT. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION AT ST. LUKE'S HOSPITAL IS GOVERNED AND CONTROLLED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, ACCORDING TO POLICIES SET BY THE BOARD AS A WHOLE. THE COMMITTEE IS MADE UP ENTIRELY OF COMMUNITY LEADERS, NONE OF WHOM ARE EMPLOYED BY ST. LUKE'S HOSPITAL. THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION PROGRAM FOR THE CEO, CFO AND OTHER EXECUTIVES AND PRESENTS THE SUMMARY OF ITS ANALYSIS TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL. CONTEMPORANEOUS DOCUMENTS AND RECORDKEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS ARE MAINTAINED BY THE CEO AND HUMAN RESOURCES DEPARTMENT. THE COMMITTEE, WITH THE AID OF AN INDEPENDENT CONSULTANT, HAS ESTABLISHED A COMPENSATION PHILOSOPHY FOR THE ORGANIZATION. THIS PHILOSOPHY DEFINES A PEER GROUP OF ORGANIZATIONS ACROSS THE COUNTRY AND INCLUDES ORGANIZATIONS OF SIMILAR SIZE, SCOPE, AND MANAGEMENT CHALLENGE. IT ALSO ESTABLISHES THE COMPETITIVE LEVEL AT WHICH THE COMMITTEE WANTS TO COMPENSATE ST. LUKE'S HOSPITAL EXECUTIVES COMPARED TO THE PEER GROUP ORGANIZATIONS. THE COMMITTEE REVIEWS COMPARABILITY DATA ON SALARY LEVELS, INCENTIVE PAY, AND BENEFIT COSTS, ASSESSING EACH ELEMENT OF COMPENSATION INDEPENDENTLY AND TOTAL COMPENSATION IN AGGREGATE. THE COMMITTEE RETAINS INDEPENDENT CONSULTANTS TO GATHER COMPARABILITY DATA ON EXECUTIVE COMPENSATION IN SLH'S PEER GROUP. THESE CONSULTANTS ASSIST THE COMMITTEE IN MAKING ITS DETERMINATION THAT EXECUTIVE COMPENSATION AT SLH REMAINS REASONABLE AND CONSISTENT WITH SLH'S BOARD-APPROVED EXECUTIVE COMPENSATION PHILOSOPHY. THE COMMITTEE REVIEWS THE COMPENSATION PROGRAM FOR THE CEO, CFO AND OTHER EXECUTIVES OF THE ORGANIZATION IN DEPTH EVERY FEW YEARS AND THE LAST FULL REVIEW OCCURRED IN 2009. IN THE YEARS BETWEEN COMPREHENSIVE REVIEWS, THE COMMITTEE RELIES ON UPDATES TO THE PEER GROUP DATA BASED ON THE YEAR-TO-YEAR MARKET MOVEMENT IN THE INDUSTRY, AS PROVIDED BY THE INDEPENDENT CONSULTANT. THE COMMITTEE DILIGENTLY FOLLOWS BEST PRACTICES IN GOVERNING EXECUTIVE COMPENSATION, INCLUDING THE PROCESS PRESCRIBED BY THE IRS FOR GOVERNING EXECUTIVE COMPENSATION IN THE TAX-EXEMPT SECTOR. IT IS COMMITTED TO ACCURATELY DISCLOSING EXECUTIVE COMPENSATION ON FORM 990 FORM 990, PART VI, SECTION C, LINE 19 ST. LUKE'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND UPDATED ANNUALLY BY THE BOARD OF DIRECTORS. THEY ARE NOT AVAILABLE TO THE GENERAL PUBLIC. FINANCIAL INFORMATION IS MADE AVAILABLE THROUGH ST. LUKE'S ANNUAL REPORT (PUBLISHED EVERY YEAR AND AVAILABLE ON ST. LUKE'S WEBSITE AT WWW.SLHDULUTH.COM) AND THE FORM 990 IS MADE AVAILABLE TO THE PUBLIC IN ACCORDANCE WITH THE INTERNAL REVENUE SERVICE GUIDANCE. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY 24,339,626. CAPITAL REIMBURSEMENT FROM ST. LUKE'S FOUNDATION 223,137. CONTRIBUTION TO SLH VOLUNTEER SERVICE GUILD -5,000. ST LUKE'S FOUNDATION 1000 EAST FIRST STREET NO 102 DULUTH MN 55805 411448118 FUNDRAISING SUPPORT FOR HEALTH CARE/HOSPITAL MN 501(C)(3) LINE 11A, I ST LUKE'S HOSPITAL OF DULUTH 1 LAKE VIEW MEMORIAL HOSPITAL INC 325 11TH AVENUE TWO HARBORS MN 55616 410786046 HEALTH CARE/HOSPITAL MN 501(C)(3) LINE 3 ST LUKE'S HOSPITAL OF DULUTH 1 LAKE VIEW MEMORIAL HOSPITAL FOUNDATION OF NORTHEAST MINNESOTA 325 11TH AVENUE TWO HARBORS MN 55616 411700972 FUNDRAISING SUPPORT FOR LAKE VIEW MEMORIAL HOSPITAL MN 501(C)(3) LINE 7 N/A 0 CRITICAL CARE SERVICES INC DBA LIFELINK III 3010 BROADWAY STREET NE MINNEAPOLIS MN 554131768 411518013 HEALTH CARE EMERGENCY TRANSPORTATION MN 501(C)(3) LINE 11C, III-FI N/A 0 0 1 1 1 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0 ST LUKE'S FOUNDATION C 636057 FAIR MARKET VALUE ST LUKE'S FOUNDATION L 260451 FAIR MARKET VALUE LAKE VIEW MEMORIAL HOSPITAL INC L 1394678 FAIR MARKET VALUE LAKE VIEW MEMORIAL HOSPITAL INC D 4311097 FAIR MARKET VALUE