2011-08-10T14:18:22-05:00 2010-09-30 Deloitte Tax LLP 50 Fremont Street San Francisco CA 941052230 990 2009-10-01 820161600 St Luke's Regional Medical Center STLU 2083811106 190 E Bannock Boise ID 83712 Peter DiDio 2083811251 2011-08-10 4157834000 2009 2016-02-24 21:20:13Z Gary L Fletcher 190 E Bannock Boise ID 83712 725801006 0 X www.stlukesonline.org X 1906 ID HEALTH CARE SERVICES 19 12 6621 752 1470747 -283087 4026538 3173619 623981972 710752565 9816090 7463029 400848 598138 638225448 721987351 3123808 3404966 0 306664350 350828443 0 0 289552232 326155155 599340390 680388564 38885058 41598787 1049293177 1107452302 682658244 716538701 366634933 390913601 Provide Health Care Services 0 0 392353023 1928153 350460109 Medical & Surgical:St. Luke's Regional Medical Center is comprised of two hospital campuses(Boise and Meridian), one urgent care center(Eagle), and physicians offices throughout the Treasure Valley. The hospitals provide 24-hour emergency care, diagnostic procedures, a variety of inpatient and outpatient care, 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 gold standard for nursing care. In addition, St. Luke's has the only Children's hospital in the state of Idaho.During FY'10, the hospital provided qualified inpatient care for 29,837 admissions, covering 87,459 patient days. In addition, the hospital provided patient care associated with 577,919 outpatient visits. 82611274 272000 49438660 Physician Services:St. Luke's is a physician integrated organization, with over 200 providers serving across a variety of areas, including Family Medicine, Internal Medicine, various Pediatric specialties, surgery, Neurology, Orthopedics, Urology, and Heart & Vascular (see 4c-Heart & Vascular)During FY'10 St. Luke's physician practices had 340,373 patient visits. 41467082 573226 104189222 Heart & Vascular: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 defibulators (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 14-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 cathertization and nuclear cardiology. Also included in the practice are special clinics designed to manage irregular heart(arrhythmias)pacemakers and defibrillators, blood thinning medications, congestive heart failure,and lipids.During FY'10 SLICA had 34,372 visits. 31717323 241951 43976845 Emergency & Transport 28447379 228172 41472385 Children's Hospital 19934097 161463 29347500 Women's Services 11417910 0 82970664 Imaging 2382898 0 2559168 Management Services 1207579 0 1600098 Other Services 4831979 0 3954114 Joint Ventures 99939165 631586 205880774 616370544 1 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 1 585 0 6621 0 0 0 0 0 0 0 0 0 0 19 12 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X St Luke's Health System Ltd 2083811106 190 E Bannock Boise ID 83712 Ms Barbara L Wilson 5.00 X 0 0 0 Mr J Patrick McMurray 4.00 X 0 0 0 Mr Michael M Mooney 4.00 X 0 0 0 Mr Jim Everett 4.00 X 0 0 0 Mr A J Balukoff 4.00 X 0 0 0 Mr Rich Raimondi 4.00 X 0 0 0 Mr Charles H Wilson 3.00 X 0 0 0 Mr Jan B Packwood 3.00 X 0 0 0 Thomas J Coffman MD 3.00 X 44000 0 0 Thomas R HuntingtonMD 3.00 X 11500 0 0 Mr George Iliff 3.00 X 0 0 0 Mr John Jackson 3.00 X 0 0 0 Ms Carolyn Terteling- 3.00 X 0 0 0 Ms Cathy R Silek 3.00 X 0 0 0 Ms Gay Simplot 3.00 X 0 0 0 Bishop Brian Thom 3.00 X 0 0 0 Mr Herb Patriarche 3.00 X 0 0 0 Alan Swajkoski MD 3.00 X 30000 0 0 Mr Gary L Fletcher 40.00 X X 899965 0 233002 Mr Jeffrey S Taylor 40.00 X 328735 0 87181 Ms Rebecca A Call 40.00 X 58712 0 8678 Mr Christopher W Roth 40.00 X 292409 0 60094 Ms Pamela H Bernard 40.00 X 218670 0 40299 Barton F Hill MD 40.00 X 254472 0 48923 Ms Joanne T Clavelle 40.00 X 216633 0 54182 William A Jones MD 40.00 X 951993 0 42676 Karl P Undesser MD 40.00 X 754748 0 88146 Adrian J Curnow MD 40.00 X 851857 0 46925 Murali N Bathina MD 40.00 X 823491 0 70449 Larry A Tansey MD 40.00 X 816910 0 38847 6554095 0 819402 201 0 1 0 Emergency Medicine Of Idaho 13960 W Wainwright Suite A Boise ID 83713 Emergency Room Physicians 14810210 McDermottWill& Emery 227 West Monroe Street Chicago IL 606065096 Legal Services 1054658 Hummel Architects PLLC 2785 Bogus Basin Road Boise ID 83702 Architectural Services 944447 Idaho Pulmonary Associates 2347 E Gala St Meridian ID 836424881 Medical Services 752886 Fulbright & Jaworski LLP 8000 Maryland Ave St 1190 St Louis MO 63105 Legal Services 686305 37 1406974 1766645 3173619 Net Patient Revenue 900099 688452001 688452001 Joint Venture Income 900099 3678623 3678623 Outpatient Retail Rx 446110 3517846 2734046 783800 VHA Coop Cash Distrib. 900099 1885282 1885282 13218813 13218813 710752565 166191 166191 7278791 7278791 3524769 3692358 -167589 -167589 -167589 139344 121297 18047 18047 18047 LAUNDRY 812300 686947 686947 EMPLOYEE PARKING REV 900099 78780 78780 765727 721987351 709968765 1470747 7374220 3404966 3404966 2601842 2601842 278220175 243910047 34310128 20654683 17969574 2685109 31923543 27773482 4150061 17428200 15162534 2265666 26804382 25811359 993023 3313603 3313603 6194 6194 120363 120363 588869 588869 1153347 1065237 88110 2507673 223191 2284482 6700465 5624003 1076462 9133367 9133367 7749185 6358318 1390867 1451173 1087089 364084 10573806 10573806 43717765 43717765 3102776 3033447 69329 Supplies 128510905 126278516 2232389 Contract Services 31791754 26254234 5537520 Provision for Bad Debt 24883999 24883999 Repairs 9518049 9504752 13297 Patient Transport 3034984 3034984 11492496 7536845 3955651 680388564 616370544 64018020 0 43467861 55726155 123311754 68329468 58983107 76142574 490727 490727 19876273 18764627 3127694 2922679 714096282 333015465 423896040 381080817 299129666 272097314 5917691 7722458 14968863 15918970 12429537 46594161 43693964 161662352 1049293177 1107452302 81633919 98747430 4925357 4493167 492214220 485832054 1390116 372515 102494632 127093535 682658244 716538701 X 366290694 390630409 344239 283192 366634933 390913601 1049293177 1107452302 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 120363 120363 120363 120363 680268201 775809865 680388564 775930228 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 154142 149583 168264 120363 592352 250000 250000 250000 250000 1000000 1500000 23504852 22091190 45596042 16549616 408621790 154931030 270240376 2871519 2871519 216659360 178084435 38574925 23797955 23797955 381080817 Def. Bond Finance Costs 8271246 Retention Bonus 715417 Physician Loans 1705970 Escrow Deposits 205000 Executive Flex Plan 806029 Due From Related Organizations 149958690 161662352 Third Party Settlement 53292129 Benefit Plan Liabilities 62252374 Accrued Interest Payable-Bonds 4289938 Professional Liability 7259094 127093535 1 1 X 1 X 400.000000000000 1 X 1 1 1 0 1 1 15152698 15152698 0.02310 71706020 69338750 2367270 0.00360 6524800 5566229 958571 0.00150 93383518 74904979 18478539 0.02820 15475195 15475195 0.02360 7663703 530492 7133211 0.01090 11285092 11285092 0.01720 1707124 1707124 0.00260 1707576 1707576 0.00260 37838690 530492 37308198 0.05690 131222208 75435471 55786737 0.08510 0 12234543 0 101103681 124958694 -23855013 X 1 1 Heart and Vascular ManatgementLLC Consulting Services on Heart & Vascular service lines. 0.51000 SLRMCMMC Oncology ServicesLLC Oncology Services 0.50000 Idaho GynOncology Services Gynecology/Oncology Services 0.50000 Idaho Cytogenetics LaboratoryLLC Genetic Testing 0.50000 St Luke's-Elk's Rehabilitation ServicesLLC Physical/Speech/Occupational Therapy Services 0.50000 Wound Care and Hyperbaric Treatment CenterLLC Wound Care Services 0.50000 St Luke's Family HealthLLC Family Medicine Clinic 0.50000 Southwest Idaho Community NetworkLLC Group Purchasing-Drugs 0.60670 SL Phys Realty-LouiseLLC Medical Office Building 0.86680 1500 ShorelineLLC Administrative Office Building 0.54730 3399 East Louise MOBLLC Medical Office Building 0.69840 Ortho Neuro ManagementLLC Consulting Services on Ortho Neuro service lines. 0.58180 ICHNLLC Group Purchasing-Code Correct Claims Denial Management Software 0.25000 St Luke's Regional Medical Center

190 E Bannock Boise ID 83712

X X X X St Luke's Meridian Medical Center

520 S Eagle Road Meridian ID 83642

X X X St Luke's Eagle Urgent Care

3101 E State St Eagle ID 83616

Urgent Care Part I, Line 3c: (A) St. Luke's may 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 will be considered only if the patient, driver, and/or owner of the motor vehicle had a motor vehicle liability policy and has properly submitted a claim for payment 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 7f: 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. Amount of bad debt expense included in Form 990, Part IX, line 25 is $24,883,999. Part III, Line 4: 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: 100% of the shortfall in medicare reimbursement is considered a community benefit.The source of the information is the Medicare Cost Report for fiscal year 2010. 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 V: St. Luke's Regional Medical Center, Ltd. is a physician integrated organization with over 200 physicians serving across a variety of areas, including family medicine,internal medicine,various pediatric specialties, surgery,neurology,orthopedics,urology,heart & vascular, occupational health, endocrinology, OB/GYN, and pulmonology. The financial results of these practices are included in various calculated results throughout Schedule H. Part VI, Line 2: St. Luke's/MSTI determines community needs in three primary ways.First, we conduct a bi-annual community survey covering the organization's primary services area of Ada and Canyon counties. The survey is randomly administered by a professional research company via telephone to heads of households. Sample sizes provide a margin of error of approximately +/-5%. In 2010, we added Gem, Payette, and Washington counties to the sample. Survey results are used as a development tool for our strategic planning process and to provide community perception,awareness, and anecdotal information about health needs in this community. The timing of the survey is significant as we reflect on our mission as the cornerstone of the organization and the strategies that will address the identified needs to support that mission. We also garner information from our constituents at various other times through focused surveys(written,telephone, or focus group) to address a specific organizational need related to community or hospital services. Secondarily, we analyze data provided through such agencies as Ada Planning Association(COMPASS), United Way, Kids Count, BLue Cross of Idaho, and the State of Idaho. These organizations report various socio-economic facts or identify key needs, which help to further develop the picture of health challenges and opportunities across our service area. Finally, we create forums from different walks of life to dialogue about the health needs of the community and the opportunties to address those needs. These individuals range from the volunteers that provide an ongoing source of ambassadorship between St. Luke's and the community we serve, to the members of affiliated services(i.e., Humphreys Diabetes Center and the Family Medicine Residency of Idaho), to the leadership of affiliated medical facilities(i.e. McCall,Mountain Home,Gooding,Challis,Wood River, Stanley, and Weiser) and community support organizations(i.e. Healthy Community Access Program, The United Way, Central District Health Department, and Terry Reilly Health Services), to our formal and informal board leadership(Children's Advisory Board, Medical Center Board of Directors, Women's Forum, and Strategic Initiatives Committee), to our own staff who participate in a variety of health-related volunteer roles. 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 languages: 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 which St. Luke's independently determines patient eligibility for patient care, 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 primary service area includes Idaho's Ada County, 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. Part VI, Line 5: Part VI, Line 6: 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 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, all hospital locations within the St. Luke's Health System maintain an open medical staff. Any physician can apply for practicing privilieges as long as they meet St. Luke's criteria. Part VI, Line 7: As the only Idaho-based not-for-profit 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 the people in our region." Working together, we share resources, skills, and knowledge to provide the best possible care, no matter which of our hospitals you choose. 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 Physician Clinics --St. Luke's Eagle Urgent Care(2) St. Luke's Wood River Medical Center,which consists of a critical access hospital located in the Wood River Valley, 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 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.(4) Mountain States Tumor Institute(MSTI) is the region's largest provider of cancer services and a nationally recognized leader in cancer research. We provide advanced care to thousands of cancer patients each year at clinics in Boise,Fruitland,Meridian,Nampa, and Twin Falls,Idaho. We are 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, WOC Nursing. MSTI is expanding as rapidly as today's cancer treatment. Patients can now visit a MSTI or Breast Cancer detection center at 12 different locations in southwest Idaho and Eastern Oregon. Locations include Boise,Meridian, Nampa, Twin Falls, and Fruitland. In addition, St. Luke's partners with other regional facilities through management service contracts. These partners include:(1) Challis Area Health Center(2) Elmore Medical Center(3) McCall Memorial Hospital(4) North Canyon Medical Center(5) Salmon River Clinic(5) Weiser Memorial Hospital ID 1 Boise State University 1910 University Drive Boise ID 83725 826010706 501(c)(3) 133989 Multi-year commitment for nursing building and funds for nursing scholarships St Luke's Health Foundation Ltd 190 E Bannock Boise ID 83712 810600973 501(c)(3) 1043366 Cover operational needs for the foundation. Family Medicine Residency of Idaho 777 N Raymond St Boise ID 83712 205934739 501(c)(3) 1671566 Funds used to support the family residency program in Idaho YMCA 1050 W State St Boise ID 83702 820200908 501(c)(3) 50700 Fund YMCA community programs Chamber Of Commerce-Boise Metro PO Box 2368 Boise ID 83701 820100595 501(c)(6) 36654 General sponsorship opportunities Nampa Harvest Festival Association PO Box 231 Boise ID 83653 820148165 501(c)(3) 12500 Funds will be used to help put on the Tough Enough for Pink program. Leukemia & Lymphoma Society PlushlandInc 701 E Third Suite 380 Los Angeles CA 90013 135644916 501(c)(3) 12500 Funds will be used to support finding a cure for blood cancer. Women's and Children's Alliance 720 West Washington Boise ID 83702 820204464 501(c)(3) 12100 Funds will be used to support programs of WCA, which provide safe shelter, education, opportunity and hope to women and children victimized by domestic and/or sexual violence Idaho Stampede Community Foundation Inc PO Box 6525 Boise ID 83707 470881811 501(c)(3) 7500 Funds will sponsor the Idaho Stampede basketball team during the 08-09 NBA season. Epilepsy Foundation Of Idaho 310 W Idaho Street Boise ID 83702 237160426 501(c)(3) 6250 Funds will be used to provide a summer camp for kids between ages 7-17 who have a seizure disorder or epilepsy. Genesis World Mission Inc 215 West 35TH Street Garden City ID 83714 820505074 501(c)(3) 5000 Funds will be used to help underwrite the costs of the Garden City Community Clinic & Volunteer Physicians Network. Learning Lab Inc 715 S Capital 403 Boise ID 83702 820461933 501(c)(3) 5750 Funds will be used for the Lab's Families Health Month to teach families to improve their health and well being through increased health literacy and knowledge of nutrition and exercise. Ronald McDonald House Charities Of Idaho Inc Golf Tournament C/O Cactus Petes Inc PO Box 508 Jackpot Nevada 89825 Jackpot NV 89825 943030996 501(c)(3) 5000 Funds will be used to "Share a Night" and offset the $10 nightly donations that families pay at the house. Terry Reilly Health Services PO Box 9 Nampa ID 83653 820300537 501(c)(3) 5000 Funds will be used to provide specialized out-patient counseling services to low-income and indigent victims of child abuse and their families through the Terry Reilly Health Services SANE SOLUTIONS program. American Cancer Society 2676 Vista Ave Boise ID 83705 841316555 501(c)(3) 15000 Funds will be utilized to support Relay for Life and Making Strides Against Breast Cancer events in the Treasure Valley, Wood River and Magic Valley. Caringbridgeorg 1715 Yankee Doodle Rd 301 Eagan MN 55121 421529394 501(c)(3) 5000 Provides free websites that connect people experiencing a significant health challenge to family and friends. Boise Public Schools Foundation 8169 W Victory Rd Boise ID 83709 820400689 501(c)(3) 5000 Raise funds for innovative and motivating programs that enrich and add to the education of Boise School Dist students. Downtown Boise Association 720 W Idaho St Boise ID 83702 820417200 501(c)(3) 5000 Assist with the operation and promotion of downtown Boise as a clean, safe and vibrant place in which to work, shop, live and play. Family Advocacy Center & Education Services (FACES) 417 S 6th St Boise ID 83702 204883532 501(c)(3) 17500 Funds will be used to fund children advocate programs. Health Education & Leadership Program (HELP) 400 Lake Lowell Ave Nampa ID 83686 760720963 501(c)(3) 5000 Provide scholarships for students desire to enter the health care profession. Humphreys Diabetes Center Inc 1226 W River St Boise ID 83702 820491110 501(c)(3) 7500 Provides diabetes prevention and self-mgmt education and research opportunities for those at risk for diabetes. Idaho Elks Rehab Hospital 600 N Robbins Rd Ste 101 Boise ID 83701 820302317 501(c)(3) 6000 Provides state of the art rehabilitation services to the physically challenged throughout Idaho & neighboring states. The Idaho Foodbank PO Box 5601 Boise ID 83705 820425400 501(c)(3) 12174 Funds to help distribute free emergency food to individuals and families in need. Idaho Voices for Children PO Box 8882 Boise ID 83707 820478703 501(c)(3) 5500 Develop and promote a state-level unified policy agenda that targets child health, education, safety, and family economic security. March of Dimes 3222 W Overland Rd Boise ID 83705 131846366 501(c)(3) 10000 To improve health of babies by preventing birth defects, premature birth and infant mortality. Susan G Komen Race for the Cure 6901 E Emerald Suite 209 Boise ID 83704 752462834 501(c)(3) 35000 Provide funds for quality care for breast cancer patients and energizing science to discover and deliver cures for breast cancer. United Way 2340 S Vista Ave Boise ID 83705 820299013 501(c)(3) 6070 Mobilize the caring power of the community to improve lives. 26 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The organization endeavors to monitor its grants to ensure that such grants are used for proper purposes and not otherwise diverted from their intended use. This is accomplished by requesting recipient organizations to affirm that funds must be used solely in accordance with the grant request and budget on which the grant was based and that funds not expended for the stated purpose are to be returned to the organization. Reports are requested from time to time as deemed appropriate. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 Mr Gary L Fletcher 420075 0 0 0 479890 0 222072 0 10930 0 1132967 0 104915 0 Mr Jeffrey S Taylor 285556 0 1040 0 42139 0 77546 0 9635 0 415916 0 13069 0 Mr Christopher W Roth 259845 0 0 0 32564 0 45853 0 14241 0 352503 0 15519 0 Ms Pamela H Bernard 171719 0 807 0 46144 0 34277 0 6022 0 258969 0 4629 0 Barton F Hill MD 214910 0 0 0 39562 0 30210 0 18713 0 303395 0 5693 0 Ms Joanne T Clavelle 202154 0 0 0 14479 0 37831 0 16351 0 270815 0 0 0 William A Jones MD 900637 0 9233 0 42123 0 27892 0 14784 0 994669 0 0 0 Karl P Undesser MD 538263 0 176684 0 39801 0 66993 0 21153 0 842894 0 0 0 Adrian J Curnow MD 625441 0 190115 0 36301 0 27892 0 19033 0 898782 0 0 0 Murali N Bathina MD 540298 0 249324 0 33869 0 60638 0 9811 0 893940 0 0 0 Larry A Tansey MD 767227 0 0 0 49683 0 27892 0 10955 0 855757 0 0 0 Part I, Line 1a St. Luke's has agreed to directly or indirectly pay all taxes caused by the vesting of accruals of the adjusted benefit prior to termination of employment. The payment shall be made in a manner which results in the executive having no personal outlay for taxes resulting from or related to the adjusted benefit for any associated taxes. Part I, Line 4b: SERP Award SERP Gross-up Total Gary L. Fletcher $196,558 $142,335 $338,893 Idaho Health Facilities Authority 826051863 451295TW9 2008-12-04 126435101 Capital Projects for Health Care Facilities 0 0 Idaho Health Facilities Authority 826051863 451295TX7 2009-03-04 150000000 Capital Projects for Health Care Facilities 0 0 Idaho Health Facilities Authority 826051863 451295VK2 2010-09-09 210427891 Current Refunding of Prior Issues 0 0 126435101 12945309 1410198 112389945 2008 0 0 1 1 150484918 43534081 1266320 105684517 0 0 0 1 210427891 1 0 1 1 0 0 1 1 0 0.00000 0.00000 0.00000 1 0 0 1 1 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 S-Sixteen Limited Partnership Board Member is parent of four members of S-Sixteen 2699541 St. Lukes Regional Medical Center leases property from S-Sixteen. 0 Delta DentalInc Common Board Member 210993 Delta Dental is a third party administrator of the employee dental plan for St. Luke's Health System and its related organizations. 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 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 of Member Expectations. This authority to remove Directors shall not be used merely becuase there is a difference in business judgment between the Director and the Corporation or the Member, and shall never be used to remove one or more Directors from the Corporation's Board of Directors in order to change a decision made by the Corporation's Board of Directors; (c) Employment and termination of the Chief Executive Officer of the Corporation; (d) Appointment of the auditor for the Corporation and the coordination of the Corporation's annual audit; (e) Sales,lease,exchange,mortgage,pledge,creation of a security interest in or other disposition of real or personal property of the Corporation if such property has a fair market value in excess of a limit set from time to time by the Member and that is not otherwise contained in an Approved Budget; (f) Sale,merger,consolidation,change of membership,sale of all or substantially all of the assets of the corporation, or closure of any facility operated by the Corporation; (g) The dissolution of the Corporation; (h) Incurrence of debt by or for the Corporation in accordance with requirements established from time to time by the Member and that is not otherwise contained in an Approved Budget; and (i) Authority to establish policies to promote and develop an integrated, cohesive health care delivery system across all corporations for which the Member serves as the corporate member. Form 990, Part VI, Section B, line 11 The Form 990 is prepared by an independent public accounting firm based on audited financial statements and with the assistance of the organization's finance and accounting staff. The final draft of the 990 is reviewed by the Chief Financial Officer and the Finance Committee of the Board of Directors. The Board receives the final version of the Form 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 exits, the affected parties must excuse themselves from participating in the situation. 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. Similar analysis is also completed for physicians and other health care specialties such as nurses and pharmacists. These surveys are usually done every two years, with the most recent compensation survey completed during calendar year 2008. 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 To ensure physician compensation and benefits remain within industry standards and legal requirements for not-for-profit institutions, St. Luke's 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 Form 990, Part VI, Section C, Line 19: Because St. Luke's Regional Medical Center, Ltd. is a private corporation, it does not make its governing documents,conflict of interest policy,or financial statements available to the public. Schedule K Supplental Information Part I: Bond Issues: Bond Number 1: Proceeds from the sale of the 2008A Bonds will be used (1) to finance,refinance, or reimburse St. Luke's Health System, Ltd. for a portion of the costs of the acquisition,construction,renovation,improvement, remodeling, and equipping of health care facilities owned and operated by the operating group. (2) Fund a bond reserve in an amount equal to the bond reserve requirement, and (3) to pay certain costs of issuance of the bonds. Bond Number 2: Proceeds for the sale of the 2009AB Bonds will be used (1) to finance,refinance,or reimburse St. Luke's Health System, Ltd. for a portion of the costs of the acquisition,construction, renovation, improvement, and equipping of health care facilities owned and operated by members of the Obligated Group, and (2) to pay certain costs for the issuance of the bonds. Part III. Line 3c. Bond counsel is engaged to review management and service contracts when we are planning and working on a new bond issuance. St Luke's Health SystemLtd 190 E Bannock Boise ID 83712 562570681 Health Care Services ID 501(c)(3) 11-3 N/A Mountain States Tumor Institute 100 E Idaho Boise ID 83712 820295026 Health Care Services ID 501(c)(3) 3 N/A St Luke's Wood River Medical CenterLtd 100 Hospital Drive Ketchum ID 83340 841421665 Health Care Services ID 501(c)(3) 3 N/A St Luke's Health FoundationLtd 190 E Bannock Boise ID 83712 810600973 Solicit Donations ID 501(c)(3) 7 N/A St Luke's Magic Valley Regional Medical CenterLtd 650 Addison Avenue West Twin Falls ID 83301 562570686 Health Care Services ID 501(c)(3) 3 N/A Humphreys Diabetes CenterInc 1226 River Street Boise ID 83702 820491110 Diabetes Prev.-Self-Mgmt. ID 501(c)(3) 9 N/A SL Phys Realty-LouiseLLC 190 E Bannock Boise ID 83712 263731325 Real Estate Lease ID N/A Related 648319 766972 1 1 1500 ShorelineLLC 190 E Bannock Boise ID 83712 270681501 Real Estate Lease ID N/A Related 105209 812508 1 1 3399 East Louise MOBLLC 190 E Bannock Boise ID 83712 270848198 Real Estate Lease ID N/A Related 138654 1033965 1 1 Ortho-Neuro ManagementLLC 190 E Bannock Boise ID 83712 264483076 Mgmt. Consulting ID N/A Related -207252 1781248 0 1 Heart and Vascular ManagementLLC 190 E Bannock Boise ID 83712 262486481 Mgmt. Consulting ID N/A Related 839297 449143 0 1 SLRMCMMC Oncology ServicesLLC 190 E Bannock Boise ID 83712 262430000 Health Care ID N/A Related 477119 4449247 0 1 Idaho GynOncology ServiceLLC 1055 N Curtis Rd Boise ID 83706 202975807 Health Care ID N/A Related -109881 51467 0 1 Idaho Cytogenetics LaboratoryLLC 190 E Bannock Boise ID 83712 331012210 Health Care ID N/A Related -11540 -6381 0 1 St Luke's-Elk's Rehabilitation ServiceLLC 204 Fort Place PO BOX 1100 Boise ID 83701 820503100 Health Care ID N/A Related 341317 3155538 0 1 Wound Care and Hyperbaric Treatment Center 600 N Robbins Road Boise ID 83702 900288299 Health Care ID N/A Related 743386 4319747 0 1 St Luke's Family HealthLLC 190 E Bannock Boise ID 83712 820497633 Health Care ID N/A Related -188666 489713 0 1 Southwest Idaho Community NetworkLLC PO Box 607 Boise ID 837010607 820506533 Group Purchasing-Drugs ID N/A Related -2136 1020 0 1 Select Medical NetworkInc PO Box 1576 Boise ID 83701 810594024 Provider Network ID N/A C 0.50000 0 1 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 St Luke's Health FoundationLtd B 1043366 St Luke's Health FoundationLtd C 1369474 St Luke's Health SystemLtd O 61971267 Heart and Vascular ManagementLLC O 3720210 Ortho Neuro O 2520000 SL Phys Realty-LouiseLLC J 1748291 1500 ShorelineLLC J 1097481 3399 East LouiseMOB-LLC J 1602060 St Luke's Health SystemLtd N 31926628 Mountain States Tumor Institute N 34987644 St Luke's Wood River Medical CenterLtd N 23998021 St Luke's Health FoundationLtd N 627311 St Luke's Magic Valley Regional Medical CenterLtd Q 81439030 Humphreys Diabetes CenterInc O 201533