2012-11-15T12:02:05-06:00 2011-12-31 990 2011-01-01 431933950 SAINT LUKES CANCER INSTITUTE SAIN 8169322000 4321 WASHINGTON NO 5100 KANSAS CITY MO 64111 AMY NACHTIGAL 8169322000 2012-11-15 2011 2016-02-24 21:20:13Z JULIE QUIRIN 4321 WASHINGTON NO 5100 KANSAS CITY MO 64111 23204119 0 X WWW.SAINTLUKESHEALTHSYSTEM.ORG X LLC 2001 MO CANCER TREATMENT 8 4 132 7 0 0 409285 482764 21333421 22604034 104554 117321 0 0 21847260 23204119 17173 13750 0 0 13503519 14441471 0 0 0 10951940 7438274 24472632 21893495 -2625372 1310624 6691726 7453833 22518968 21386515 -15827242 -13932682 X SAINT LUKE'S CANCER INSTITUTE IS COMITTED TO THE HIGHEST LEVELS OF EXCELLENCE IN PROVIDING HEALTH SERVICES TO ALL PATIENTS IN A CARING ENVIRONMENT. WE ARE DEDICATED TO CANCER PATIENTS. AS A MEMBER OF THE SAINT LUKE'S HEALTH SYSTEM WE ARE COMMITTED TO ENHANCING THE PHYSICAL, MENTAL AND SPIRITUAL HEALTH OF THE COMMUNITIES WE SERVE. 0 0 19178614 13750 22604034 SAINT LUKES CANCER INSTITUTE (SLCI) IS A 9 BED SPECIALTY HOSPITAL AND ONE OF THE LARGEST NON-PROFIT PROVIDERS IN THE REGION DEDICATED TO PROVIDING COMPREHENSIVE CANCER SERVICES THAT INCLUDE PREVENTION, EARLY DETECTION, DIAGNOSIS, TREATMENT, RESEARCH, EDUCATION AND SUPPORTIVE CARE. IN 2011 THERE WERE 880 PATIENT DAYS AND 23,574 OUTPATIENT VISITS. THE HOSPITAL PARTICIPATES IN THE MEDICAID AND MEDICARE PROGRAMS AND HAS CHARITY CARE POLICIES FOR ASSISTING PEOPLE WITHOUT ADEQUATE MEANS TO PAY FOR THEIR CARECURRENTLY, SAINT LUKES CANCER INSTITUTE OFFERS INPATIENT ONCOLOGY CARE WITH AN EMPHASIS ON THE CARE OF GYNECOLOGIC ONCOLOGY AND LEUKEMIA/LYMPHOMA PATIENTS; OUTPATIENT INFUSION SERVICES THAT INCLUDE: CHEMOTHERAPY, PHOTOPHERSIS, THERAPEUTIC PLASMA EXCHANGE, AND BLOOD MANAGEMENT; RADIATION THERAPY; SPECIALIZED HIGH DOSE RADIATION THERAPY; PROSTATE BRACHYTHERAPY; LARGEST GYNECOLOGIC ONCOLOGY PROGRAM IN THE REGION; MEDICAL ONCOLOGY PROGRAM WITH PHYSICIANS SPECIALIZING IN BREAST, COLON AND LUNG CANCERS; CELL PROCESSING LAB; CORD BLOOD PROGRAM ASSOCIATED WITH THE NMDP AND CARDINAL GLENNON; GENETIC COUNSELING; PET SCANNING; CANCER SCREENING; COMPREHENSIVE BREAST CENTER; BEHAVIORAL HEALTH SPECIALIST OFFERING SUPPORT TO PATIENTS AND FAMILIES AT NO COST; COMMUNITY OUTREACH AND EDUCATION.WE PROVIDE THE ONLY MOBILE MAMMOGRAPHY PROGRAM IN THE KANSAS CITY AREA, PROVIDING SCREENING MAMMOGRAMS TO UNINSURED AND UNDERINSURED WOMEN IN THE KANSAS CITY METROPOLITAN AREA. SLCI ALSO INVESTS IN THE FUTURE OF HEALTH CARE THROUGH RESEARCH ACTIVITIES. 19178614 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 1 132 1 0 0 0 0 0 0 0 0 0 0 X 8 4 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION CO ST LUKES HOSPITAL OF KANSAS CITY 8169322000 4401 WORNALL ROAD KANSAS CITY MO 64111 X JULIE QUIRIN 5.00 X X 0 537220 86793 JEFFREY WIEMAN MD 40.00 X X 165653 0 22232 THOMAS L BROWN 2.00 X 0 0 0 GAYDEN CARRUTH PHD 2.00 X 0 0 0 CHARLIE NEWELL 2.00 X 0 0 0 THOMAS L WAGSTAFF 2.00 X 0 0 0 ALI SHWAIKI MD 2.00 X 327456 0 30808 THOMAS WILLARD 2.00 X 0 0 0 AMY NACHTIGAL 5.00 X 0 266929 41223 JAMA JOHNSON 5.00 X 0 173860 2919 KARIN MCCRARY 40.00 X 0 124889 28726 DEBBIE WHITE 5.00 X 0 253534 32707 ROBERT BELT 40.00 X 602377 0 14669 LOWELL BYERS 40.00 X 595145 0 42314 MICHELLE DUDZINSKI 40.00 X 600662 0 35229 MUHAMMAD RIAZ 40.00 X 594141 0 28575 BRENDA SHOUP 40.00 X 593821 0 34164 3479255 1356432 400359 23 0 1 0 VARIAN MEDICAL SYSTEMS INC 70140 NETWORK PLACE CHICAGO IL 606731701 SERVICE AGREEMENT 461212 HUMAN ARC PO BOX 951886 CLEVELAND OH 44193 UNINSURED ELIGIBILITY 138057 PER SE TECHNOLOGIES PO BOX 403421 ATLANTA GA 303843421 BILLING SERVICES 104574 SIEMENS MEDICAL SOLUTIONS USA INC PO BOX 120001 DEPT 0733 DALLAS TX 753120733 SERVICE AGREEMENT 103000 SIEMENS MEDICAL SOLUTIONS DEPT CH 14195 PALENTINE IL 600554195 SERVICE AGREEMENT 101856 5 17508 465256 482764 NET PATIENT REVENUE 622110 21741305 21741305 OTHER PROGRAM REVENUE 622110 472749 472749 PET SCAN SERVICES 622110 389980 389980 22604034 117321 117321 23204119 22604034 0 117321 13750 13750 546148 546148 12074531 11693620 380911 364682 337894 26788 880157 815505 64652 575953 533646 42307 -302468 -302468 13575 13575 1902522 1551214 351308 2921 2921 225810 213846 11964 64531 60908 3623 845082 743672 101410 25243 18713 6530 69950 65966 3984 613408 539799 73609 1113832 980172 133660 444498 367811 76687 SHARED SERVICES - SLHS 1688000 556559 1131441 MEDICAL SUPPLIES 818294 818294 0 BAD DEBTS -179126 -179126 92202 43450 48752 21893495 19178614 2714881 0 1189366 594583 2180732 3135915 40444 57005 268694 536863 14596926 11957054 2438886 2639872 15975 14580 184025 172421 373604 302594 6691726 7453833 1644948 1634176 20874020 19752339 22518968 21386515 X -15827242 -13932682 -15827242 -13932682 6691726 7453833 X 1310624 583936 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 490 0 0 0 490 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: LINE 1(F): PORTION OF DUES PAID TO VARIOUS HOSPITAL AND MEDICAL ASSOCIATIONS USED TOWARD LOBBYING ACTIVITIES. 291250 291250 2559118 2239156 319962 11294037 9047861 2246176 743771 670037 73734 2639872 OTHER LIABILITIES 187000 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 3972042 PAYABLES TO AFFILIATES 332121 NOTES PAYABLE TO SLH, 501C3 AFFILIATE 15261176 19752339 PART XI, XII, AND XIII - THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN THE CONSOLIDATED AUDIT OF SAINT LUKE'S HEALTH SYSTEM. 1 1 X 1 X 1 X 1 1 1 0 0 388051 388051 0.01760 3717544 5671017 -1953473 0.00000 4105595 5671017 -1565422 144319 144319 0.00650 490394 490394 0.02220 15516 250 15266 0.00070 650229 250 649979 0.02940 4755824 5671267 -915443 0 -179126 2832530 4835243 -2002713 X 1 1 1 1 SAINT LUKES CANCER INSTITUTE

4401 WORNALL ROAD KANSAS CITY MO 64111

X X X SAINT LUKES CANCER INSTITUTE 1 1 1 200.000000000000 1 400.000000000000 1 X X X 1 1 X X X 1 0 1 X 0 0 2 SLCI PHYSICIAN CLINICS

4320 WORNALL ROAD KANSAS CITY MO 64111

PHYSICIAN CLINIC DIAGNOSTIC BREAST CARE CENTER

4321 WASHINGTON KANSAS CITY MO 64111

DIAGNOSTIC BREAST CARE CENTER PART I, L7 COL(F): OUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) WAS $21,893,495. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $(179,126). THIS LEFT US WITH A TOTAL EXPENSE OF $22,072,621 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). PART III, LINE 4: BAD DEBT EXPENSE IS REPORTED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT IT ALIGNS WITH GAAP.FINANCIAL STATEMENT FOOTNOTE REGARDING BAD DEBT EXPENSE: THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE (INCLUDING COPAYMENT AND DEDUCTIBLE AMOUNTS FROM PATIENTS), THE SYSTEM ANALYZED CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN PERFORMED. THESE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS AND ARE ADJUSTED AS NEEDED IN FUTURE PERIODS. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WHEY THEY ARE DEEMED UNCOLLECTIBLE.BAD DEBT IS RECORDED CONSISTENT WITH FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO DIRECTLY FROM THE MEDICARE COST REPORT. SHORTFALLS ARISE FROM PAYMENTS THAT ARE LESS THAN WHAT IT COSTS TO PROVIDE THE CARE AND SERVICES. WE ACCEPT ALL MEDICARE PATIENTS KNOWING THE COST OF PROVIDING THE CARE MAY EXCEED THE FUNDS WE RECEIVE FROM MEDICARE FOR THE SERVICE. OUR SHORTFALL IS CONSIDERED TO BE COMMUNITY BENEFIT. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. ADDITIONALLY, IT IS IMPLIED IN INTERNAL REVENUE SERVICE REVENUE RULING 69-545 THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT HOSPITALS, INDICATES THAT PARTICIPATION IN PUBLICLY-FINANCED PROGRAMS, SUCH AS MEDICARE, IS EVIDENCE THAT A HOSPITAL MEETS THE COMMUNITY BENEFIT STANDARD. PART III, LINE 9B: IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE THE ACCOUNT IS ADJUSTED ACCORDINGLY. ANY REMAINING BALANCE WOULD BE COLLECTED UNDER THE DEBT COLLECTION POLICY. OUR COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. ALTHOUGH WE ARE NOT LEGALLY BOUND BY THE FAIR DEBT COLLECTION PRACTICES ACT, THE PRINCIPLES ADDRESSED ARE GENERALLY FOLLOWED. SAINT LUKES CANCER INSTITUTE PART V, SECTION B, LINE 13G: THE HOSPITAL FOLLOWS THE SAINT LUKE'S HEALTH SYSTEM POLICIES FOR FINANCIAL ASSISTANCE. THE HOSPITAL PROVIDES EDUCATION ON FINANCIAL ASSISTANCE ELIGIBILITY TO PATIENTS AND PERSONS WHO MAY BE BILLED FOR SERVICES THROUGH MANY SOURCES INCLUDING THE SLHS WEB SITE, INFORMATION ON BILLING STATEMENTS NOTIFYING PATIENTS THAT THE HOSPITAL HAS FINANCIAL ASSISTANCE FOR WHICH THEY MAY QUALIFY, INFORMATION UPON CHECK-IN LOCATED IN THE ADMITTING PATIENT PACKETS, ON OUR B-131 RELEASE TO TREAT FORMS SIGNED BY ALL PATIENTS REQUESTING SERVICES, VISITS WITH INPATIENTS BY SOCIAL WORKER TEAMS, AND FOLLOW-UP CALLS TO PATIENTS AFTER DISCHARGE. FINANCIAL ASSISTANCE APPLICATIONS OR MEDICAID APPLICATIONS ARE REQUESTED ON ALL UNINSURED INPATIENTS PRIOR TO DISCHARGE. THE HOSPITAL ALSO CONTRACTS WITH ELIGIBILITY ENROLLMENT COMPANIES TO SCREEN ALL UNINSURED PATIENTS WITH A BALANCE OVER $2,000, ANY PATIENTS IDENTIFIED BY OUR SOCIAL WORKER TEAMS, AND ALL PATIENTS THAT REQUEST ASSISTANCE IN APPLYING FOR MEDICAID OR OTHER GOVERNMENT COVERAGE. PART VI, LINE 2: THE HOSPITAL ASSESSES COMMUNITY NEEDS ON AN ANNUAL BASIS IN NUMEROUS WAYS, INCLUDING THROUGH ITS COMPREHENSIVE, DATA DRIVEN, ANNUAL STRATEGIC PLANNING PROCESS. THE HOSPITAL OBTAINS HIDI MARKET DATA AND OTHER OUTPATIENT MARKET DATA THROUGH ITS ANNUAL ENVIRONMENTAL ASSESSMENT PROCESS. WITH THIS DATA, THE HOSPITAL IDENTIFIES SERVICES RECEIVED BY THE RESIDENTS OF OUR COMMUNITY (DEFINED BY OUR PRIMARY AND SECONDARY SERVICE AREAS). ANY PREDOMINANT SERVICES NOT CURRENTLY OFFERED BY THE HOSPITAL ARE CONSIDERED AT THIS TIME.ANOTHER ELEMENT OF THE COMMUNITY NEEDS ASSESSMENT INVOLVES ANNUALLY UPDATING ITS MEDICAL STAFF DEVELOPMENT PLAN TO ENSURE APPROPRIATE MEDICAL STAFF LEVELS IN A VARIETY OF MEDICAL SPECIALTIES AND SUBSPECIALTIES TO SERVE THE PATIENTS IN OUR COMMUNITY. PART VI, LINE 3: SEE RESPONSE TO PART V, LINE 13G. PART VI, LINE 4: THE HOSPITAL IS LOCATED IN THE URBAN CORE OF KANSAS CITY AND PROVIDES PATIENT CARE SERVICES TO THE METROPOLITAN KANSAS CITY AREA. PART VI, LINE 5: THE BOARD OF DIRECTORS IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS, ALMOST ALL OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THEY ARE INVOLVED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS, IN FUNDRAISING, AND IN GENERAL STEWARDSHIP.MEDICAL STAFF PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.THE HOSPITAL USES RESOURCES TO MAINTAIN AND TO EXPAND ACCESS POINTS OF CARE FOR PATIENTS THROUGHOUT THE COMMUNITY INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING: 1) MOBILE BREAST IMAGING PROGRAM, 2) PARTICIPATION IN THE SUSAN KOMEN FOUNDATION FOR BREAST CANCER, 3) PARTICIPATION IN THE METROCARE PROGRAM OF THE METROPOLITAN MEDICAL SOCIETY, WHICH OFFERS FREE CARE FOR ELECTIVE PROCEDURES FOR THE UNINSURED COMMUNITY. PART VI, LINE 6: THE HOSPITAL IS AFFILIATED WITH SAINT LUKE'S HEALTH SYSTEM, WHICH CONSISTS OF 11 AREA HOSPITALS AND SEVERAL PRIMARY AND SPECIALTY CARE PRACTICES, AND PROVIDES A RANGE OF INPATIENT, OUTPATIENT, AND HOME CARE SERVICES. FOUNDED AS A FAITH-BASED, NOT-FOR-PROFIT ORGANIZATION, OUR MISSION INCLUDES A COMMITMENT TO THE HIGHEST LEVELS OF EXCELLENCE IN HEALTH CARE AND THE ADVANCEMENT OF MEDICAL RESEARCH AND EDUCATION. THE HEALTH SYSTEM IS AN ALIGNED ORGANIZATION IN WHICH THE PHYSICIANS AND HOSPITALS ASSUME RESPONSIBILITY FOR ENHANCING THE PHYSICAL, MENTAL, AND SPIRITUAL HEALTH OF PEOPLE IN THE METROPOLITAN KANSAS CITY AREA AND THE SURROUNDING REGION. 1 SUSAN G KOMEN RACE FOR THE CURE 1111 MAIN STREET KANSAS CITY MO 64105 751835298 501C3 13500 SPONSORSHIP 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANTS ARE PROVIDED TO QUALIFIED 501(C)(3) CHARITIES. ALL DONEE INFORMATION IS KEPT AS PART OF THE ORGANIZATION'S BOOKS AND RECORDS. 0 1 0 0 0 0 0 0 0 JULIE QUIRIN 0 352328 0 126746 0 58146 0 76610 0 10183 0 624013 0 45983 JEFFREY WIEMAN MD 96346 0 50 0 69257 0 7599 0 14633 0 187885 0 68807 0 ALI SHWAIKI MD 295152 0 30675 0 1629 0 11025 0 19783 0 358264 0 0 0 AMY NACHTIGAL 0 215835 0 33134 0 17960 0 39475 0 1748 0 308152 0 16406 JAMA JOHNSON 0 22147 0 72700 0 79013 0 0 0 2919 0 176779 0 12632 KARIN MCCRARY 0 123441 0 50 0 1398 0 9625 0 19101 0 153615 0 0 DEBBIE WHITE 0 205962 0 42580 0 4992 0 18375 0 14332 0 286241 0 0 ROBERT BELT 596029 0 50 0 6298 0 4900 0 9769 0 617046 0 0 0 LOWELL BYERS 591552 0 50 0 3543 0 18375 0 23939 0 637459 0 0 0 MICHELLE DUDZINSKI 595846 0 50 0 4766 0 19600 0 15629 0 635891 0 0 0 MUHAMMAD RIAZ 561286 0 20050 0 12805 0 9800 0 18775 0 622716 0 0 0 BRENDA SHOUP 592352 0 50 0 1419 0 11025 0 23139 0 627985 0 0 0 PART I, LINE 4B 457(F) PLAN PARTICIPANTS AND AMOUNT INCLUDED IN COLUMN C FOR THE PLAN: JULIE QUIRIN - $13,127 SUPPLEMENTAL INFORMATION PART III PART II: REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS FOR JAMA JOHNSON, AMY NACHTIGAL, JULIE QUIRIN, DEBBIE WHITE, AND KARIN MCCRARY IS COMPENSATION FOR SERVICES RENDERED TO THE FILING AND RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 2 JULIE QUIRIN, AMY NACHTIGAL, DEBBIE WHITE, AND THOMAS BROWN HAVE A BUSINESS RELATIONSHIP BECAUSE THEY ARE DIRECTORS, OFFICERS, AND/OR EMPLOYEES OF THE SAME AFFILIATED TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 AS PART OF AN INTEGRATED HEALTH SYSTEM, THE ORGANIZATION ROUTINELY DELEGATED VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO RELATED ENTITIES. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER IS SAINT LUKE'S HEALTH SYSTEM, A 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNING BODY IS ELECTED BY THE SOLE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS SPECIFIED RESERVE POWERS OVER MAJOR DECISIONS SUCH AS AMENDMENTS TO ARTICLES AND BYLAWS, DEBT, BUDGETS, CAPITAL EXPENDITURES AND STRATEGIC OPERATING DECISIONS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PREPARED JOINTLY BY ACCOUNTING STAFF FOR THE ENTITY AND SAINT LUKE'S HEALTH SYSTEM (SYSTEM) TAX STAFF. THE RETURN IS REVIEWED BY THE ENTITY'S CFO BEFORE FILING. THE 990 DRAFT WAS ALSO PRESENTED TO THE AUDIT COMMITTEE OF THE SYSTEM BOARD OF DIRECTORS FOR REVIEW. THE 990 WAS MADE AVAILABLE TO THE ORGANIZATION'S BOARD MEMBERS BEFORE FILING WITH THE IRS FORM 990, PART VI, SECTION B, LINE 12C SAINT LUKE'S HEALTH SYSTEM AND ITS AFFILIATES, INCLUDING THE FILING ORGANIZATION, HAVE COMPREHENSIVE WRITTEN CONFLICT OF INTEREST POLICIES APPLICABLE TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES. ANY ACTUAL, POSSIBLE OR PERCEIVED CONFLICT OF INTEREST IS EXPECTED TO BE HANDLED THROUGH FULL AND TIMELY DISCLOSURE OF ANY SUCH INTEREST, TOGETHER WITH ABSENCE OF PERSUASION IN ANY DISCUSSION AND IN ANY VOTE WHEREIN THE INTEREST IS INVOLVED. DISCLOSURE IS TO BE MADE WHEN THE INTEREST ARISES, AT ANY TIME THE INTEREST BECOMES A MATTER OF GOVERNING BOARD ACTION, AND THEN ANNUALLY THROUGH COMPLETION OF A CONFLICT OF INTEREST QUESTIONNAIRE. THE SYSTEM COMPLIANCE OFFICER OR THE SYSTEM VICE PRESIDENT OF HUMAN RESOURCES REVIEWS COMPLETED QUESTIONNAIRES AND FURTHER INVESTIGATES POSSIBLE CONFLICTS OF INTEREST. A REPORT IS PROVIDED TO THE AUDIT COMMITTEE OF THE SYSTEM BOARD OF DIRECTORS AND ANY IDENTIFIED CONFLICT OF INTEREST IS REPORTED TO THE APPLICABLE ENTITY. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, THE SAINT LUKE'S HEALTH SYSTEM BOARD OF DIRECTORS' COMPENSATION COMMITTEE REVIEWS, DISCUSSES, SETS AND APPROVES COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT EXECUTIVE AND OFFICERS. INDEPENDENT, EXTERNAL DIRECTORS SERVE ON THE COMPENSATION COMMITTEE. AN INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY PROVIDES A WRITTEN REPORT AND REASONABLENESS OPINION. THE CONSULTANT REVIEWS THE SYSTEM'S EXECUTIVE TOTAL COMPENSATION PHILOSOPHY AND ANALYZES MARKET COMPETITIVENESS (IN TOTAL AND BY EACH COMPENSATION ELEMENT) FOR THE EXECUTIVES USING APPROPRIATE COMPARABILITY DATA. COMPENSATION COMMITTEE ACTIONS ARE CONTEMPORANEOUSLY DOCUMENTED. THE PROCESS SATISFIES THE REBUTTABLE PRESUMPTION PROCEDURE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT PUBLICLY AVAILABLE. FORM 990, PART VII, BOX E REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS FOR JULIE QUIRIN, AMY NACHTIGAL, AND DEBBIE WHITE IS FOR THE ENTIRE CALENDAR YEAR AND IS FOR COMPENSATION FOR SERVICES RENDERED TO THE FILING AND RELATED ORGANIZATIONS. THESE INDIVIDUALS WORKED 40 HOURS OR MORE PER WEEK FOR ALL RELATED ORGANIZATIONS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PENSION OBLIGATION TRANSFER TO SLHS -74,412. RISK RETENTION GROUP SUBSCRIBER SAVINGS ACCOUNT DIVIDEND -117,179. TRANSFER ASSETS FROM SLH 775,527. TOTAL TO FORM 990, PART XI, LINE 5: 583,936. NUMBER REPORTED IN BOX 3 OF FORM 1096 FORM 990, PART V, LINE 1A SAINT LUKE'S CANCER INSTITUTE (SLCI) IS PART OF SAINT LUKE'S HEALTH SYSTEM, AN INTEGRATED HEALTH SYSTEM. THE MAJORITY OF SLCI'S VENDORS ARE PAID THROUGH A CENTRALIZED PAYMENT SYSTEM WITH 1099S ISSUED BY THE CENTRALIZED SERVICE ENTITY. INVESTMENT INCOME FORM 990, PART VIII, LINE 3 INVESTMENT INCOME INCLUDES $117,179 OF SUBSCRIBER SAVINGS ACCOUNT ALLOCATION FROM RELATED RISK RETENTION GROUP. SLCI PHYSICIAN SERVICES LLC 4401 WORNALL ROAD KANSAS CITY MO 64111 261960133 PHYSICIAN SERVICES - BILLING MO N/A SAINT LUKES HEALTH SYSTEM INC 10920 ELM AVE KANSAS CITY MO 64134 431747502 HEALTH SYSTEM KS 501(C)(3) 509(A)(3) - TYPE 1 ST LUKES HOSPITAL OF KANSAS CITY 0 ST LUKES HOSPITAL OF KANSAS CITY 4401 WORNALL ROAD KANSAS CITY MO 64111 440545297 HEALTH CARE MO 501(C)(3) 170B1AIII 0 SAINT LUKE'S NORTHLAND HOSPITAL CORPORATION 601 SOUTH 169 HIGHWAY SMITHVILLE MO 64089 440565393 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKE'S SOUTH HOSPITAL INC 12300 METCALF AVENUE OVERLAND PARK KS 66213 481203262 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKE'S EAST HOSPITAL 100 NE SAINT LUKES BLVD LEES SUMMIT MO 64086 562488077 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKE'S MEDICAL GROUP 6750 ANTIOCH SUITE 210 SHAWNEE MISSION KS 66204 431598353 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 CRITTENTON 10918 ELM AVE KANSAS CITY MO 64134 440545808 HEALTH CARE MO 501(C)(3) 170B1AIII ST LUKES HOSPITAL OF KANSAS CITY 0 SAINT LUKE'S HEALTH SYSTEM HOME CARE AND HOSPICE 3100 BROADWAY SUITE 1000 KANSAS CITY MO 64111 431127200 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 ST LUKE'S OF TRENTON 191 IOWA BLVD TRENTON MO 64683 431707306 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKE'S HOSPITAL OF GARNETT 421 SOUTH MAPLE GARNETT KS 66032 742849611 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 CABOT WESTSIDE HEALTH CENTER 2121 SUMMIT KANSAS CITY MO 64108 440546280 HEALTH CARE MO 501(C)(3) 170B1AVI SAINT LUKES HEALTH SYSTEM 0 MIDWEST EAR INSTITUTE INC 4200 PENNSYLVANIA SUITE 100 KANSAS CITY MO 64111 480905027 HEALTH CARE KS 501(C)(3) 170B1AIII ST LUKES HOSPITAL OF KANSAS CITY 0 SAINT LUKE'S HOSPITAL OF CHILLICOTHE 100 CENTRAL STREET CHILLICOTHE MO 64601 431735565 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 CUSHING MEMORIAL HOSPITAL CORPORATION 711 MARSHALL LEAVENWORTH KS 66048 480543792 HEALTH CARE KS 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKE'S CARE 10920 ELM AVE KANSAS CITY MO 64134 260185090 HEALTH CARE MO 501(C)(3) 509(A)(3) - TYPE 1 SAINT LUKES HEALTH SYSTEM 0 MEDICAL PLAZA IMAGING ASSOCIATES LLC 4401 WORNALL ROAD KANSAS CITY MO 64111 431609584 HEALTH CARE MO 501(C)(3) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SAINT LUKE'S COLLEGE OF HEALTH SCIENCES 8320 WARD PARKWAY SUITE 300 KANSAS CITY MO 64114 272716128 POST SECONDARY NURSING EDUCATION MO 501(C)(3) 170B1AII ST LUKES HOSPITAL OF KANSAS CITY 0 SLCC INC 4330 WORNALL ROAD SUITE 2000 KANSAS CITY MO 64111 271994652 HEALTH CARE KS APPLYING FOR 501 (C) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 SLNC INC 4401 WORNALL ROAD KANSAS CITY MO 64111 451470888 HEALTH CARE KS APPLYING FOR 501 (C) 170B1AIII SAINT LUKES HEALTH SYSTEM 0 MEDICAL PLAZA PARTNERS LP 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431357824 OWN & OPERATE MEDICAL OFFICE BUILDINGS MO N/A MEDICAL PARK ASSOCIATES A LP 601 SOUTH 169 HIGHWAY SMITHVILLE MO 64089 431311049 OWN & OPERATE MEDICAL OFFICE BUILDINGS MO N/A ST LUKE'S SURGICENTER-LEE'S SUMMIT LLC 11221 ROE AVE SUITE 230 OVERLAND PARK KS 66211 470853481 HEALTHCARE MO N/A SAINT LUKE'S SOUTH SURGERY CENTER LLC 11221 ROE AVE SUITE 230 OVERLAND PARK KS 66211 201721929 HEALTHCARE KS N/A FAMILY ADVOCATES LLC 10918 ELM AVENUE KANSAS CITY MO 64134 202739036 FOSTER CARE MO N/A SAINT LUKE'S CARDIOLOGY SERVICES LLC 10920 ELM AVENUE KANSAS CITY MO 64134 263726426 HEALTHCARE MO N/A SAINT LUKE'S-GI DIAGNOSTICS LLC 4321 WASHINGTON SUITE 5700 KANSAS CITY MO 64111 274142549 HEALTHCARE MO N/A SAINT LUKE'S HEALTH SYSTEM RISK RETENTION GROUP 10920 ELM AVENUE KANSAS CITY MO 64134 371471890 INSURANCE SC N/A C ST LUKE'S HEALTH VENTURES INC 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431278476 ACCOUNTING MO N/A C MEDICAL PLAZA MANAGEMENT INC 4320 WORNALL ROAD SUITE 410 KANSAS CITY MO 64111 431352317 MEDICAL OFFICE BUILDING MANAGEMENT MO N/A C VENTURE FINANCIAL SERVICES INC 9500 E 63RD ST STE 202 RAYTOWN MO 64133 431605740 COLLECTIONS MO N/A C SPELMAN DEVELOPMENT CORPORATION 601 S 169 HIGHWAY SMITHVILLE MO 64089 431296007 MEDICAL OFFICE BUILDING RENTALS MO N/A C 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 0 1 1 TRANSACTIONS WITH RELATED ORGANIZATIONS SCHEDULE R, PART V, ITEM 1 SAINT LUKE'S HEALTH SYSTEM (SYSTEM) AND ITS AFFILIATED ENTITIES OPERATE AS A HIGHLY INTEGRATED HEALTH CARE DELIVERY SYSTEM. THE SYSTEM MANAGES AND OPERATES RELATED HOSPITALS AND THEIR AFFILIATES AS A COMMON MISSION ORIENTED HEALTH CARE SYSTEM IN ORDER TO BETTER SERVE THE HEALTH-RELATED NEEDS OF GREATER KANSAS CITY AND SURROUNDING AREAS. AS A RESULT, THERE ARE NUMEROUS INTERCOMPANY INTERACTIONS INCLUDING CENTRALIZED SUPPORT SERVICES AND SHARING OF RESOURCES AND COSTS.